Single Rooted Teeth

The goal of this clinical trial is to evaluate whether locally applied diclofenac sodium, with or without hyaluronidase, can reduce post-surgical pain and swelling in adult male and female patients (18 years or older) with asymptomatic single-rooted teeth and periapical lesions (5-10 mm in diameter). The main questions it aims to answer are: Does local application of diclofenac sodium reduce postoperative pain and swelling compared to no medication? Does the combination of diclofenac sodium and hyaluronidase offer greater reduction in postoperative pain and swelling than diclofenac sodium alone? Researchers will compare four groups (diclofenac only, hyaluronidase only, diclofenac + hyaluronidase, and no medicament) to see if the medicated groups experience significantly less pain and swelling after periapical surgery compared to the control group. Participants will: Undergo root canal treatment followed by periapical surgery in a single visit. Receive a randomly assigned intra-osseous gel (diclofenac, hyaluronidase, both, or none) placed into the surgical cavity. Record their postoperative pain using a visual analogue scale at specified intervals (6, 12, 24, 48 hours, and 7 days). Return for clinical assessments of swelling at 24, 72 hours, and 5 days post-surgery

This randomized clinical trial compares postoperative pain and MMP-9 levels after root canal treatment of necrotic teeth with apical periodontitis, using either single-visit or two-visit instrumentation. The primary outcome is pain intensity measured at multiple intervals using a Visual Analogue Scale. The secondary outcome is the periapical expression of MMP-9 assessed via ELISA. The trial aims to determine whether treatment timing impacts inflammation and healing.