Selective Curettage and Tissue Adhesive in Endodontic Microsurgery

Summary

The goal of this randomized clinical trial is to determine whether selective curettage combined with cyanoacrylate tissue adhesive improves clinical outcomes in endodontic microsurgery compared with the conventional approach. The study purpose is to evaluate the postoperative healing associated with this conservative surgical protocol.

The main questions it aims to answer are:

Does selective curettage with tissue adhesive reduce postoperative pain, swelling, and complications compared to complete curettage with suturing?

How does selective curettage affect clinical and radiographic healing of persistent periapical lesions?

Researchers compared complete lesion curettage with suturing to selective curettage (40-70% lesion removal) with cyanoacrylate tissue adhesive closure to assess differences in healing and patient-related outcomes.

Participants :

Underwent endodontic microsurgery using one of the two surgical protocols Attended follow-up visits at 1, 3, and 7 days for clinical evaluation of pain, swelling ,Discomfort , Bleeding , Local reaction and Wound Dehiscence

Attended follow-up visits at 3, 6, and 12 months for clinical and radiographic evaluation of periapical healing using 2D radiographs and CBCT

Conditions

• Healing and Patient Related Outcomes

Interventions

PROCEDURE

Selective Lesion Curettage and Cyanoacrylate Tissue Adhesive

Selective curettage is a conservative approach to treat periapical lesions by removing part of the granulomatous tissue while avoiding complications and damage to the neighboring structures. It also provides the least traumatic approach with minimal post-operative complications. It had an additional advantage, which is providing tissue samples for biopsy of the lesion, especially in cases where there was a diagnostic dilemma regarding its origin . In the selective curettage technique, approximately 50-70% of the granulomatous tissue was removed while preserving the portion in close proximity to critical areas, followed by standard root-end resection and retrofilling then Clinical and radiographic assessments, including CBCT, for bone healing assesment .

PROCEDURE

Complete Periapical Lesion Curettage and Suturing

Complete Periapical Lesion Curettage and Suturing is a conventional endodontic microsurgical procedure performed to manage persistent periapical pathology following root canal treatment. After administration of local anesthesia, a full-thickness mucoperiosteal flap is elevated to expose the periapical region. The periapical lesion is completely curetted and removed, followed by apical root-end resection. A retrograde cavity is prepared using ultrasonic tips and sealed with a biocompatible root-end filling material. Hemostasis is achieved, and the surgical flap is repositioned and stabilized using conventional sutures. This approach represents the standard surgical protocol for endodontic microsurgery and serves as the active comparator in this study.

Sponsors & Collaborators

• Mansoura University

  lead OTHER

Principal Investigators

• Mohamed A El-dreny, Assis.Lec · Faculty of Dentistry , Mansoura University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-12-25

Primary Completion

2026-01-29

Completion

2026-02-27

Countries

• Egypt

Study Locations