{"id":510,"date":"2025-12-30T18:45:50","date_gmt":"2025-12-30T18:45:50","guid":{"rendered":"https:\/\/dentistrykazakhstan.kz\/?p=510"},"modified":"2026-03-11T07:16:25","modified_gmt":"2026-03-11T07:16:25","slug":"%d0%bf%d0%b5%d1%80%d1%81%d0%be%d0%bd%d0%b0%d0%bb%d0%b8%d0%b7%d0%b0%d1%86%d0%b8%d1%8f-%d1%8d%d0%bd%d0%b4%d0%be%d0%b4%d0%be%d0%bd%d1%82%d0%b8%d1%87%d0%b5%d1%81%d0%ba%d0%be%d0%b3%d0%be-%d0%bb%d0%b5%d1%87","status":"publish","type":"post","link":"https:\/\/dentistrykazakhstan.kz\/en\/%d0%bf%d0%b5%d1%80%d1%81%d0%be%d0%bd%d0%b0%d0%bb%d0%b8%d0%b7%d0%b0%d1%86%d0%b8%d1%8f-%d1%8d%d0%bd%d0%b4%d0%be%d0%b4%d0%be%d0%bd%d1%82%d0%b8%d1%87%d0%b5%d1%81%d0%ba%d0%be%d0%b3%d0%be-%d0%bb%d0%b5%d1%87\/","title":{"rendered":"PERSONALIZATION OF ENDODONTIC TREATMENT FOR CHRONIC APICAL PERIODONTITIS"},"content":{"rendered":"

Received: 17.12.2025
\nAccepted: 24.12.2025
\nPublished online: 30.12.2025
\nUDC: 616.314.163-08
\nDOI: 10.70113\/1815-9443.2025.46.53.005<\/a><\/p>\n

 <\/p>\n

PERSONALIZATION OF ENDODONTIC TREATMENT FOR CHRONIC APICAL PERIODONTITIS<\/strong><\/p>\n

 <\/p>\n

Tulegenova I.M.1<\/sup>, Kopbayeva M.T.1<\/sup>, Yelubay N.E.1<\/sup><\/em><\/p>\n

Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan<\/em><\/p>\n

\u00a0<\/em><\/h2>\n

Background.<\/strong> Chronic apical periodontitis (CAP) is a major cause of secondary tooth loss, and treatment success depends on adequate disinfection of the root canal system, particularly in anatomically complex canals.<\/p>\n

Aim.<\/strong> To evaluate the effectiveness of a personalized endodontic protocol for CAP using clinical, radiological, and microbiological outcomes.<\/p>\n

Materials and Methods<\/strong>. An open-label randomized controlled study included 80 patients aged 18 – 60 years diagnosed with CAP. Participants were randomly allocated to a personalized protocol group (n=40) or a standard protocol group (n=40). The personalized protocol involved instrumentation with Endostar E3 Azure, irrigation with 3% sodium hypochlorite with ultrasonic activation, and final irrigation with the herbal agent Rotokan for 2 minutes; the control group received the standard protocol with 3% sodium hypochlorite and ultrasonic activation without Rotokan. Outcomes included clinical symptom scores at day 7, radiological healing assessed by CBCT-based indices (PUOD) and periapical index (PAI, D. Orstavik scale) at 12 months, and microbiological findings. Statistical significance was set at p<0.05.\n\nResults.<\/strong> Both groups showed clinical improvement; however, symptom reduction at day 7 was greater in the personalized protocol group (1.15\u00b10.04 vs 1.43\u00b10.06; p<0.05). At 12 months, PUOD was higher in the personalized group (96.7\u00b14.00% vs 89.5\u00b14.10%; p<0.05), and mean PAI was lower (1.0\u00b10.08 vs 1.80\u00b10.07). Microbiological assessment demonstrated markedly lower residual microbial growth in the personalized protocol group compared with the control group.\n\nConclusion<\/strong>. A personalized, CBCT-informed endodontic protocol incorporating enhanced irrigation and final Rotokan irrigation was associated with improved short-term clinical outcomes and superior radiological healing at 12 months compared with the standard approach.<\/p>\n

Keywords:<\/strong> endodontics; chronic apical periodontitis; root canal system; irrigation; sodium hypochlorite; cone-beam computed tomography; periapical index.<\/p>\n

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