Comparing Calcium Silicate, Calcium Hydroxide Slurry with Sodium Hypochlorite, and Calcium Hydroxide for Retreatment of Lower First Molars with Periapical Lesions

What this Trial Is About

This clinical trial focuses on patients with failed root canal treated lower first molars that have periapical lesions. It aims to compare the anti-inflammatory effects of three different intracanal medications Calcium Hydroxide slurry mixed with 3% Sodium Hypochlorite, Calcium Silicate, and Calcium Hydroxide alone. The study evaluates these treatments through biological, radiographic, and clinical assessments to determine their effectiveness in retreatment cases. Participants are randomly assigned to one of three groups receiving either the calcium hydroxide slurry with sodium hypochlorite, calcium silicate Bio-C Temp, or calcium hydroxide as intracanal medications. After initial cleaning and shaping of the root canals using a rotary file system and irrigation with 3% sodium hypochlorite, these medications are applied inside the canals. Biological samples are collected at the first visit and again two weeks later after medication removal to measure levels of the inflammatory biomarker IL-1B. Radiographic evaluations using CBCT scans occur before treatment and 12 months after to assess lesion size reduction. During the study, participants rate their pain at various times after treatment using a visual analog scale VAS. Clinical and radiographic follow-ups are scheduled at 1 week, 1 month, 6 months, and 12 months post-treatment to monitor healing through palpation, percussion, pain questionnaires, and digital radiographs. The study also measures the biological inflammatory marker and observes changes in lesion volume to evaluate the effects of the intracanal medications. The total participation duration includes these follow-ups over one year.

Biological, Radiographic and Clinical Evaluation of Various Inter-Visit Root Canal Dressings in Retreatment Cases