- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03981237
Postoperative Pain After Ultrasonically and Laser-activated Irrigation During Root Canal Treatment
Postoperative Pain After Ultrasonically and Laser-activated Irrigation During Root Canal Treatment: a Randomized Clinical Trial
Study Overview
Status
Conditions
Detailed Description
Patients older than 18 years who require root canal treatment of an asymptomatic tooth with vital or necrotic pulp are included. Those teeth are subjected to root canal treatment using hand and rotating/reciprocating instruments, in combination with irrigation (3% NaOCl, 17% EDTA). After chemomechanical preparation, the teeth are randomly allocated to one of the following groups, according to the final irrigant activation:
- Ultrasonically activated irrigation (UAI), with an Irrisafe file (Satelec Acteon, Mérignac, France) held 1-3mm from working length, driven by an ultrasonic device, activated for 3 x 20 seconds. In between each 20-second cycle, each canal is rinsed with 1 mL NaOCl and finally with 2 mL.
- Laser-activated irrigation (LAI), with the tip of a pulsed Er:YAG laser (2940 nm, Fidelis II, Fotona) held above the canal entrance, activated for 2 x 30s. Settings are 20 Hz, 50 μs, 20 mJ. In between each 30-second cycle, each canal is rinsed with 1 mL NaOCl and finally with 2 mL.
The canals are then dried using paper points and obturated with gutta percha and an epoxy resin sealer using warm vertical condensation. Finally, the endodontic access is sealed with a provisional or permanent filling.
The patient is asked to keep a pain diary after the treatment, indicating postoperative pain on a visual analogue scale at 6, 24, 48 and 72 hours after treatment. Pain medication (Ibuprofen 400mg) is prescribed, and the intake of analgesic tablet is recorded at the same times.
Pre-Treatment Procedure
- Medical + dental history
- Clinical examination: sensibility tests, percussion, palpation, mobility, pockets measurement
- Radiographic examination
- Pulpal and periapical diagnosis
- Intensity of pre-op pain on 100mm VAS scale
- Patient information and informed consent
- Explanation on how to complete the pain diary and how and when to return it
Endodontic Protocol
- Anesthesia
- Rubber dam, disinfection of operative field
- Removal of caries and/or defective restorations
- Access cavity
- Build-up to provide a reservoir for the irrigation if necessary
- Crown-down preparation
- Length determination
- Apical enlargement
Irrigation protocol
- 3% NaOCl
- 17% EDTA when shaping completed
- Irrigation throughout the whole procedure with 27G notched-end needle 2 - 3 mm from WL
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
East Flanders
-
Ghent, East Flanders, Belgium, 9000
- Universitair Ziekenhuis Gent
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- subject has an asymptomatic (VAS 0-0,4mm) tooth requiring primary endodontic treatment
- subject must be able to undergo primary endodontic treatment
Exclusion Criteria:
- analgesic intake over the last 12h
- immunocompromised patients
- pregnant women
- tooth with incompletely formed apex/apices
- subjects with more than one tooth in need of RCT
- previously root canal treated teeth
- subjects with intolerance on NSAID's
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Root canal treatment with laser-activated irrigation
In these patients, the root canals of the tooth are chemomechanically prepared.
After shaping, irrigant activation is performed by means of a pulsed erbium laser.
The canals are then dried and obturated.
|
The root canals and the pulp chamber are filled with NaOCl 3%.
Per canal, the laser tip is placed above the root canal entrance and activated (frequency 20 Hz, pulse energy 20 mJ and pulse length 50 μs) for 30s.
TThe canal is then rinsed with NaOCl using a 27G needle, followed by a second application of laser, identical to the first.
After rubber dam isolation and field disinfection, the pulp chamber is accessed.
The root canal(s) is/are located and shaped using manual and mechanical NiTi instruments in combination with NaOCl (3%) irrigant.
The canals are dried using paper points and obturated with gutta percha and epoxy resin sealer.
The tooth is sealed with a temporary or permanent filling.
|
ACTIVE_COMPARATOR: Root canal treatment with ultrasonically activated irrigation
In these patients, the root canals of the tooth are chemomechanically prepared.
After shaping, irrigant activation is performed by means of an ultrasonically driven instrument.
The canals are then dried and obturated.
|
After rubber dam isolation and field disinfection, the pulp chamber is accessed.
The root canal(s) is/are located and shaped using manual and mechanical NiTi instruments in combination with NaOCl (3%) irrigant.
The canals are dried using paper points and obturated with gutta percha and epoxy resin sealer.
The tooth is sealed with a temporary or permanent filling.
The root canals and the pulp chamber are filled with NaOCl 3%.
An Irrisafe file, driven by an ultrasonic unit according to the manufacturers' instructions, is held at 1-3 mm from WL (precurved if canal is curved) and activated for 30 s.
The canal is then rinsed with NaOCl using a 27G needle.
This cycle is repeated three times (i.e.
3*20s).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Level of post-operative pain after 24 hours
Time Frame: 24 hours after intervention
|
Self-reported pain intensity at 24h after intervention, indicated on a 100mm Visual Analogue Scale.
The VAS is a straight line with one end (point 0) meaning no pain and the other end( point 10) meaning the worst pain imaginable.
|
24 hours after intervention
|
Level of post-operative pain after 6 hours
Time Frame: 6 hours after intervention
|
Self-reported pain intensity at 6h after intervention, indicated on a 100mm Visual Analogue Scale.
The VAS is a straight line with one end (point 0) meaning no pain and the other end( point 10) meaning the worst pain imaginable.
|
6 hours after intervention
|
Level of post-operative pain after 48 hours
Time Frame: 48 hours after intervention
|
Self-reported pain intensity at 48h after intervention, indicated on a 100mm Visual Analogue Scale.
The VAS is a straight line with one end (point 0) meaning no pain and the other end( point 10) meaning the worst pain imaginable.
|
48 hours after intervention
|
Level of post-operative pain after 72 hours
Time Frame: 72 hours after intervention
|
Self-reported pain intensity at 72h after intervention, indicated on a 100mm Visual Analogue Scale.
The VAS is a straight line with one end (point 0) meaning no pain and the other end( point 10) meaning the worst pain imaginable.
|
72 hours after intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Analgesic intake
Time Frame: 6, 24, 48, 72 hours after intervention
|
Number of analgesic tablets (Ibuprofen 400mg) taken at 6, 24, 48 and 72h after intervention
|
6, 24, 48, 72 hours after intervention
|
Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- B670201939441
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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