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Decayed Primary MolarsPhase 4NCT05190783

Partial Versus Complete Pulpotomy Using Three Different Materials in Primary Molars: a Clinical Study

A Phase 4 study testing Formocresol, MTA and TheraCal in people with Decayed Primary Molars, run by Mansoura University at 1 site in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purposes of the study to compare partial pulpotomy versus complete pulpotomy in primary molars using three different materials (Formocresol, MTA, Theracal LC) . After 6, 9, 12 and 15 months follow up each case will be evaluated radiographically and clinically. Read more about this study

Who is it for?
Ages 3 to 6 yearsHealthy volunteers can take part
Conditions the study is for
Decayed Primary Molars
What is being tested?
Formocresol, MTA and TheraCal
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteEgypt
Study dates
1 Mar 2019to 1 Nov 2021
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 3 to 6 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • No history of spontaneous or nocturnal pain.
  • History of transient pain of sensitivity resulting from various stimuli: hot, cold and sweets.
  • Patient who had a bilateral deep carious lesion at second primary molars.
  • absence of tenderness to percussion
  • absence of physiologic or pathologic tooth mobility
  • Radiographic evidence of no internal or external resorption.
  • There is not an intraradicular or periapical bone loss or widening of the periodontal ligament space.

Who cannot join

  • history of spontaneous or nocturnal pain.
  • Patient who had a unilateral deep carious lesion.
  • presence of tenderness to percussion
  • presence of physiologic or pathologic tooth mobility
  • Radiographic evidence of internal or external resorption.
  • There is an intraradicular or periapical bone loss or widening of the periodontal ligament space.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Mansoura University

    Al Mansurah, Dakahlia Governorate, 35516

Other trials in Egypt

About this study

The purposes of the study to compare partial pulpotomy versus complete pulpotomy in primary molars using three different materials (Formocresol, MTA, Theracal LC) . After 6, 9, 12 and 15 months follow up each case will be evaluated radiographically and clinically. the radiographic criteria to be evaluated are (radiolucency, resorption, widening in periodontal ligament space, Crypt involvement) and clinical criteria are ( pain, tenderness, fistula, abnormal mobility) upon these criteria some recommendations will be made on success and failure rate of each material and each technique.

Read the detailed description

In children, deep carious lesions represent the most common disease of primary teeth; 42% of children aged 2 to 11 have dental carious lesions in their primary teeth, with an average of 1.6 decayed teeth per child. The most important objective of pediatric dentistry treatment is the preservation of functional primary teeth until natural exfoliation. In the era of conservative dentistry we are now focusing on repair rather than replacement.

Challenges regarding the best treatment modality in primary molars with deep carious lesions that are free of signs or symptoms have continued over the years. Based on a recent systematic review and a new American Academy of Pediatric Dentistry (AAPD) Guideline for vital pulp therapy in primary teeth, indirect pulp therapy (IPT), direct pulp cap (DPC), and pulpotomy are all viable options for treating the pulp in primary teeth with deep carious lesions.

Partial pulpotomy (PP) was originally a means of preserving the remaining coronal and radicular pulp tissues in permanent teeth after a traumatic pulp exposure. In 1982, Cvek introduced this technique for permanent traumatized teeth with complicated crown fracture, which involved removing two mm of pulp and then dressing the non-inflamed pulp with calcium hydroxide. However, according to the new AAPD best practices recommendation, PP is also indicated in young permanent teeth with a carious pulp exposure in which pulpal bleeding can be controlled within several minutes.

Calcium Hydroxide PP of primary molar teeth with deep carious lesions is used in studies conducted by Schroder and Trairatvorakul. Schroder. showed that the clinical-radiographic success rate of primary molar teeth one year after PP was 83 percent; they concluded that PP has the same favorable outcome as cervical formocresol pulpotomy (FP).

If the pulp is diagnosed as normal or as having reversible pulpitis, a new regenerative material is recommended as the dressing material. In comparison with complete pulpotomy (i.e., removal of the entire pulp chamber), PP has several advantages; it causes limited injury to the pulp and limited loss of tooth substances, and this is important for pulpal healing and easier restoration.

