This study aims to evaluate and compare the clinical and patient-reported outcomes of passive ultrasonic irrigation (PUI) and laser-activated irrigation (LAI) versus conventional syringe irrigation in adult patients undergoing non-surgical root canal treatment on mature permanent teeth, and to identify the key factors that influence these outcomes.

Inclusion Criteria:

• All permanent teeth diagnosed with any of the following conditions including irreversible pulpitis (symptomatic and asymptomatic), pulp necrosis, previously initiated therapy with or without apical periodontitis o Patients with age 18-80
• Patients with Thai ethnicity
• Patients who could read and communicate in Thai language
• Patients with well-controlled medical conditions according to ASA I and II classification

Exclusion Criteria:

• The tooth with cracks, incomplete root formation, vertical or horizontal root fractures or root resorption
• The tooth with periodontal pocket depth of 5 mm or more, degree of mobility of 2 or more
• Patients with bone metabolism disease and/or using steroids or bisphosphonates, immunosuppressed, history of radiotherapy, pregnancy o Patients with serious medical conditions that required consultation with a physician before root canal treatment
• Patients who refuse to participate or could not answer the questionnaires