Instrument motion and pain during and after root canal treatment in upper premolars with acute irreversible pulpitis

Effect of Instrumentation Kinematics on Intraoperative and Post-operative Pain in Maxillary Premolars With Acute Irreversible Pulpitis: A Randomized Clinical Trial

Not applicable Interventional Al-Azhar University · NCT07250399

This test will compare two different ways of moving root canal instruments to see which causes less pain during and after treatment in adults (ages 20–50) with painful maxillary premolars.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment56 (estimated)
Ages20 Years to 50 Years
SexAll
SponsorAl-Azhar University Academic / other
Locations1 site (Cairo)
Trial IDNCT07250399 on ClinicalTrials.gov

What this trial studies

This randomized, parallel-group trial will enroll about 50 adults aged 20–50 with symptomatic acute irreversible pulpitis in maxillary first or second premolars. Participants will be randomly assigned to root canal preparation with either the EdgeOne Fire reciprocating system or the JZ file system, with standardized instrumentation and irrigation protocols and pain measured using a visual analog scale at baseline, during treatment, and at multiple post-treatment time points. The protocol follows PRIRATE 2020 reporting guidelines and is conducted at the Endodontic Department, Faculty of Dental Medicine for Girls, Al-Azhar University. The main outcomes are intraoperative and postoperative pain intensity and the incidence of post-endodontic pain between the two kinematic approaches.

Who should consider this trial

Good fit: Adults 20–50 years old with symptomatic acute irreversible pulpitis in a maxillary first or second premolar with Type I canals, closed apices, normal periapical appearance, and the ability to consent and record pain scores.

Not a fit: Patients with other tooth types, open apices, chronic periapical disease, major systemic conditions affecting pain, or those outside the 20–50 age range were not studied and may not benefit.

Why it matters

Potential benefit: If one instrument motion causes less tissue injury and debris extrusion, patients could have less pain during and after root canal treatment and a quicker, more comfortable recovery.

How similar studies have performed: Previous comparisons of reciprocating versus other kinematics have produced mixed results, with some studies reporting reduced debris extrusion and early postoperative pain but no clear consensus.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Maxillary first and second bi-rooted premolar teeth having type I root canal.
* have mature teeth with closed apex.
* Teeth with prolonged response to the pulp tests.
* Spontaneous pain (preoperative visual analog scale score )4-6).
* Teeth with normal periapical appearance.
* Restorable teeth.
* Patients who will be able to understand the informed consent form and pain recording scales used in the study will be included.

Exclusion Criteria:

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Where this trial is running

Cairo

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions the Effect of Instrumentation Kinematics on Intraoperative and Post-operative Paininstrumentation kinematicspost-operative painacute irreversible pulpitis
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.