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Dental CariesNCT05733923

Evaluation of Chemo-mechanical Caries Removal Materials in Caries Removal

A study testing Traditional Escavation, Excavation with Sodium Hypochlorite Gel 2.5%. and Excavation with Papacarie Duo in people with Dental Caries, run by Damascus University at 1 site in Syria.

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 evolution of conservative dentistry that adopts the preservation of tooth structure and affected dentin that can remineralize and save the pulp from exposure, in addition to pain and fear that companies' traditional caries removal methods had led to the development of chemomechanical caries removal materials… Read more about this study

Who is it for?
Ages 18 to 40 years
Conditions the study is for
Dental Caries
What is being tested?
Traditional Escavation, Excavation with Sodium Hypochlorite Gel 2.5%. and Excavation with Papacarie Duo
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
90 participants
Where
1 siteSyria
Study dates
25 Feb 2023to 15 May 2024
Phase
Interventional
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 18 to 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Wide carious lesion (Class 1 Black) on Molars at the middle third of dentine confirmed with a periapical x-ray
  • No pulp involvement is assured with a periapical radiograph.
  • Good oral hygiene
  • Cooperated patient.
  • No oral diseases.

Who cannot join

  • Pulp exposure or bleeding during excavation.
  • Pregnancy
  • Systematic diseases
  • Gingival and periodontal involvement.
  • Lack of patient cooperation.

Trial locations and contacts

1 site in 1 country.

Syria1 site
  • Faculty of Dentistry, Damascus University

    Damascus

Other trials in Syria

About this study

Official title: Effectiveness of Papain-based Materials Compared With NaOCl-based Materials in Chemo-mechanical Caries Removal: A Randomized Controlled Trial

  • The evolution of conservative dentistry that adopts the preservation of tooth structure and affected dentin that can remineralize and save the pulp from exposure, in addition to pain and fear that companies' traditional caries removal methods had led to the development of chemomechanical caries removal materials (CMCR).

The old generations of CMCR agents were NaOcl-based materials which have disadvantages such as odor taste, Unpleasant smell, high cost, Limited shelf life, and time consumption.

Read more
  • All of the reasons described led to a new generation of CMCR materials depending on Enzymes such as Papain.

Brix3000 and Papacarie duo are Papain-based materials with promising effects in caries removal and fewer disadvantages.

Selecti-solve is a dental gel whose active ingredient is papain enzyme, it removes dental caries without the need for anesthesia and is selective for the infected dentin layer only which avoids the unnecessary loss of dentin, enamel breaking, and pulp exposure.

This study aims to evaluate the efficacy of Papain-based materials compared to old NAOcl-Based materials in reducing the disadvantages of CMCR agents.

Read the detailed description

In previous literature, there has not been any study that compared the whole group of chemo-mechanical caries removal materials with such a unique collection of Papain-based CMCR agents.

Papain-based agents could be promising materials in the evolution of Atraumatic Restorative treatment (ART) and Chemomechanical Caries removal methods that support conservative dentistry and the conservation of tooth structure and pulp vitality.

Brix3000 has EBE technology (Encapsulating Buffer Emulsion) that claims to elevate the efficiency of Papain Enzyme and permits the use of a higher concentration of Papain 3,000 U/mg in the whole material (10%).

Papacarie Duo has a unique combination of the main component of Papain Enzyme 6,000 U/mg and a small percentage of chloramine t that claims to increase efficiency and reduce the side effect of chloramine-based CMCR materials.

Selecti-solve is a new material that consists of Papain as the main product and has promising effects in chemo-mechanical caries removal methods.

Conditions
Dental Caries
Being tested
Traditional Escavation, Excavation with Sodium Hypochlorite Gel 2.5%., Excavation with Papacarie Duo, Excavation with Brix3000, Excavation with Selecti-solve
Keywords
Chemo-mechanical caries removal, Papain-based agents, Minimum invasive dentistry, Conservative dentistry, Dental fear, Tooth Decay
Medical subject headings
Dental Caries

What participants receive

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

  • Traditional EscavationProcedure or surgery

    Patients will receive an operative procedure to remove dental caries by traditional excavation using Carbide burs on a micromotor handpiece at low speed with air and water cooling.

    • Group 6: 15 carious teeth will be excavated chemo-mechanically using Selecti-solve.
  • Excavation with Sodium Hypochlorite Gel 2.5%.Procedure or surgery

    Patients will receive an operative procedure to remove dental caries by traditional excavation using Carbide burs on a micromotor handpiece at low speed with air and water cooling. In addition, teeth will be excavated chemo-mechanically using Sodium Hypochlorite Gel 2.5%.

  • Excavation with Papacarie DuoProcedure or surgery

    Patients will receive an operative procedure to remove dental caries by traditional excavation using Carbide burs on a micromotor handpiece at low speed with air and water cooling. In addition, teeth will be excavated chemo-mechanically using a Papacarie Duo.

  • Excavation with Brix3000Procedure or surgery

    Patients will receive an operative procedure to remove dental caries by traditional excavation using Carbide burs on a micromotor handpiece at low speed with air and water cooling. In addition, teeth will be excavated chemo-mechanically using a Brix3000.

  • Excavation with Selecti-solveProcedure or surgery

    Patients will receive an operative procedure to remove dental caries by traditional excavation using Carbide burs on a micromotor handpiece at low speed with air and water cooling. In addition, teeth will be excavated chemo-mechanically using a Selecti-solve.

