Retreatment and Diabetes

June 25, 2026 updated by: Ipek Eraslan Akyuz, TC Erciyes University

The Effect of Nonsurgical Endodontic Retreatment on Postoperative Pain in Patients With Diabetes Mellitus: A Prospective Clinical Study

ABSTRACT This prospective, controlled, single-center clinical study aims to compare postoperative pain levels and analgesic consumption after nonsurgical endodontic retreatment in individuals with diabetes mellitus and systemically healthy individuals. In addition, the study aims to evaluate the relationship between HbA1c levels, type of antidiabetic medication, and postoperative pain within the diabetes mellitus group.

A total of 54 patients with single-rooted teeth requiring nonsurgical endodontic retreatment due to persistent endodontic problems following previous root canal treatment will be included. Participants will be allocated into two groups according to systemic status: a diabetes mellitus group and a systemically healthy control group, with 27 patients in each group.

All retreatment procedures will be performed by a single operator using a standardized clinical protocol. Previous root canal filling materials will be removed, root canals will be reshaped, irrigated according to a standardized irrigation protocol, and obturated using an epoxy resin-based root canal sealer and gutta-percha cones with the cold lateral condensation technique.

Postoperative pain will be assessed using a Visual Analog Scale at 6, 12, 24, and 48 hours after treatment and on postoperative days 3, 4, 5, 6, and 7. Analgesic consumption will be recorded at the same follow-up time points. Intergroup comparisons, changes in pain scores over time, and associations between HbA1c levels, antidiabetic medication type, and postoperative pain will be evaluated using appropriate statistical tests. The statistical significance level will be set at p < 0.05.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

50

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 Locations

  • Turkey (Türkiye)
    • Kayseri
      • Kayseri, Kayseri, Turkey (Türkiye), 38039
        • Erciyes University

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

Yes

Description

Inclusion Criteria:

Patients aged 18 to 60 years. Patients classified as medically healthy (ASA I) for the control group or as having diabetes mellitus (ASA II or ASA III) for the diabetes mellitus group.

Single-rooted, single-canal teeth with closed apices. Teeth with previous root canal treatment completed at least 4 years before enrollment.

Teeth with root canal filling ending 1 to 4 mm coronal to the radiographic apex.

Teeth diagnosed with asymptomatic apical periodontitis. Teeth with a periapical index score between 2 and 4. Teeth without pain on percussion or palpation. Teeth not requiring periodontal or prosthetic treatment. Teeth suitable for rubber dam isolation.

Exclusion Criteria:

Use of analgesics, antibiotics, or corticosteroids within the last 2 weeks before nonsurgical endodontic retreatment.

Teeth with periodontal attachment loss. Teeth with vertical root fracture, external root resorption, or perforation. Teeth with fractured prosthetic restorations. Non-restorable teeth. Patients with severe pain and/or acute apical abscess. Pregnant patients. Teeth with calcified root canals. Individuals considered unable to comply with treatment procedures because of intellectual disability, developmental delay, or advanced age.

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patient with Diabetes mellitus
Procedure: root canal retreatment
root canal retreatment
Experimental: Healty patient
Procedure: root canal retreatment
root canal retreatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain intensity assessed using the 100-mm Visual Analog Scale (VAS)
Time Frame: 6, 12, 24, and 48 hours after nonsurgical endodontic retreatment and on postoperative days 3, 4, 5, 6, and 7
Postoperative pain intensity will be assessed using a 100-mm Visual Analog Scale (VAS). The VAS ranges from 0 to 100 mm, where 0 indicates no pain and 100 indicates the worst imaginable pain. Higher scores indicate greater postoperative pain intensity. Pain will be recorded at each scheduled follow-up assessment.
6, 12, 24, and 48 hours after nonsurgical endodontic retreatment and on postoperative days 3, 4, 5, 6, and 7

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Analgesic consumption after nonsurgical endodontic retreatment
Time Frame: 6, 12, 24, and 48 hours after treatment and on postoperative days 3, 4, 5, 6, and 7.
Analgesic consumption will be recorded at 6, 12, 24, and 48 hours after treatment and on postoperative days 3, 4, 5, 6, and 7. Participants will record each dose of 400 mg ibuprofen taken for postoperative pain. Higher values indicate greater analgesic consumption.
6, 12, 24, and 48 hours after treatment and on postoperative days 3, 4, 5, 6, and 7.
Association between HbA1c level and postoperative pain intensity
Time Frame: HbA1c level assessed at baseline; postoperative pain assessed at 6, 12, 24, and 48 hours and on postoperative days 3, 4, 5, 6, and 7.
The association between glycated hemoglobin (HbA1c) levels and postoperative pain intensity measured using the 100-mm Visual Analog Scale (VAS) will be evaluated in participants with diabetes mellitus.
HbA1c level assessed at baseline; postoperative pain assessed at 6, 12, 24, and 48 hours and on postoperative days 3, 4, 5, 6, and 7.

Collaborators and Investigators

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

Sponsor

TC Erciyes 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)

January 1, 2026

Primary Completion (Actual)

March 1, 2026

Study Completion (Actual)

April 1, 2026

Study Registration Dates

First Submitted

June 12, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

July 1, 2026

Study Record Updates

Last Update Posted (Actual)

July 1, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025/336

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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