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NCT Number: NCT07578311

Effect of a Herbal Intracanal Medication On Postoperative Pain And Flare up Incidence In Non Surgical Root Canal Retreatment

The primary objective of this randomized clinical trial is to evaluate and compare the effectiveness of two natural, herbal-based intracanal medications-Propolis and Green Tea Polyphenolics (EGCG)-against the conventional Calcium Hydroxide in reducing postoperative pain and the incidence of flare-ups during non-surgical root canal retreatment.

Postoperative pain is a common complication in endodontics, particularly in retreatment cases where complex bacterial environments and procedural challenges increase the risk of discomfort and acute flare-ups. While Calcium Hydroxide is the traditional gold standard due to its antimicrobial properties, natural phytotherapeutics like Propolis and Green Tea are being investigated for their potent anti-inflammatory, antioxidant, and antibacterial benefits, which may offer superior biocompatibility and symptomatic relief.

Forty patients requiring endodontic retreatment of single-rooted teeth will be randomly assigned to one of three groups:

Group I (Control): Receives Calcium Hydroxide paste.

Group II: Receives Propolis-based medication.

Group III: Receives Green Tea Polyphenolic-based medication.

The study follows a two-visit protocol. During the first visit, the previous root canal filling is removed, the canal is cleaned and shaped, and the assigned medication is placed. Postoperative pain will be assessed using a Visual Analog Scale (VAS) at 6, 12, 24, 48, 72 hours, and 7 days. Flare-up incidence (sudden severe pain or swelling) will also be monitored. In the second visit, the medication is removed, and the canal is permanently sealed using a bioceramic sealer and gutta-percha. The results will help determine if these herbal alternatives can provide a more comfortable treatment experience for patients undergoing root canal retreatment.

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Key information

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Failed previously performed endodontic treatment of single-rooted teeth.
  • Presence of a periapical lesion ranging from 1 mm to 2 mm in diameter.
  • Teeth with complete root formation.
  • Teeth without evidence of external or internal root resorption.

Exclusion criteria

  • Pregnant females.
  • Patients with uncontrolled systemic diseases.
  • Patients currently under antibiotic or analgesic administration.
  • Patients presenting with facial swelling.
  • Teeth not indicated for endodontic retreatment (e.g., poor oral hygiene, mobile teeth, or recessed teeth).

Treatment and study plan

Calcium hydroxide

Drug

Following chemo-mechanical preparation and canal drying, Calcium Hydroxide paste is inserted into the root canal using a specialized syringe. The material is placed 0.5-1 mm from the apex to ensure complete filling without extrusion. It remains in the canal until the second visit for obturation.

Propolis Extract

Drug

After cleaning, shaping, and drying the root canal, a Propolis-based natural resinous substance is used as an intracanal medication. The material is delivered via syringe to a depth of 0.5-1 mm from the apex. This herbal medicament is utilized for its antimicrobial and anti-inflammatory properties.

Green Tea Polyphenolics (EGCG)

Drug

Following the standardized cleaning protocol and canal drying, Green Tea Polyphenolics (EGCG) extract is inserted as an intracanal medication. The extract is placed 0.5-1 mm from the apex using a syringe. It serves as an herbal antioxidant and antimicrobial agent during the inter-appointment period.

Primary outcomes

  1. Postoperative pain

    Time frame: 6, 12, 24, 48, 72 hours and 7 days after the first visit to collect the postoperative pain data.

    Postoperative pain is to be assessed using visual analog scale (VAS), A scale from (0 to 10) where "0" means no pain and "10" means a severe pain that has never faced before.

    Patients will be contacted by phone at 6, 12, 24, 48, 72 hours and 7 days after the first visit to collect the postoperative pain data.

  2. Flare-Up Incidence

    Time frame: Within 7 days post-treatment

    Flare-up is assessed through asking the patient to notify the investigator if any sudden severe pain or swelling takes place.

    This could require an unscheduled emergency visit or prescription of additional medication.

Study contacts

Contact information is provided by the study sponsor or research team.

Abdullah Aiman Ghanemah

CONTACT

[email protected]

+201060493986

Sponsors and collaborators

Lead sponsor

Minia University

Other

Registry information

Official study title

Effect Of Phytotherapeutics As Intracanal Medication On Postoperative Pain And Flare up Incidence In Non Surgical Root Canal Retreatment. (Randomized Clinical Trial)

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
May 11, 2026
Registry last updated
May 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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