NCT07448571

Brief Summary

The goal of this randomized controlled clinical trial is to determine whether regenerative endodontic treatment can improve healing outcomes in teeth with apical periodontitis following failed root canal treatment. The study includes adult patients who require non-surgical root canal retreatment due to persistent periapical lesions. The main questions it aims to answer are: Does regenerative endodontic treatment improve periapical healing compared with conventional non-surgical root canal retreatment? Does regenerative treatment increase long-term treatment success and tooth survival? Researchers will compare conventional non-surgical root canal retreatment with regenerative endodontic treatment using injectable platelet-rich fibrin (i-PRF) to see if the regenerative approach results in better clinical and radiographic outcomes. Participants will: Be randomly assigned to receive either conventional retreatment or regenerative endodontic treatment. Undergo clinical and radiographic evaluations over a two-year follow-up period. Be assessed for pain, sensitivity, pulp vitality, hard tissue formation, and periapical healing.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
140

participants targeted

Target at P50-P75 for not_applicable

Timeline
18mo left

Started May 2025

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress41%
May 2025Dec 2027

Study Start

First participant enrolled

May 1, 2025

Completed
10 months until next milestone

First Submitted

Initial submission to the registry

February 26, 2026

Completed
6 days until next milestone

First Posted

Study publicly available on registry

March 4, 2026

Completed
3 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2026

Expected
1.5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2027

Last Updated

March 4, 2026

Status Verified

February 1, 2026

Enrollment Period

1.1 years

First QC Date

February 26, 2026

Last Update Submit

February 26, 2026

Conditions

Keywords

apical periodontitisroot canal retreatmentregenerative endodontic treatmentInjectable Platelet-Rich FibrinNon-Surgical Endodontic RetreatmentPeriapical HealingRandomized Controlled Trial

Outcome Measures

Primary Outcomes (1)

  • Change in Periapical Index (PAI) Score

    Periapical healing will be assessed using standardized periapical radiographs and scored according to the Periapical Index (PAI) system. Changes in lesion size and PAI scores from baseline to follow-up visits over a 24-month period will be evaluated.

    Baseline and up to 24 months

Secondary Outcomes (4)

  • Postoperative Pain Intensity

    Baseline and up to 24 months

  • Percussion and Palpation Sensitivity

    Baseline and up to 24 months

  • Pulp Vitality Response

    Baseline and up to 24 months

  • Proportion of Teeth With Successful Healing (PAI ≤ 2)

    Baseline and up to 24 months

Study Arms (2)

Conventional Non-Surgical Root Canal Retreatment

ACTIVE COMPARATOR

Participants will receive conventional non-surgical root canal retreatment.

Procedure: Non-Surgical Root Canal Retreatment

Regenerative Endodontic Treatment With Injectable Platelet-Rich Fibrin

EXPERIMENTAL

Participants will receive regenerative endodontic treatment using injectable platelet-rich fibrin as a biological scaffold.

Procedure: Regenerative Endodontic Treatment

Interventions

Conventional non-surgical root canal retreatment will be performed under local anesthesia and rubber dam isolation. Previous root canal filling materials will be removed, followed by standardized chemomechanical preparation and irrigation. The canals will be obturated using resin-based sealer and gutta-percha with lateral condensation technique, and the tooth will be restored with a permanent coronal restoration.

Conventional Non-Surgical Root Canal Retreatment

Regenerative endodontic treatment will be performed under local anesthesia and rubber dam isolation. After removal of previous root canal filling materials and standardized canal preparation, injectable platelet-rich fibrin obtained from the patient's autologous blood will be applied into the canal space as a biological scaffold. Mineral trioxide aggregate will be placed coronally, followed by permanent composite restoration.

Regenerative Endodontic Treatment With Injectable Platelet-Rich Fibrin

Eligibility Criteria

Age18 Years - 50 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Patients aged between 18 and 50 years.
  • Single-rooted maxillary anterior teeth with closed apices.
  • Presence of periapical lesion confirmed radiographically.
  • Previously treated root canal tooth requiring non-surgical retreatment.
  • Tooth has not previously undergone non-surgical root canal retreatment.
  • Tooth is considered restorable.
  • Patient is systemically healthy.
  • Patient is willing to participate and provides informed consent.

You may not qualify if:

  • Teeth without radiographic evidence of periapical lesion.
  • Teeth with developmental anomalies.
  • Patients with systemic diseases that may affect healing.
  • Pregnant patients.
  • Teeth presenting with internal or external root resorption.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Marmara University

Istanbul, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Periapical PeriodontitisPeriapical Diseases

Condition Hierarchy (Ancestors)

Jaw DiseasesStomatognathic DiseasesPeriodontal DiseasesMouth DiseasesPeriodontitis

Study Officials

  • Idil OZDEN, PhD

    Marmara University

    STUDY CHAIR

Central Study Contacts

Idil OZDEN, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants will be randomly assigned in a 1:1 ratio to one of two parallel treatment groups. One group will receive conventional non-surgical root canal retreatment, and the other group will receive regenerative endodontic treatment using injectable platelet-rich fibrin. Each participant will receive only one assigned intervention and will be followed prospectively for outcome assessment.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Research Assistant

Study Record Dates

First Submitted

February 26, 2026

First Posted

March 4, 2026

Study Start

May 1, 2025

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

December 1, 2027

Last Updated

March 4, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will not share

Locations