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The purpose of this study is to determine whether enlarging the apical foramen causes postoperative pain in maxillary anterior teeth with apical periodontitis.
Foraminal enlargement (FE) is an intentional procedure that enlarges the cement canal. However, some RCTs indicate that enlarging the FE causes postoperative pain, flare-up, and destroy the apical constriction, whilst some RCTs pointed out there is no difference in terms of pain when a FE has been performed in maxillary anterior teeth with apical periodontitis. We will assess the risk of postoperative pain as risk ratio (RR). The binary (dichotomous) data: 0-44 mm: Mild or no pain; 45-100 mm: Moderate to severe pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | Endodontic treatment will be performed in maxillary anterior teeth with necrotic pulp and periapical periodontitis. Local anaesthesia will be provided (2% Novocaine with 1:80,000 epinephrine), isolation with rubber dam and standard access cavity preparation will be done.Using 2.5 % sodium hypochlorite, canal negotiation will be done. Foraminal enlargement will be achieved with rotary files in foraminal enlargement group after determining working length. Coronal flaring with # 2 and #3 Gates-Glidden drills will be done. The canals will be obturated with gutta-percha and epoxy resin sealer. The treatments will be carried out in single-visit. |
|
| Control | No Intervention | In the control group, no foraminal enlargement will be performed. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Foraminal enlargement | Procedure | After determining the working length, a rotary file will be inserted 1 mm beyond the WL and the apical foramen will be enlarged. |
|
| Measure | Description | Time Frame |
|---|---|---|
| 100-mm Visual Analog Scale (VAS). | The severity of pain in 12 h, 24 h, and 2, 3, 4, and 5 days according to the VAS: no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm) | 5 days |
| Measure | Description | Time Frame |
|---|---|---|
| The number of patients taking an analgesic following the endodontics treatment. | The patients were asked to take an analgesic in the 5 days of time frame. | 5 days |
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Inclusion Criteria:
Mature permenent maxillary anterior teeth having pulpal necrosis and apical periodontitis.
Exclusion Criteria:
Systemic disorders, diabetes, pregnancy, less than 18 years of age, immunocompromised, patients who had taken antibiotics in the past 1 month, patients who had a positive history of analgesic use within the past 3 days, previously accessed teeth.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ibrahim Ethem Yaylali, PhD | Contact | 05378707924 | ibotenring@yahoo.com | |
| ibrahim E Yaylali, PhD | Contact | 05378707924 | ibotenring@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| ibrahim ethem yaylali | Military Hospital, Isparta | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Isparta Military Hospital | Recruiting | Isparta | 32010 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D010485 | Periapical Periodontitis |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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Single-blind. (Participants)
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D010483 | Periapical Diseases |
| D007571 | Jaw Diseases |
| D009057 | Stomatognathic Diseases |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D010518 | Periodontitis |