Minimally Invasive Root Canal Treatment With Active Disinfection on Single Rooted Teeth With Periapical Lesions

Summary

A novel form of root canal treatment RCT, referred as minimally invasive endodontics MIE, has emerged recently to adopt a unique approach that emphasize reducing tooth structural changes post-treatment (32). MIE seeks to maintain as much of the tooth's healthy coronal, cervical, and radicular anatomy as practical. Access opening, root canal cleaning and shaping, as well as surgical endodontics are all potential areas where MIE can be applied in endodontic therapy (34,36). Technological and technical progress, based on new tools, files and devices, are now allowing the simplification of this approach.

In the context of endodontics, the question may be whether conventional therapeutic approaches are minimally invasive enough (32,34), or whether a less invasive approach is required. This preliminary clinical study examined radiographically a minimally invasive shaping protocol combined with heated multi-sonic based irrigation to achieve disinfection with the removal of the least amount of dentin from the root's hard tissue during root canal shaping, compared to conventionally instrumented root canals, by focusing on the following aspects:

* The change in the area of the periapical lesion (measured in square millimeters) between T0, T3, T6 and T9
* The speed of repair of healed/healing periapical lesions (absolute speed of shrinkage and relative speed of shrinkage).

In addition, this study evaluated the association between radiographic outcomes and the type of endodontic treatment. Results obtained concerning the mentioned factors were compared across both techniques as well as the available ex-vivo and in vivo studies present in the literature. With the objective of cleaning and disinfecting the root canals as a complex while conserving root integrity, further efforts, to adopt such technique in posterior teeth where the mastication force and stress are at their most, could be done to set guidelines for an effective and more conservative root canal therapy.

Conditions

• Radiographic Healing of Periapical Lesions Following Ultrasonic Activation of Heated Sodium Hypochlorite Without Instrumentation of Root Canals

Interventions

PROCEDURE

non-instrumented root canal treatment with passive ultrasonic activation of heated sodium hypochlorite

Root canals were irrigated with room temperature 5.25% sodium hypochlorite which was activated ultrasonically for 30 seconds and then intra-canal heated using a heat carrier to a temperature fixed at 150 degree celsius. Three consecutive cycles of PAU and intra-canal heating of sodium hypochlorite were performed. After the first and the last cycle, root canals were irrigated with 5 mL of 17% ethylenediaminetetraacetic acid (EDTA) and kept in the canal for 60 seconds and then flushed out with 5 mL of saline. Root canals of this group were kept un-instrumented.

PROCEDURE

conventional root canal treatment with passive ultrasonic activation of heated sodium hypochlorite

Root canals were convetionally prepared using Reciproc Blue rotary files according to the manufacturer's instructions. Once the instrumentation was done, the canal was irrigated with 5 mL of 17% ethylenediaminetetraacetic acid (EDTA) kept for 60 seconds and then flushed with 5 mL of saline. NaOCl was placed in the canal and PUA followed by intracanal heating was performed three times as described for group 1 (IHAN).

Sponsors & Collaborators

• Saint-Joseph University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

40 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-07-07

Primary Completion

2023-10-07

Completion

2024-04-07

Countries

• Lebanon

Study Locations