Evaluating Cross-linked Hyaluronic Acid in Endodontic Microsurgery for Adults with Apical Periodontitis of First Molars

What this Trial Is About

Researchers are evaluating the use of cross-linked hyaluronic acid as an addition to endodontic microsurgery in adults with apical periodontitis affecting first molars in the upper or lower jaw. This randomized clinical trial aims to determine if the addition of this material improves soft and hard tissue healing, reduces inflammation and pain after surgery, and supports more stable outcomes over 12 months of follow-up. The study hypothesis is that cross-linked hyaluronic acid may provide regenerative and anti-inflammatory benefits in this dental surgery context. Participants previously treated with non-surgical root canal therapy will be randomly assigned to one of two groups. The test group will receive endodontic microsurgery combined with the application of cross-linked hyaluronic acid into the bone defect and under the flap before closure. The control group will undergo the same surgical procedure without the addition of any grafting or regenerative material. All surgeries will be done under local anesthesia and an operating microscope, following a standardized microsurgical protocol including flap elevation, root-end resection, retrograde preparation, filling, and suturing. During the study, participants will be monitored for early soft tissue healing at four days after surgery using a wound healing score and for postoperative pain with a visual analogue scale over the first two weeks. Longer-term assessments will include evaluation of bone healing through radiographs and cone beam CT scans at 3, 6, and 12 months, as well as cortical plate healing. The total follow-up period is 12 months. Safety and healing outcomes will be carefully observed to provide clinical evidence on the effects of adjunctive cross-linked hyaluronic acid in endodontic microsurgery.

Hyaluronic Acid in Endodontic Microsurgery