Comparing Post Operative Pain With and Without Apical Patency Technique in Asymptomatic Irreversible Pulpitis Teeth

August 23, 2026 updated by: Misbah, Bolan Medical Complex Hospital Quetta Pakistan
Primary Outcome - Measure Presence of postoperative pain Primary Outcome - Time Frame 24 hours post-treatment Primary Outcome - Description Postoperative pain assessed using the Numerical Rating Scale (NRS), categorized as present (NRS ≥1) or absent (NRS = 0)

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Apical patency is a root canal preparation technique in which a small flexible K-file is passively passed just beyond the apical foramen to maintain canal permeability and prevent apical debris accumulation. Although this method improves irrigation flow to the apical third and reduces the risk of canal blockage, ledge formation, and transportation, its association with postoperative pain remains debatable. This randomized clinical trial aims to compare the frequency of postoperative pain between two treatment protocols in patients with asymptomatic irreversible pulpitis involving maxillary or mandibular premolars. Participants will be randomly allocated into two equal groups. In the Apical Patency Group (APG), a pre-curved #10 K-file will be gently passed 0.5 mm beyond the radiographic working length after each rotary instrument, without filing motion. In the Non-Patency Group (NPG), instrumentation and recapitulation will be strictly confined to the established working length, with no instrument intentionally passing beyond the apex. All procedures will be performed under standard endodontic protocols using rubber dam isolation, 2% lidocaine anesthesia, and 3% sodium hypochlorite irrigation. Postoperative pain severity will be self-assessed by patients using the 11-point Numerical Rating Scale (NRS) at 24 hours post-treatment. The primary outcome will be the presence or absence of pain, while secondary analysis will explore pain intensity categories (mild, moderate, severe)."

Study Type

Interventional

Enrollment (Estimated)

150

Phase

  • 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

  • Name: Dr. Misbah Principal Investigator, BDS FCPS
  • Phone Number: +92-334-1364014
  • Email: khanmusbah@gmail.com

Study Locations

  • Pakistan
    • Balochistan
      • Quetta, Balochistan, Pakistan, 87300
        • Department of Operative Dentistry, Bolan Medical Complex Hospital Unit 2

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria Age 20-50 years; maxillary or mandibular first/second premolar; diagnosed with asymptomatic irreversible pulpitis (no history of spontaneous pain; caries extending ≥2/3 into dentine; no tenderness to percussion/palpation; exaggerated, prolonged response to pulp vitality testing - cold, hot, or EPT)

Exclusion Criteria Uncontrolled diabetes mellitus; uncontrolled hypertension; bleeding disorder; use of anticoagulant therapy; active peptic ulcer; ischemic heart disease; compromised hepatic or renal function; immature apex; internal or external root resorption; blocked or sclerosed canal; periapical radiolucency; acute apical periodontitis; grade 3 mobility; root fracture; teeth in which patency cannot be maintained; symptomatic irreversible pulpitis; non-restorable teeth; retreatment cases

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
Intervention / Treatment
Experimental: Apical Patency Group
Arm 1 - Apical Patency Group (APG) A #10 K-file is passed 0.5 mm beyond working length after each rotary instrument
Procedure: Apical Patency Technique
After each rotary instrument, a pre-curved #10 K-file was passively passed 0.5 mm beyond the working length. No filing motion was performed.
Active Comparator: Non-Patency Group
Arm 2 - Non-Patency Group (NPG) Recapitulation confined to working length only; no instrument passed beyond apex
Procedure: Non-Patency Technique
No instrument was intentionally passed beyond the working length. Recapitulation was performed only to the working length.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Primary Outcome - Measure Presence of postoperative pain
Time Frame: 24 hours post-treatment
Postoperative pain assessed using the Numerical Rating Scale (NRS), categorized as present (NRS ≥1) or absent (NRS = 0)
24 hours post-treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Intensity Over Time
Time Frame: 6, 12, 24, 48, and 72 hours after completion of root canal treatment
Outcome Measure Description Mean post-operative pain intensity measured on the Numerical Rating Scale (0-10, where 0=no pain and 10=worst pain imaginable). Assessed at multiple time points: 6, 12, 24, 48, and 72 hours after root canal treatment.
6, 12, 24, 48, and 72 hours after completion of root canal treatment
6, 12, 24, 48, and 72 hours after completion of root canal treatment
Time Frame: Up to 72 hours after completion of root canal treatment
Time in hours from completion of root canal treatment until the participant achieves a pain-free state (Numerical Rating Scale score = 0).
Up to 72 hours after completion of root canal treatment

Collaborators and Investigators

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

Sponsor

Bolan Medical Complex Hospital Quetta Pakistan

Investigators

  • Study Chair: Dr Syed Attaullah Shah, BDS, Fcps, Bolan medical College sandeman Provisional hospital Quetta

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 (Estimated)

August 24, 2026

Primary Completion (Estimated)

November 1, 2026

Study Completion (Estimated)

November 15, 2026

Study Registration Dates

First Submitted

June 10, 2026

First Submitted That Met QC Criteria

June 10, 2026

First Posted (Actual)

June 15, 2026

Study Record Updates

Last Update Posted (Actual)

August 26, 2026

Last Update Submitted That Met QC Criteria

August 23, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • BolanMed

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

No plan to share individual participant data.

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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