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Irriversible PulpitisPOPNCT07526844

Effect of Instrumentation Systems and Sealers on Postoperative Pain

A study testing TruNatomy, ProTaper Gold and AH Plus in people with Irriversible Pulpitis, run by European University of Lefke.

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Official record

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Trial summary

The goal of this randomized clinical trial is to evaluate whether different root canal preparation systems and sealer types affect postoperative pain after root canal treatment in adult patients (18-60 years) with asymptomatic irreversible pulpitis in mandibular premolars. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Irriversible Pulpitis
What is being tested?
TruNatomy, ProTaper Gold and AH Plus
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
144 participants
Where
No sites listed yet
Study dates
15 Oct 2026to 30 Oct 2027
Phase
Interventional

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Asymptomatic teeth with delayed positive response to thermal and electric pulp testing
  • Vital teeth with signs of irreversible pulpitis
  • Mature mandibular first or second premolars
  • Periodontally healthy teeth Exclusion Criteria
  • Patients with systemic conditions (e.g., diabetes, immunocompromised status, pregnancy)
  • Antibiotic use within the past month
Show all 12Show fewer
  • Use of analgesics within 7 days prior to treatment
  • Known allergy to materials used
  • Teeth with periapical lesions
  • Non-vital or symptomatic teeth
  • Teeth requiring post-core restorations
  • Calcified canals, root resorption, or immature teeth

Who cannot join

None listed.

About this study

Official title: Impact of TruNatomy and ProTaper Gold Ni-Ti Systems Using Resin-based or Bioceramic Sealers on Postoperative Pain After Root Canal Treatment: a Randomized Clinical Trial

The goal of this randomized clinical trial is to evaluate whether different root canal preparation systems and sealer types affect postoperative pain after root canal treatment in adult patients (18-60 years) with asymptomatic irreversible pulpitis in mandibular premolars.

The main questions it aims to answer are:

Read more

Do different instrumentation systems (TruNatomy vs ProTaper Gold) influence postoperative pain levels? Do different sealer types (AH Plus vs TotalFill BC) affect postoperative pain and analgesic consumption? Researchers will compare TruNatomy and ProTaper Gold systems combined with AH Plus or TotalFill BC sealers to determine their effect on postoperative pain.

Participants will:

Undergo single-visit root canal treatment using one of the assigned file system and sealer combinations Record their pain levels using a Numerical Rating Scale (NRS) at specific time intervals (6, 12, 24, 48, 72 hours, and 7 days) Take ibuprofen only if needed and record analgesic intake Attend a follow-up visit on the 7th day

Read the detailed description

Postoperative pain remains a significant concern in endodontic treatment, even in cases of asymptomatic irreversible pulpitis. Although root canal therapy is highly effective, patients may experience discomfort due to mechanical, chemical, or microbial irritation of periapical tissues during treatment. Among these factors, the type of instrumentation system and root canal sealer may influence the degree of postoperative pain through their effects on debris extrusion, canal shaping characteristics, and biological tissue response.

Minimally invasive instrumentation systems have been introduced to preserve dentin structure and maintain the original canal anatomy. TruNatomy (Dentsply Maillefer) is designed with a slim Ni-Ti wire and regressive taper, aiming to reduce canal transportation and minimize apical extrusion of debris. In contrast, ProTaper Gold (Dentsply Maillefer) features a progressive taper and enhanced cutting efficiency, which may improve shaping ability but could potentially increase the extrusion of debris beyond the apex.

In addition to instrumentation, the chemical composition and biological properties of root canal sealers may influence postoperative outcomes. AH Plus, an epoxy resin-based sealer, demonstrates strong adhesion and dimensional stability. TotalFill BC Sealer, a calcium silicate-based bioceramic material, is characterized by high biocompatibility and bioactivity, including calcium ion release, which may promote favorable tissue response.

This study is designed as a prospective, randomized clinical trial with a factorial structure to evaluate both the independent and combined effects of instrumentation systems and sealer types on postoperative pain. The interaction between these variables will also be assessed to determine whether specific combinations are associated with increased or reduced pain levels.

All treatments will be performed under standardized clinical conditions using a single-visit protocol, with consistent irrigation regimens and obturation techniques to minimize confounding variables. Pain intensity will be recorded at multiple postoperative time points using a validated numerical scale, allowing evaluation of both the intensity and temporal pattern of pain.

The findings of this study are expected to provide clinically relevant evidence regarding the selection of instrumentation systems and root canal sealers to optimize patient comfort following endodontic treatment.

Being tested
TruNatomy, ProTaper Gold, AH Plus, TotalFill BC
Keywords
Post Operative Pain, Irreversible Pulpitis, NiTi File, Canal Sealer
Medical subject headings
Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TruNatomyDevice

    Rotary nickel-titanium (NiTi) endodontic file system used for root canal shaping with minimally invasive design. Instrumentation performed according to manufacturer instructions.

  • ProTaper GoldDevice

    Heat-treated rotary nickel-titanium (NiTi) endodontic file system used for root canal shaping following manufacturer-recommended protocol.

  • AH PlusOther

    Epoxy resin-based root canal sealer used for obturation with gutta-percha using a single-cone technique.

  • TotalFill BCOther

    Calcium silicate-based bioceramic root canal sealer used for obturation with gutta-percha using a single-cone technique.

Study groups in NCT07526844
Study groupRoleWhat they receive
TruNatomy + AH PlusExperimentalName: TruNatomy + AH Plus Type: Experimental Intervention: Device: TruNatomy file system Other: AH Plus sealer
Receives: Device: TruNatomy; Other: AH Plus
TruNatomy + TotalFill BCExperimentalName: TruNatomy + TotalFill BC Type: Experimental Intervention: Device: TruNatomy Other: TotalFill BC
Receives: Device: TruNatomy; Other: TotalFill BC
ProTaper Gold + AH PlusExperimentalName: ProTaper Gold + AH Plus Type: Experimental Intervention: Device: ProTaper Gold Other: AH Plus
Receives: Device: ProTaper Gold; Other: AH Plus
ProTaper Gold + TotalFill BCExperimentalName: ProTaper Gold + TotalFill BC Type: Experimental Intervention: Device: ProTaper Gold Other: TotalFill BC
Receives: Device: ProTaper Gold; Other: TotalFill BC

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Postoperative Pain Intensity (Numerical Rating Scale)

    Postoperative pain will be assessed using a Numerical Rating Scale (NRS, 0-10), where 0 indicates no pain and 10 indicates worst imaginable pain. Patients will record pain levels at 6, 12, 24, 48, and 72 hours, and on day 7 following root canal treatment.

    Measured: 6, 12, 24, 48, 72 hours and 7 days post-treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Apr 2026
  2. Study start15 Oct 2026 (estimated)
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion30 Oct 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
144 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07526844
Sponsor's protocol ID
BAYEK057.03
Other IDs
BAPKO0442620
Acronym
POP
Status last verified
Sep 2026
First submitted
7 Apr 2026
Last updated
11 Sep 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

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