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Sonic Irrigation Activation for Postoperative Pain After Root Canal Treatment (VAS)

25. september 2026 opdateret af: Saidu College of Dentistry

Effect of Sonic Irrigation Activation on Postoperative Pain After Root Canal Treatment in Adults With Asymptomatic Apical Periodontitis: A Randomized Controlled Trial

This randomized controlled clinical trial will evaluate whether sonic activation of the root canal irrigant using the EndoActivator system reduces postoperative pain after root canal treatment compared with conventional syringe irrigation.

Adults aged 18 to 60 years with pulp necrosis and asymptomatic apical periodontitis involving restorable permanent single-rooted premolars will be eligible to participate. A total of 176 participants will be randomly assigned in a 1:1 ratio to either conventional syringe irrigation or sonic irrigation activation using the EndoActivator system.

Root canal treatment procedures, including instrumentation, irrigant concentration and volume, irrigation delivery, obturation, and postoperative instructions, will be standardized between the two groups. The main difference between the groups will be the method used to activate the irrigant.

The primary outcome will be postoperative pain intensity measured using a 100-mm Visual Analog Scale (VAS) 24 hours after root canal treatment. Pain will also be assessed at 6, 48, and 72 hours and at 7 and 14 days. Additional outcomes will include the proportion of participants reporting pain, rescue analgesic use, time to first analgesic use, total analgesic consumption, and adverse events.

The study will be conducted in the Department of Operative Dentistry and Endodontics, Saidu College of Dentistry, Saidu Sharif, Swat, Khyber Pakhtunkhwa, Pakistan. Each participant will be followed for 14 days after treatment.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a prospective, two-arm, parallel-group randomized controlled clinical trial designed to compare the effect of sonic irrigation activation with conventional syringe irrigation on postoperative pain following root canal treatment in adults with pulp necrosis and asymptomatic apical periodontitis.

Eligible participants will be adults aged 18-60 years requiring primary root canal treatment of restorable permanent single-rooted premolars. Participants must have a clinical diagnosis of pulp necrosis and radiographic evidence of apical periodontitis/periapical radiolucency without spontaneous preoperative pain or clinically significant pain on percussion or palpation. Participants with symptomatic apical periodontitis, acute apical abscess, previous endodontic treatment, root fracture, severe root curvature, open apices, root resorption, severely calcified or obliterated canals, severe periodontal disease, or other specified exclusion criteria will not be enrolled.

A total of 176 participants will be recruited and allocated in a 1:1 ratio using a computer-generated randomization sequence with variable block randomization. Allocation will be concealed using sequentially numbered, opaque, sealed envelopes. The operator cannot be blinded because the irrigation activation method must be known during treatment. However, the postoperative outcome assessor will remain blinded to treatment allocation, and the statistician will analyze coded treatment groups.

In the conventional irrigation group, final irrigation will be performed using a sterile side-vented endodontic irrigation needle positioned approximately 1-2 mm short of the working length. In the sonic activation group, the same irrigants, concentrations, volumes, sequence, and exposure times will be used, followed by activation using the EndoActivator system. The EndoActivator tip will be positioned approximately 1-2 mm short of the established working length without binding. The activation protocol will be standardized before recruitment.

The primary outcome will be postoperative pain intensity measured on a 100-mm Visual Analog Scale, with 0 mm representing no pain and 100 mm representing the worst imaginable pain, assessed at 24 hours after treatment. Secondary outcomes will include pain intensity at 6, 48, and 72 hours and 7 and 14 days; the proportion of participants reporting postoperative pain; requirement for rescue analgesics; time to first analgesic use; total number of analgesic tablets consumed during the 14-day follow-up; and adverse events or procedural complications.

Postoperative pain will be assessed longitudinally over the 14-day follow-up period. A linear mixed-effects model will be used to analyze repeated pain measurements, with treatment group, time, and treatment-by-time interaction as fixed effects and participant as a random effect. The difference between groups at the primary 24-hour endpoint will be reported with a 95% confidence interval and p-value.