Pulpotomy is the pulp treatment most commonly used for primary teeth with a deep carious lesion approaching the pulp. With pulpotomy, a portion of the pulp is removed: the coronal pulp is removed and the radicular pulp is preserved. After treatment, the cavity is filled with a medicament followed by a final restoration.

Formocresol pulpotomy (FCP) was developed in 1932 by Charles A. Sweet.". The original FCP was a three-appointment procedure which has been reduced to a one-appointment procedure; it is still the most common treatment for primary teeth with caries approaching the pulp.

Studies have shown formocresol therapy to have a success rate between 70% and 90%.Histologic results have been variable in contrast to the high clinical success rate. Formocresol is still considered a gold standard by which all new modalities are compared.

MTA is used in pulp capping whether indirect or directly it has the advantage of biocompatibility to the pulp tissues and stimulates the odontoblast for thicker secondary dentine formation without tunnel defects and formation of hydroxyapatite like material to seal the pulp tissues. Although it has slow setting time, discolor the tooth, relatively high cost compared to the gold stander calcium hydroxide.

TheraCal light Cured (LC) is a single paste calcium silicate-based material promoted by the manufacturer for use as a pulp capping agent and as a protective liner for use with restorative materials, cement, or other base materials. The material might be very likable for clinicians because of its ease of handling. According to Alberto Danga in 2009 the cytotoxic effect of resin-based light-cured (Theracal) on human pulp tissue was least when compared to other materials.

There is a lack of evidence in partial pulpotomy treating primary teeth. In this study a Randomized control trial will be performed to have an evidence based answer for treating primary teeth with partial pulpotomy.

Being tested
Formocresol, MTA, TheraCal, pulpotomy, partial pulpotomy
Keywords
Partial Pulpotomy, pulpotomy, MTA, Theracal, Formocresol

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FormocresolDrug

    mixture of formalin, cresol and glycerine used for fixation of pulp tissues

  • MTADrug

    Also called Mineral trioxide aggregate

    material used for pulp regeneration, direct and indirect pulp capping

  • TheraCalDrug

    light cured resin modified calcium silicate filled liner designed for use in direct and indirect pulp capping

  • pulpotomyProcedure or surgery

    removal of the carious tooth structure and unroofing of the pulp chamber with a round carbide bur with high speed and water spray. The coronal pulp tissue will be then removed using a #4 carbide bur with slow speed and sharp spoon excavator.

  • partial pulpotomyProcedure or surgery

    complete removal of caries till exposure occurs. The exposed surface of the pulp will be gently removed using a sterile round diamond bur and a high-speed, water-cooled handpiece with light hand pressure. The removal of the pulp did not exceed approximately two mm.

Study groups in NCT05190783
Study groupRoleWhat they receive
formocresol pulpotomyExperimentalgold standard arm which pulpotomy will be done with formocresol
Receives: Drug: Formocresol; Procedure: pulpotomy
formocresol partial pulpotomyActive comparatorpartial pulpotomy will be done with formocresol
Receives: Drug: Formocresol; Procedure: partial pulpotomy
MTA pulpotomyActive comparatorin this group complete pulpotomy will be done with MTA
Receives: Drug: MTA; Procedure: pulpotomy
MTA partial pulpotomyActive comparatorin this study group partial pulpotomy will be done with MTA
Receives: Drug: MTA; Procedure: partial pulpotomy
pulpotomy with Theracal LCActive comparatorin this study group complete pulpotomy will be done with Theracal LC
Receives: Drug: TheraCal; Procedure: pulpotomy
partial pulpotomy with Theracal LCActive comparatorin this study group partial pulpotomy technique will be done with Theracal LC
Receives: Drug: TheraCal; Procedure: partial pulpotomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. post operative pain

    numerical/visual analogue scale 0 no pain 10 worst possible pain

    Measured: 15 months

Secondary outcomes (7)
  1. radiolucency

    measuring tool is periapical xray

    Measured: 15 months

  2. fistula

    visual inspection

    Measured: 15 months

  3. tooth mobility

    clinical method of assessing tooth mobility 0 no mobility 3 mobility more than 2 mm bucco-lingualy

