Clinical Research Directory

Inclusion Criteria: • Patients aged 18-75 years with ASA (American Society of Anesthesiologists) classification 1 and 2. ASA 1: A normal healthy patient. Example: Fit, non-obese BMI (Body Mass Index) under 30, a non-smoking patient with good exercise tolerance. ASA 2: A patient with mild systemic disease. Example: Patient with no functional limitations and a well-controlled disease (e.g., treated hypertension, obesity with BMI under 35, frequent social drinker, or cigarette smoker). * Patients who agreed to participate and who have signed the informed consent. * Patients presenting with symptomatic and/or asymptomatic apical periodontitis and radiographic evidence of apical periodontitis in anterior or posterior teeth larger than 1.5 mm in diameter. * Mature tooth with closed apices. * Tooth that has never been treated with root canal therapy. Exclusion Criteria: * Patients who have pre-existing health or oral conditions that placed them at risk during the trial. * Patients with generalized untreated periodontal disease. * Patients with a history of analgesic intake within the past 3 days or antibiotics in the last 1 month. * Uncooperative patients. * Teeth with immature apices, root resorption, or requiring extensive prosthetic rehabilitation. * Teeth that cannot be made functional nor restored or difficult to access teeth with no importance (wisdom teeth). * Teeth with insufficient periodontal support. * Teeth with poor prognosis for root canal treatment, for example due to deep root caries, large root resorption or open apex cases. * Fractured teeth * Local anatomical factors such as an inaccessible root end * Presence of fractured instrument in the root canal * Pregnant women * Patients unable to understand the study procedure.