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Removal of Intracanal Medicaments by Different Techniques Using Cone Beam Computed Tomography Analysis (Ca(OH)2 - CBCT)

17 juli 2026 bijgewerkt door: Mahmoud Basuoni Basuoni Aboseira, Tanta University

"Removal of Intracanal Medicament by Different Techniques: (Cone Beam Computed Tomography Analysis) (Clinical Study)"

the goal of this study is to evaluate the efficency of different activation techniques in removal of intracanal medication using cone beam computed tomography analysis

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

the primary etiological factors for pulpal and periradicular diseases are microorganisms. Therefore, the primary purpose of endodontic treatment is to completely eradicate microorganisms from the root canal. This is achieved through chemo-mechanical preparation of the canal, which includes proper cleaning and shaping by instrumentation and irrigation.

Complexity of the root canal system compromises the eradication of microorganisms completely by traditional methods. The remaining bacteria may multiply between appointments and reach the same previous concentration. Therefore, intracanal medicaments play an important role in canal disinfection.

Intracanal medication becomes more necessary in cases involving bacteria that are resistant to routine treatment, as well as in situations where successful completion of therapy is hindered by persistent pain or continuous exudate.

The concept is to temporarily fill the root canal with a material that would chemically and physically enhance eradication and prevent the proliferation of microorganisms.

The most commonly used intracanal medicament is calcium hydroxide (Ca(OH)2), Through releasing hydroxyl ions disrupts the structural integrity of bacterial cytoplasmic membranes. In addition, Ca(OH)₂ indirectly affects anaerobic microorganisms within the root canal through a reaction between calcium ions and aqueous carbon dioxide, resulting in degradation of bacterial lipopolysaccharides.

Moreover, the biological properties of Ca(OH)₂ as antimicrobial action, induction of hard tissue deposition, and promotion of improved tissue repair all of this make that it considered as the material of choice of intracanal medicament.

However , despite its benefits, Ca (OH)₂ remnants on the canal walls showed multiple disadvantages such as; affecting sealer penetration into dentinal tubules, weakening their final bond to dentin and delaying the setting of some sealers such as zinc oxide eugenol so, Ca (OH)₂ remnants still one of the obstacles during complete the root canal obturation and interference with the physical properties of sealers has been shown to increase apical leakage and eventually compromise the outcome of endodontic treatment.

Additional disadvantages of Ca (OH)₂ include the challenge of removing it from the root canal walls and complete removal of it prior to final obturation is critical. However, manual irrigation alone was unable to completely remove intracanal medicament regardless of the agent use Numerous methods have been suggested for the removal of Ca (OH)₂ from the root canal such as : (1) Manual irrigation with a syringe (2) Manual dynamic agitation (3) Canal brush (4) Passive ultrasonic irrigation (5) Sonic irrigation (6) XP-shaper (7) XP-finisher (8) Rins Endo (9) Endo vac Numerous methods have been used to assess the amount of Ca (OH)₂ remnants within the root canal. These include digital photographs, stereomicroscopy, scanning electron microscopy, and micro-computed tomography.

However, the recent availability of cone beam computed tomography (CBCT) is considered an accurate, noninvasive imaging technique and has been employed to evaluate the quantity of residual intracanal calcium hydroxide. CBCT provides a three-dimensional volume measurement without the need to section the specimens Group assignment

Patients will be randomly divided into three equally treated groups (n=10) According to the type of activation technique as follow:

Group 1: Manual Dynamic Agitation (MDA)* Group 2: Sonic Activation† Group 3: XP-finisher activation‡

After intracanal medicament placement, the volume of the medicament will be measured using CBCT analysis software†††. The patient will then be recalled after one week[19]. At the recall visit, the tooth will be isolated and the intracanal medicament will be removed according to the assigned group:

Group 1: MDA Group 2: Sonic Activation Group3: XP-finisher activation Following intracanal medicament removal according to each group, a second CBCT scan will be taken for evaluation. CBCT interpretation will be used to detect the remnants of intracanal medicament and measure its volume using the cone-beam analysis software After image evaluation, the canal will be dried with sterile paper points, and root canal obturation will be performed using gutta-percha cone* and a resin-based sealer*, employing the cold lateral condensation technique.

Studietype

Ingrijpend

Inschrijving (Geschat)

30

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

    • Gharbia Governorate
      • Tanta, Gharbia Governorate, Egypte, 31773
        • faculty of dentistry, Tanta university
        • Contact:
        • Hoofdonderzoeker:
          • Ahmed h labib, professor of endodontics
        • Onderonderzoeker:
          • Mohammed f Ali Mansour, lecturer of endodontics
        • Onderonderzoeker:
          • Mahmoud B Basuoni Aboseira, BDS

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  1. Restorable mature non-vital single canal anterior tooth with or without signs of periapical pathosis.
  2. Teeth without anatomical variations
  3. Medically free patients

Exclusion Criteria:

  1. Non-restorable tooth
  2. Retreatment cases
  3. Teeth with root fractures
  4. Teeth with root resorption

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Manual Dynamic Agitation (MDA)
Removal of intracanal calcium hydroxide using manual dynamic agitation
Manual dynamic agitation was used for the removal of intracanal calcium hydroxide following standardized root canal preparation and irrigation.
Experimenteel: Sonic Activation
Removal of intracanal calcium hydroxide using sonic activation
Sonic activation was used for the removal of intracanal calcium hydroxide following standardized root canal preparation and irrigation.
Experimenteel: XP-Endo Finisher Activation
Removal of intracanal calcium hydroxide using XP-Endo Finisher activation
XP-Endo Finisher activation was used for the removal of intracanal calcium hydroxide following standardized root canal preparation and irrigation.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Volume of Remnants of Intracanal Calcium Hydroxide
Tijdsspanne: 1 week after intracanal medicament placement
The volume of remnants of intracanal calcium hydroxide after removal using the assigned activation technique, measured by cone beam computed tomography (CBCT).
1 week after intracanal medicament placement

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: Ahmed H Labib, professor of endodontics, faculty of dentistry, Tanta university
  • Studie directeur: Mohammed F Ali Mansour, lecturer of endodontics, faculty of dentistry, Tanta university

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 augustus 2026

Primaire voltooiing (Geschat)

1 februari 2027

Studie voltooiing (Geschat)

1 maart 2027

Studieregistratiedata

Eerst ingediend

17 juli 2026

Eerst ingediend dat voldeed aan de QC-criteria

17 juli 2026

Eerst geplaatst (Werkelijk)

22 juli 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

22 juli 2026

Laatste update ingediend die voldeed aan QC-criteria

17 juli 2026

Laatst geverifieerd

1 juli 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • END/5-26/3587

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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