الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The present study was conducted to clinically evaluate the effect of three different irriga-tion protocols on the outcome of single visit revascularization in mature permanent teeth with chronic apical periodontitis.
Thirty six mature necrotic single rooted teeth with periapical lesions were randomly se-lected and divided equally into three groups according to the irrigation agitation protocol. Teeth were agitated in group 1 using manual dynamic agitation, group 2 using sonic activation and group 3 using passive ultrasonic activation.
For all patients, access opening was performed under rubber dam isolation and canal preparation was then completed using ProTaper Next system till file X4. A total amount of 20 ml of 2.5 % sodium hypochlorite were used in a sequence of 5ml after each Protaper next file. For the disinfection protocol, the canals were irrigated using additional 2 ml of 2.5% sodium hypochlorite. In group 1: manual dynamic agitation was performed by corresponding gutta per-cha point size X4 in push–pull strokes at an approximate rate of 100 strokes/minute for 6o se-conds, in group 2: EndoActivator device was applied for disinfection activation using its Blue Tips (35/04) at 10,000 cycles/minute for 60 seconds and in group 3: Irrisafe tip (size 10) was used at frequency 30 KHz for 60 seconds. A flush of 15 ml saline was then applied and fol-lowed by a final irrigation with 20ml of 17% EDTA. The apical foramen was then enlarged with file size 40 and then file size 20 was used to invoke bleeding in the canal. The bleeding was allowed to clot and then covered with biodentine followed by a layer of glass ionomer base and composite as a final restoration.
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All patients were recalled for clinical and radiographic evaluation at 1, 3, 6, 9 and 12 months follow up period. Vitality of the teeth were evaluated using both cold test and electric pulp testing after 12 months. Radiographic assessment using Periapical index score and CBCT scoring index were performed to evaluate the change of size of periapical lesion.
Data were statistically analyzed using Kolmogorov-Smirnov test, Chi-square test, ANO-VA, Kruskal Wallis test, Wilcoxon signed ranks test and Friedman test.
Clinical examination results showed no pain/sensitivity to percussion/palpation or swell-ing in all 36 teeth after 12 months follow up.
Regarding healing of the periapical lesions, there was a statistical significant decrease in the size of the periapical lesions in all three groups after 12 month follow up. Nine out of all thirty six teeth (25%) showed positive response to both cold and electric pulp testing indicating regain of vitality. No statistical significant difference was found between the three disinfection protocols on the final outcome of the treatment after 12 month follow up.