Objective: The objective of this study will be to evaluate the effectiveness of different
endodontic treatment techniques in postoperative symptoms, apical repair, longevity of
rehabilitations, and oral health-related quality of life.
Methods: This prospective, randomized, double-blind clinical study was approved at the
Research Ethics Committee (nº 2.353.996) and will consist of a sample of 350 patients who
will be attended in the clinics of the Federal University of Fluminense/Institute of Health
of Nova Friburgo (UFF/ISNF), in which they will be selected based on eligibility criteria.
Patients aged up to 18 years, with teeth with necrotic pulps and radiographic evidence of
periapical lesion will be included. These patients will be randomly divided into 8 groups: I
(35 patients): unirradicular teeth will be submitted to endodontic treatment with foraminal
enlargement, instrumentation with reciprocating rotation, sodium hypochlorite as irrigant,
lateral condensation filling with MTA Fillapex; II (35 patients): unirradicular teeth will be
submitted to endodontic treatment with foraminal enlargement, instrumentation with
reciprocating rotation, sodium hypochlorite as irrigant, photobiomodulation (aPDT and LLLT),
lateral condensation filling with MTA Fillapex; III (35 patients): unirradicular teeth will
be submitted to endodontic treatment with foraminal enlargement, instrumentation with
reciprocating rotation, chlorhexidine as irrigant, lateral condensation filling with MTA
fillapex; IV (35 patients): unirradicular teeth will be submitted to endodontic treatment
with foraminal enlargement, instrumentation with reciprocating rotation, sodium hypochlorite
as irrigant, lateral condensation filling with AH Plus; V (35 patients): unirradicular teeth
will be submitted to endodontic treatment with foraminal enlargement, instrumentation with
reciprocating rotation, sodium hypochlorite as irrigant, cryotherapy with saline solution,
lateral condensation filling with MTA Fillapex; VI (35 patients): unirradicular teeth will be
submitted to endodontic treatment with foraminal enlargement, instrumentation with
reciprocating rotation, sodium hypochlorite as irrigant, cryotherapy with saline solution,
lateral condensation filling with AH Plus; VII (35 patients): unirradicular teeth will be
submitted to endodontic treatment with foraminal enlargement, instrumentation with
reciprocating rotation, sodium hypochlorite as irrigant, ozone therapy, lateral condensation
filling with MTA Fillapex; VIII (35 patients): unirradicular teeth will be submitted to
endodontic treatment with foraminal enlargement, instrumentation with reciprocating rotation,
sodium hypochlorite as irrigant, ozone therapy, lateral condensation filling with AH Plus; IX
(35 patients): molars will be submitted to endodontic treatment with foraminal enlargement,
instrumentation with reciprocating rotation, conventional irrigation with sodium
hypochlorite, lateral condensation filling with MTA fillapex; X (35 patients): molars will be
submitted to endodontic treatment with foraminal enlargement, instrumentation with
reciprocating rotation, passive ultrasonic irrigation with sodium hypochlorite, lateral
condensation filling with MTA fillapex. The analysis of the postoperative symptoms will be
performed by the visual analog pain scale at 1th, 2th, 3th, 4th, 5th, 6th, 7th, 14th and 30th
days and by the clinical evaluation of edema in 48 and 72 hours. The periapical lesion repair
will be evaluated clinically and radiographically at 3, 6, 12, 18 and 24 months. The
longevity of rehabilitations will be performed clinically and radiographically for 24 months.
In addition, patients will respond a quality of life questionnaire (OHIP-14) on the day of
endodontic treatment, on the 7th day and on the 30th day.
Data analysis: The data will be inserted into a statistical program (SPSS), obtaining the
frequencies of the characterization variables of the sample. The appropriate tests will be
used to compare the means of the groups.
