Evaluation of the Effect of Different Irrigation Activation Methods During Endodontic Retreatment

August 18, 2026 updated by: Magdy Mohy Eldeen, Minia University

Evaluation of the Effect of Different Irrigation Activation Methods During Endodontic Retreatment on Postoperative Pain and Periapical Healing in Single-Rooted Teeth: A Randomized Controlled Clinical Trial

The persistent and secondary intraradicular infections are the primary causes of post-treatment disease following endodontic treatment of any tooth. When conventional root canal treatment fails, endodontic retreatment is often the preferred option, as it represents one of the most conservative approaches.

Endodontic retreatment involves removing old root canal filling material followed by cleaning, shaping, and refilling the canals. It may be associated with postoperative pain due to periapical tissue irritation and apical extrusion of debris during instrumentation.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Endodontic retreatment involves removing old root canal filling material followed by cleaning, shaping, and refilling the canals. It may be associated with postoperative pain due to periapical tissue irritation and apical extrusion of debris during instrumentation.

Also, the retreatment procedure plays a critical role in enhancing periapical healing and improving long-term outcomes in failed initial treatments.

Activation of irrigants during endodontic retreatment enhances the removal of residual gutta-percha, sealers, and debris, especially in lateral canals and complex areas. It also boosts disinfectant effectiveness, improving canal cleanliness and retreatment outcomes.

Ultrasonic activation uses high frequency vibrations to enhance irrigant penetration and fluid dynamics during endodontic retreatment. It improves the removal of residual filling materials and debris more effectively than conventional irrigation. The technique promotes cavitation and acoustic streaming, boosting disinfectant effectiveness and reducing bacterial load. Overall, ultrasonic activation enhances canal cleaning and contributes to better retreatment outcomes.

XP endo Finisher R is a specialized endodontic instrument designed for retreatment to improve removal of residual root filling materials from canals that conventional files cannot fully clean, especially in oval or curved anatomies. It uses flexible MaxWire alloy that expands in the canal, increasing contact with walls and enhancing removal of remnants and debris. Studies using micro CT imaging show that XP endo Finisher R significantly reduces filling material volume compared to some conventional techniques and is effective as a supplementary step after primary retreatment files .

CBCT provides three dimensional imaging that allows more accurate assessment of periapical healing and detection of residual pathology following endodontic retreatment compared with conventional 2 D radiographs. It is more sensitive in identifying persistent apical lesions and missed anatomy that may impact retreatment success. CBCT evaluation can influence clinical decision making and treatment planning by revealing details not seen in traditional imaging.

Systematic reviews show CBCT based outcome assessments often report different success rates due to this increased diagnostic sensitivity. Overall, CBCT contributes to a more comprehensive evaluation of retreatment outcomes and helps guide management further.

Despite the increasing use of irrigation activation techniques during endodontic retreatment, limited clinical evidence exists comparing XP-endo Finisher R with ultrasonic activation regarding postoperative pain and periapical healing outcomes.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
34

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Egypt
      • Minya, Egypt
        • Recruiting
        • Dentistery Hospital, Minia University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Patients with mature teeth.
  • Patients with failed previous Endo treatment related by periapical periodontitis
  • Single Rooted with single root canal.
  • Patients should be free from any systemic disease that may affect predictable outcome.
  • Patients who agree to the consent and will commit to follow-up period

Exclusion Criteria:

  • Patients with immature roots.
  • Patients with any systemic disease that may affect normal healing.
  • Patients with swelling.
  • Pregnant females.
  • Patients who could/would not participate in follow-up.
  • Patients with old age.
  • Teeth with periodontal involvement.
  • Teeth with vertical root fractures.
  • Non-restorable teeth

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Xp Finisher R file Group
About 17 cases suffering from caries then the Caries will be removed with a sterile stone will undergo Xp Shaper R file for irrigation activation during retreatment procedure
Procedure: Xp Finisher R file

to evaluate the incidence and severity of postoperative pain using a numeric rating scale at 24, 48, and 72 hours and periapical healing via CBCT following retreatment with two different irrigation activation techniques:

  1. Xp Finisher R file activation of irrigation.
  2. Ultrasonic activation of irrigation.
Other Names:
  • Ultrasonic activation
Active Comparator: Ultrasonic activation Group
About 17 cases suffering from caries then the Caries will be removed with a sterile stone will undergo Ultrasonic activation of irrigation activation during retreatment procedure
Procedure: Xp Finisher R file

to evaluate the incidence and severity of postoperative pain using a numeric rating scale at 24, 48, and 72 hours and periapical healing via CBCT following retreatment with two different irrigation activation techniques:

  1. Xp Finisher R file activation of irrigation.
  2. Ultrasonic activation of irrigation.
Other Names:
  • Ultrasonic activation

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Post Operative Pain
Time Frame: from 6 hours to 48 hours after the procedure
Assessing the post operative pain measured by a numerical pain rating scale (NRS) where the level of pain will be recorded as follows: 0 reading represents "no pain" ; 1- 3 reading represents "mild pain" ; 4- 6 reading represents "moderate pain" and 7- 10 reading representative sever pain.
from 6 hours to 48 hours after the procedure

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Minia University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Wael Hussien kamel, M.D, Professor of Endodontics Head of Endodontic Department,Faculty of Dentistry,Future University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 10, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 18, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 18, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 21, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 21, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 18, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • Endodontic Retreatment

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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