    Measured: 15 months

  4. tenderness

    percussion test with numerical/visual analogue scale 0 no pain 10 worst possible pain

    Measured: 15 months

  5. root resorption

    periapical xray

    Measured: 15 months

  6. widening in periodontal ligament space

    periapical xray

    Measured: 15 months

  7. permanent tooth crypt involvement

    periapical xray

    Measured: 15 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jan 2022
  2. Study start1 Mar 2019
  3. Primary completion1 Aug 2021
  4. Study completion1 Nov 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05190783
Sponsor's protocol ID
PVCPUTDMIPMACS
Status last verified
Feb 2019
First submitted
11 Dec 2021
Last updated
18 Jan 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: planning to publish my paper on pediatric dental journals

Publications

  • Smail-Faugeron V, Porot A, Muller-Bolla M, Courson F. Indirect pulp capping versus pulpotomy for treating deep carious lesions approaching the pulp in primary teeth: a systematic review. Eur J Paediatr Dent. 2016 Jun;17(2):107-12.

    PubMed 27377108
  • Katz CR, de Andrade Mdo R, Lira SS, Ramos Vieira EL, Heimer MV. The concepts of minimally invasive dentistry and its impact on clinical practice: a survey with a group of Brazilian professionals. Int Dent J. 2013 Apr;63(2):85-90. doi: 10.1111/idj.12018. Epub 2013 Mar 12.

    PubMed 23550521
  • Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, Graham L. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. Pediatr Dent. 2017 Sep 15;39(5):146-159.

    PubMed 29070150
  • Cvek M, Cleaton-Jones PE, Austin JC, Andreasen JO. Pulp reactions to exposure after experimental crown fractures or grinding in adult monkeys. J Endod. 1982 Sep;8(9):391-7. doi: 10.1016/S0099-2399(82)80092-7. No abstract available.

    PubMed 6957533
  • Schroder U, Szpringer-Nodzak M, Janicha J, Wacinska M, Budny J, Mlosek K. A one-year follow-up of partial pulpotomy and calcium hydroxide capping in primary molars. Endod Dent Traumatol. 1987 Dec;3(6):304-6. doi: 10.1111/j.1600-9657.1987.tb00639.x. No abstract available.

    PubMed 3481571
  • Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. Int Endod J. 2018 Feb;51(2):177-205. doi: 10.1111/iej.12841. Epub 2017 Sep 21.

    PubMed 28836288
  • Camp JH. Diagnosis dilemmas in vital pulp therapy: treatment for the toothache is changing, especially in young, immature teeth. J Endod. 2008 Jul;34(7 Suppl):S6-12. doi: 10.1016/j.joen.2008.03.020.

    PubMed 18565375
  • Wunsch PB, Kuhnen MM, Best AM, Brickhouse TH. Retrospective Study of the Survival Rates of Indirect Pulp Therapy Versus Different Pulpotomy Medicaments. Pediatr Dent. 2016 Oct 15;38(5):406-411.

    PubMed 28206897
  • George V, Janardhanan SK, Varma B, Kumaran P, Xavier AM. Clinical and radiographic evaluation of indirect pulp treatment with MTA and calcium hydroxide in primary teeth (in-vivo study). J Indian Soc Pedod Prev Dent. 2015 Apr-Jun;33(2):104-10. doi: 10.4103/0970-4388.155118.

    PubMed 25872627
  • El Meligy OA, Allazzam S, Alamoudi NM. Comparison between biodentine and formocresol for pulpotomy of primary teeth: A randomized clinical trial. Quintessence Int. 2016;47(7):571-80. doi: 10.3290/j.qi.a36095.

    PubMed 27175451
  • Poggio C, Arciola CR, Beltrami R, Monaco A, Dagna A, Lombardini M, Visai L. Cytocompatibility and antibacterial properties of capping materials. ScientificWorldJournal. 2014;2014:181945. doi: 10.1155/2014/181945. Epub 2014 May 18.

    PubMed 24959601

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Formocresol, MTA and TheraCal in people with Decayed Primary Molars, run by Mansoura University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

post operative pain (time frame: 15 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05190783, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jan 2022.

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