Antibacterial Effects of Intracanal Medicaments in Acute Apical Abscesses (CAM-AAA)
Comparative Evaluation of the Antibacterial Efficacy of Calcium Hydroxide and a Calcium Silicate-Based Intracanal Medicament in Teeth With Acute Apical Abscesses Using Real-Time PCR: A Randomized Clinical Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Acute apical abscess is an endodontic infection characterized by localized inflammation, pain, swelling, and purulent exudate. Although chemomechanical root canal preparation substantially reduces the bacterial load, microorganisms may remain within the root canal system. Intracanal medicaments are therefore used between treatment sessions to improve microbial reduction.
In this randomized, parallel-group clinical trial, teeth diagnosed with acute apical abscess are allocated to receive either a calcium hydroxide intracanal medicament or a calcium silicate-based intracanal medicament. All teeth undergo standardized root canal treatment and irrigation procedures.
Microbiological samples are collected at three main treatment stages: before chemomechanical preparation, after chemomechanical preparation and irrigation, and after a 7- to 10-day intracanal medication period. Bacterial DNA is analyzed using SYBR Green Real-Time PCR. Universal 16S rRNA primers are used to quantify the total bacterial load. Selected bacterial species associated with endodontic infections are also evaluated.
The primary outcome is the change in total bacterial load between the post-instrumentation sample and the sample collected after intracanal medication. Secondary outcomes include changes in selected bacterial species and bacterial levels across the different sampling stages. The study aims to determine and compare the microbial effectiveness of the two intracanal medicaments in acute apical abscess cases.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Erzurum
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Erzurum, Erzurum, Turkey (Türkiye), 25240
- Recruiting
- Ataturk University Faculty of Dentistry
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Contact:
- Halit Aladağ, DDS, PhD
- Phone Number: +905414675965
- Email: haladag@atauni.edu.tr
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of acute apical abscess
- A single-rooted permanent tooth requiring primary endodontic treatment
- Age between 18 and 65 years
- No history of systemic disease
- American Society of Anesthesiologists physical status classification I (ASA I)
- Provision of written informed consent
Exclusion Criteria:
- Previous endodontic treatment of the affected tooth
- Periodontal probing depth greater than 4 mm
- History of trauma involving the affected tooth
- Pregnancy or breastfeeding
- Immunodeficiency
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Active Comparator: Calcium Hydroxide Group
After standardized chemomechanical root canal preparation, a calcium hydroxide-based intracanal medicament is placed into the root canal to 1 mm short of the working length and remains in the canal for 7 to 10 days.
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Calcium hydroxide-based intracanal medicament placed into the prepared root canal to 1 mm short of the working length for 7 to 10 days.
|
|
Experimental: Calcium Silicate-Based Medicament Group
After standardized chemomechanical root canal preparation, a calcium silicate-based intracanal medicament is placed into the root canal to 1 mm short of the working length and remains in the canal for 7 to 10 days.
|
Calcium silicate-based intracanal medicament placed into the prepared root canal to 1 mm short of the working length for 7 to 10 days.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Total Bacterial Load After Intracanal Medication
Time Frame: From immediately after chemomechanical preparation to 7 to 10 days after intracanal medicament placement
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Total bacterial load will be quantified using universal 16S rRNA gene-based Real-Time PCR in samples collected after chemomechanical root canal preparation (S2) and after the 7- to 10-day intracanal medication period (S3).
The antibacterial effect will be evaluated as the change in log10 bacterial load from S2 to S3 and compared between the two intervention groups.
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From immediately after chemomechanical preparation to 7 to 10 days after intracanal medicament placement
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes in the Levels of Selected Endodontic Bacterial Species
Time Frame: From before chemomechanical preparation to 7 to 10 days after intracanal medicament placement
|
The levels of Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas endodontalis, Parvimonas micra, Treponema denticola, Streptococcus anginosus, Dialister pneumosintes, Campylobacter rectus, Filifactor alocis, and Olsenella uli will be evaluated using species-specific Real-Time PCR.
Changes between the samples collected before chemomechanical preparation (S1), after chemomechanical preparation (S2), and after intracanal medication (S3) will be assessed and compared between the intervention groups.
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From before chemomechanical preparation to 7 to 10 days after intracanal medicament placement
|
|
Change in Total Bacterial Load After Chemomechanical Preparation
Time Frame: From before to immediately after chemomechanical root canal preparation during the first treatment visit
|
Total bacterial load will be quantified using universal 16S rRNA gene-based Real-Time PCR in samples collected before chemomechanical root canal preparation (S1) and immediately after chemomechanical preparation (S2).
The change in log10 bacterial load from S1 to S2 will be evaluated to determine the bacterial reduction achieved by the standardized chemomechanical preparation protocol.
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From before to immediately after chemomechanical root canal preparation during the first treatment visit
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Other Study ID Numbers
- ATAUNI-ENDO-AAA-01
- 16653 (Other Grant/Funding Number: Atatürk University Scientific Research Projects Coordination Unit)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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