Clinical Research Directory
Browse clinical research sites, groups, and studies.
Biomarkers in Apical Periodontitis
Sponsor: Kırıkkale University
Summary
Aim: To evaluate the effects of three different irrigation activation techniques-conventional syringe irrigation (CSI), ultrasonic irrigation (UI), and SWEEPS (Shock Wave Enhanced Emission Photoacoustic Streaming)-on the levels of proinflammatory cytokines (Tumor Necrosis Factor Alpha (TNF-α), interleukin-1beta (IL-1β)) and proteolytic enzymes matrix metalloproteinase-9 (MMP-9) in teeth with chronic apical periodontitis. Methodology: Sixty-six male patients (aged 18-35) with single-rooted teeth, previous root canal treatment (at least 4 years ago), and periapical lesions (\<1 cm, PAI score 3 or 4) were included. Sample size was determined by G\*Power (Power=0.90, α=0.05). Following local anesthesia and rubber dam isolation, endodontic access was performed under a dental operating microscope. After removing old filling material and completing root canal preparation with Reciproc R25/R50 files, patients were randomly assigned into three groups (n=22 each): (1) CSI (30G needle), (2) UI (EMS miniPiezon), and (3) SWEEPS (Er:YAG laser, 2940 nm). Periapical exudate samples were collected using sterile paper points (2 mm beyond the apex for 60s) at the first visit (pre-treatment) and the second visit (one week post-medication with calcium hydroxide). Samples were analyzed via ELISA for TNF-α, IL-1β, and MMP-9 levels. Statistical Analysis: Data were analyzed using IBM SPSS 20. Percent changes in biomarker levels were evaluated using the Kruskal-Wallis test for inter-group comparisons and the Wilcoxon test for intra-group (pre- vs. post-treatment) comparisons. Linear regression was used to identify effective factors (group, age, gender, tooth type). Significance was set at (p \< 0.05). Keywords: Apical periodontitis, SWEEPS, Ultrasonic activation, Cytokines, MMP-9, Endodontics.
Official title: Effects of Different Irrigation Activation Techniques on Pro-inflammatory Cytokine and Proteolytic Enzyme Levels in Teeth With Chronic Apical Periodontitis
Key Details
Gender
MALE
Age Range
18 Years - 35 Years
Study Type
INTERVENTIONAL
Enrollment
66
Start Date
2026-08-30
Completion Date
2026-10-17
Last Updated
2026-10-21
Healthy Volunteers
Yes
Interventions
laser activation
NaOCl and EDTA were each delivered in four 2.5-mL portions, with each portion delivered continuously during a 20-s laser activation cycle, resulting in a total activation time of 80 s per irrigant. Activation was performed using a 2940-nm Er laser (LightWalker AT; Fotona, Ljubljana, Slovenia) equipped with an H14 handpiece and a SWEEPS tip measuring 600 μm in diameter and 9 mm in length (SWEEPS 600/9; Fotona). The laser was operated in SWEEPS mode at 20 mJ, 15 Hz, and 0.3 W, with the water and air spray functions switched off. The tip was positioned in the access cavity and maintained stationary throughout activation. Between NaOCl and EDTA application, 5 mL of saline was delivered using a 30-gauge NaviTip needle without laser activation.
PUI
NaOCl and EDTA were each delivered in four 2.5-mL portions, with each portion delivered continuously during a 20-s ultrasonic activation cycle, resulting in a total activation time of 80 s per irrigant. Activation was performed using an ultrasonic unit (miniPiezon; EMS, Nyon, Switzerland) and a 25/25 ultrasonic tip (IF43727; Satelec, Acteon, Mérignac, France) operated at 50% power. The tip was positioned 1 mm short of the working length at its deepest insertion and moved vertically over a 4-5 mm amplitude without binding to the canal walls. Between NaOCl and EDTA application, 5 mL of saline was delivered using a 30-gauge NaviTip needle without ultrasonic activation.
CSI
Irrigation was performed sequentially with 10 mL of 2.5% NaOCl, 5 mL of saline, and 10 mL of 17% EDTA using a 30-gauge NaviTip needle positioned 1 mm short of the working length. NaOCl and EDTA were each delivered in four 2.5-mL portions, each administered over 20 s, resulting in a total irrigation time of 80 s per irrigant.
Locations (1)
Kırıkkale University, Faculty of Dentistry
Kirikkale, Kırıkkale, Turkey (Türkiye)