The study will be conducted at the Department of Operative Dentistry and Endodontics, Saidu College of Dentistry, Saidu Sharif, Swat, Khyber Pakhtunkhwa, Pakistan. Ethical approval and prospective trial registration will be obtained before recruitment.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

176

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Dr Abdullah Dr Abdullah, BDS,FCPS
  • Telefonnummer: +92 333 925675 +92 333 9256750
  • E-mail: drabdullahscd@gmail.com

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 60 år (Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Adults aged 18-60 years.
  • Either sex.
  • Restorable permanent single-rooted premolar requiring primary root canal treatment.
  • Clinical diagnosis of pulp necrosis.
  • Radiographic evidence of apical periodontitis or periapical radiolucency.
  • Absence of spontaneous preoperative pain.
  • No clinically significant pain on percussion or palpation.
  • No swelling, sinus tract, or purulent drainage.
  • Adequate periodontal support.
  • No previous endodontic treatment.
  • Ability to understand and use the pain-rating scale.
  • Willingness to comply with postoperative follow-up.
  • Provision of written informed consent.

Exclusion Criteria:

  • Symptomatic apical periodontitis or acute apical abscess.
  • Preoperative spontaneous pain.
  • Swelling or sinus tract.
  • Previously treated teeth.
  • Root fracture.
  • Severe root curvature.
  • Open apices.
  • Root resorption.
  • Severely calcified or obliterated canals.
  • Severe periodontal disease.
  • Systemic disease likely to substantially influence pain perception or healing.
  • Use of analgesic or anti-inflammatory medication within 48 hours before treatment.
  • Recent antibiotic therapy.
  • Inability to complete postoperative follow-up.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Conventional Syringe Irrigation

Participants will receive standardized root canal treatment with conventional syringe irrigation using a sterile side-vented endodontic irrigation needle. The needle will be positioned approximately 1-2 mm short of the established working length without binding. Irrigation will be performed using gentle, standardized short vertical movements. The same irrigants, concentrations, volumes, sequence, exposure times, and other treatment procedures will be used as in the sonic activation group. No mechanical activation device will be used.

Conventional irrigation will be performed using a sterile side-vented endodontic irrigation needle positioned approximately 1-2 mm short of the established working length without binding. Irrigation will be performed using gentle, standardized short vertical movements. The same irrigants, concentrations, volumes, sequence, and exposure times will be used as in the sonic activation group. No mechanical activation device will be used.

Eksperimentel: Sonic Irrigation Activation Using EndoActivator

Participants will receive standardized root canal treatment with sonic irrigation activation using the EndoActivator system. The same irrigants, concentrations, volumes, sequence, and exposure times used in the conventional irrigation group will be applied. A flexible polymer EndoActivator tip of appropriate size will be positioned approximately 1-2 mm short of the established working length without binding. Sonic activation will be performed using a prespecified activation protocol, with the tip moved in a controlled manner within the irrigant-filled canal. Tip size, device setting, activation duration, number of cycles, and insertion depth will be recorded.

Sonic activation of root canal irrigant will be performed using the EndoActivator system after delivery of the standardized final irrigation solution. The same irrigants, concentrations, volumes, sequence, and exposure times will be used in both treatment groups. A flexible polymer EndoActivator tip of appropriate size will be positioned approximately 1-2 mm short of the established working length without binding. The device will be operated using a prespecified activation protocol, with controlled movement within the irrigant-filled canal. Tip size, device setting, activation duration, number of activation cycles, and insertion depth will be recorded for each participant.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Postoperative Pain Intensity Measured Using a 100-mm Visual Analog Scale (VAS)
Tidsramme: 24 hours after root canal treatment

Postoperative pain intensity will be assessed using a 100-mm Visual Analog Scale (VAS), with 0 mm representing no pain and 100 mm representing the worst imaginable pain. Higher VAS scores indicate greater postoperative pain.

24 hours after root canal treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Postoperative Pain Intensity Measured Using a 100-mm Visual Analog Scale (VAS) at Follow-Up
Tidsramme: 6 hours, 48 hours, 72 hours, 7 days, and 14 days after root canal treatment

Postoperative pain intensity will be assessed using a 100-mm Visual Analog Scale (VAS), with 0 mm representing no pain and 100 mm representing the worst imaginable pain. Higher VAS scores indicate greater postoperative pain.

6 hours, 48 hours, 72 hours, 7 days, and 14 days after root canal treatment

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

25. september 2026

Primær færdiggørelse (Anslået)

17. november 2026

Studieafslutning (Anslået)

30. november 2026

Datoer for studieregistrering

Først indsendt

20. september 2026

Først indsendt, der opfyldte QC-kriterier

25. september 2026

Først opslået (Faktiske)

29. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • SCD-OPER-2026-20

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be shared with other researchers. The study does not currently have a plan for external sharing of individual participant-level data.

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