Evaluation of postoperative pain intensity after retreatment of mandibular molar teeth obturated with gutta-percha, Mineral Trioxide Aggregate (MTA), and Cold Ceramic

Assessment of pain intensity following endodontic retreatment of asymptomatic mandibular molars with Gutta-Percha, Mineral Trioxide Aggregate, and Cold Ceramic

An interventional, single-blind, randomized, parallel, phase 2/3 clinical trial on 60 patients

All procedures will be performed by an endodontist at the Endodontic Clinic, Kurdistan University of Medical Sciences. After local anesthesia and isolation, canal access will be established and prepared with M3-Pro Gold rotary files, with working length determined using an apex locator (Root ZX) and radiographs. Apical patency will be ensured with a #10 K-file. Patients will be assigned to three groups: A: Obturation with Gutta-percha using the cold lateral compaction technique B: Obturation with Mineral Trioxide Aggregate (MTA) (Angelus, Brazil), Apical as an MTA plug and coronal by the backfill method C: Obturation with Cold Ceramic (Samin, Iran), Apical as a plug and coronal using the backfill method Pain intensity will be recorded at 8, 24, 48, and 72 hours using the Visual Analog Scale (VAS)

Inclusion Criteria: Patients with at least one mandibular molar requiring retreatment, with asymptomatic teeth and periapical radiographic lesions, and systemically healthy, will be included in the study Exclusion Criteria: Patients with uncontrolled systemic diseases, pregnant women, and those with acute periapical infections causing swelling and abscess will be excluded from the study

Group A : Gutta-percha using cold lateral compaction Group B: Mineral Trioxide Aggregate, apical plug and coronal backfill Group C: Cold Ceramic, apical plug and coronal backfill

Pain intensity after retreatment of mandibular molars obturated with three root canal filling materials: Gutta-percha, Mineral Trioxide Aggregate, and Cold Ceramic

The study will be conducted in three treatment groups, as detailed below: 1. Group A : Root canal obturation with Gutta-Percha using Cold Lateral Compaction (CLC) technique. 2. Group B: Root canal obturation with MTA (Angelus, Brazil): the apical one-third is filled with an MTA plug, and the coronal two-thirds are filled using the Backfill technique. 3. Group C: Root canal obturation with Cold Ceramic (Samin, Iran), First, the apical plug is placed, followed by the coronal backfill. • Randomization in this study will be performed using the block randomization method to allocate participants into groups. The final sample size will include 60 participants. The blocks consist of three units and are arranged in a combination of A, B, and C. The final number of blocks is six, and their sequence is as follows: 1. ABC 2. ACB 3. BAC 4. BCA 5. CBA 6. CAB To select the blocks, a random number table is used. In this method, we start from the first number in the table and move from left to right. Whenever a number between 1 and 6 appears, the corresponding block is selected, and numbers outside this range are ignored.

Patients will not be aware of the type of canal filling material used.

All data can be shared after de-identification of individual participants.

Access will begin after the publication of the results.

Researchers affiliated with academic and scientific institutions

Researchers will have access to the data under any circumstances.

For further information, you can contact the corresponding author via the following email: [ahmadyanierfan1@gmail.com]

After sending a request via email to the corresponding author, the requester will have unlimited access to the data.