Study groups in NCT05733923
Study groupRoleWhat they receive
Traditional excavationActive comparatorMechanical caries Removal with low-speed Carbide Burs on a micromotor handpiece with air and water cooling.
Receives: Procedure: Traditional Escavation
Sodium Hypochlorite CMCRExperimentalchemomechanical caries removal using Sodium Hypochlorite Gel 2.5%.
Receives: Procedure: Excavation with Sodium Hypochlorite Gel 2.5%.
Papacarie duo CMCRExperimentalchemomechanical caries removal using Papacarie duo.
Receives: Procedure: Excavation with Papacarie Duo
Selecti-solve CMCRExperimentalchemomechanical caries removal using Selecti-solve Gel.
Receives: Procedure: Excavation with Brix3000
Brix3000 CMCRExperimentalchemomechanical caries removal using Brix3000.
Receives: Procedure: Excavation with Selecti-solve

What is being measured

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

  1. Success in caries removal by a detecting dye

    The efficacy of caries removal will be assessed by a sharp probe aided by Caries Detector dye.

    The Cavity will be inspected after every application by a sharp probe to feel any tacky sensation in dentin, when it is all hard dentin, caries detector dye will be applied to aid the investigation.

    Caries detector dye will be left for 10 seconds and then rinsed with water, it will stain the organic matrix of less mineralized dentin so the cavity should be stained homogeneously so high-intensity colored spots refer to infected dentin and it will be removed.

    Measured: After procedure completion, which is expected to be within 20 minutes on average.

Secondary outcomes (2)
  1. Time required for caries removal

    Time from the beginning of the caries excavation to the end of the process will be recorded in minutes using a stopwatch.

    Measured: After procedure completion, which is expected to be within 20 minutes on average.

  2. Pain perception during caries removal

    Visual analog scale (VAS) will be used to evaluate the pain perception during the procedure of caries removal.

    The patient will be asked to choose a number from 0 to 10 matching the intensity of his or her pain experience during the procedure.

    The higher the score, the more painful the procedure is.

    Measured: After procedure completion, which is expected to be within 20 minutes on average.

Timeline

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

  1. First posted17 Feb 2023
  2. Study start25 Feb 2023
  3. Primary completion15 Oct 2023
  4. Study completion15 May 2024

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05733923
Sponsor's protocol ID
UDDS-OperativeDent-01-2023
Status last verified
Jul 2024
First submitted
29 Jan 2023
Last updated
9 Jul 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Adham MM, El Kashlan MK, Abdelaziz WE, Rashad AS. Comparison of two minimally invasive restorative techniques in improving the oral health-related quality of life of pregnant women: a six months randomized controlled trial. BMC Oral Health. 2021 Apr 30;21(1):221. doi: 10.1186/s12903-021-01581-5.

    PubMed 33931037
  • AlHumaid J, Al-Harbi F, El Tantawi M, Elembaby A. X-ray microtomography assessment of Carisolv and Papacarie effect on dentin mineral density and amount of removed tissue. Acta Odontol Scand. 2018 May;76(4):236-240. doi: 10.1080/00016357.2017.1406614. Epub 2017 Nov 21.

    PubMed 29161950
  • Cardoso M, Coelho A, Lima R, Amaro I, Paula A, Marto CM, Sousa J, Spagnuolo G, Marques Ferreira M, Carrilho E. Efficacy and Patient's Acceptance of Alternative Methods for Caries Removal-a Systematic Review. J Clin Med. 2020 Oct 23;9(11):3407. doi: 10.3390/jcm9113407.

    PubMed 33114249
  • de Souza TF, Martins ML, Tavares-Silva CM, Fonseca-Goncalves A, Maia LC. Treatment time, pain experience and acceptability of the technique for caries removal in primary teeth using the ART approach with or without Brix3000 papain gel: a preliminary randomised controlled clinical trial. Eur Arch Paediatr Dent. 2022 Oct;23(5):777-785. doi: 10.1007/s40368-021-00669-4. Epub 2021 Oct 2.

    PubMed 34599744
  • Divya G, Prasad MG, Vasa AA, Vasanthi D, Ramanarayana B, Mynampati P. Evaluation of the Efficacy of Caries Removal Using Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie - An Invitro Comparative Study. J Clin Diagn Res. 2015 Jul;9(7):ZC42-6. doi: 10.7860/JCDR/2015/12705.6202. Epub 2015 Jul 1.

    PubMed 26393204
  • Santos TML, Bresciani E, Matos FS, Camargo SEA, Hidalgo APT, Rivera LML, Bernardino IM, Paranhos LR. Comparison between conventional and chemomechanical approaches for the removal of carious dentin: an in vitro study. Sci Rep. 2020 May 15;10(1):8127. doi: 10.1038/s41598-020-65159-x.

    PubMed 32415190
  • Katiyar A, Gupta S, Gupta K, Sharma K, Tripathi B, Sharma N. Comparative Evaluation of Chemo-mechanical and Rotary-mechanical Methods in Removal of Caries with Respect to Time Consumption and Pain Perception in Pediatrc Dental Patients. Int J Clin Pediatr Dent. 2021 Jan-Feb;14(1):115-119. doi: 10.5005/jp-journals-10005-1896.

    PubMed 34326596
  • Mancini L, Pisaneschi A, Mancini V, Ginoble M, Quinzi V, Marchetti E, Marzo G. BRIX3000(R) Papain Gel for Cavity Treatment in the Adult Patient. Case Rep Dent. 2021 Jun 12;2021:6624825. doi: 10.1155/2021/6624825. eCollection 2021.

    PubMed 34194848
  • Matsumoto SF, Motta LJ, Alfaya TA, Guedes CC, Fernandes KP, Bussadori SK. Assessment of chemomechanical removal of carious lesions using Papacarie Duo: randomized longitudinal clinical trial. