Clinical Research Directory

Inclusion Criteria: * Age 18-60 (adults only) * multiple-rooted with multiple root canal. * Permanent teeth with mature apex and complete root formation. * Without root caries. * Tooth must be restorable. * Without anatomical abnormalities such as fusion. * Healthy patient category I according to ASA. * Vital tooth, with acute irreversible pulpitis and without peri-apical periodontitis. * No periapical radiolucency. * Consent Patients for who consent to participate and attend follow-up appointments. Exclusion Criteria: * single root canals or double root. * Root canal calcifications. * Root resorption or fracture. * Previously root canal treated teeth. * immunocompromised patients. * Pregnant females * Patients with systemic diseases as diabetic or hypertension patients. * Patients with facial swelling. * patients who use analgesics or antibiotics within 48-72 hours. * Allergy to any materials used (e.g., irrigants or anesthetics). * psychiatric illness * Teeth that are not indicated for endodontic treatment: bad oral hygiene, mobile teeth, or recessed teeth. * Previously endodontically treated teeth. * Teeth with sinus tract.