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Effect of Combined Root Canal Therapies in Mandibular Molars With Coexistent Mature and Immature Apices on the Healing Outcome
Sponsor: Al-Azhar University
Summary
Recent advancements in dentistry are driven by the development of dental materials and therapies that support tissue regeneration, including the application of bioactive, biocompatible calcium silicate-based materials like mineral trioxide aggregate (MTA), Biodentine, and bioceramic sealers/putties, which facilitated the integration of different treatment protocols. These root canal treatment protocols can be implemented in the same tooth based on the specific stage of root development, such as combining conventional root canal treatment in the root with a closed mature apex, and regeneration or apical plug in the root with an open immature apex, thereby gaining the benefits of each protocol with a minimally invasive, more conservative approach. No research studies have been published evaluating the effect of combined different root canal treatment protocols on the management of molars with coexistent mature and immature apices. This study will evaluate the outcomes of combined root canal therapies in mandibular molars with coexistent mature and immature apices.
Official title: Effect of Combined Root Canal Therapies in Mandibular Molars With Coexistent Mature and Immature Apices on the Healing Outcome (An in Vivo Study)
Key Details
Gender
All
Age Range
6 Years - 16 Years
Study Type
INTERVENTIONAL
Enrollment
50
Start Date
2024-10-01
Completion Date
2026-10-01
Last Updated
2026-10-23
Healthy Volunteers
No
Conditions
Interventions
Bioceramic apical plug
Two-visit treatment of mandibular molars with a mature mesial root and an immature distal root. After chemomechanical preparation (ProTaper Next; 2.5% sodium hypochlorite (NaOCl); final irrigation with 1.5% NaOCl, saline and 17% ethylenediaminetetraacetic acid (EDTA) with sonic activation), a 3 to 4 millimeter (mm) apical plug of bioceramic putty (Bio-C Repair, Angelus) is placed in the immature distal root using the Micro-Apical Placement (MAP) One system. At the second visit, the mature mesial canals are obturated with gutta-percha and a bioceramic sealer (Bio-C Sealer) using warm vertical compaction, and the tooth is restored with composite resin.
Regenerative endodontic procedure
Two-visit treatment of mandibular molars with a mature mesial root and an immature distal root. Visit 1: gentle irrigation of the immature distal canal with 1.5% sodium hypochlorite (NaOCl) and saline, then calcium hydroxide intracanal medication (Metapaste) for 2 weeks. Visit 2 (local anesthesia without vasoconstrictor): irrigation with saline and 17% ethylenediaminetetraacetic acid (EDTA), bleeding induced with a precurved size 25 K-file about 2 millimeters (mm) beyond the apex to form an intracanal blood clot, then a coronal barrier of bioceramic putty placed with the Micro-Apical Placement (MAP) One system and covered with glass ionomer. The mature mesial canals are obturated with gutta-percha and a bioceramic sealer using warm vertical compaction, and the tooth is restored with composite resin.
Locations (1)
Faculty of Dental Medicine, Al-Azhar University (Boys, Cairo)
Cairo, Egypt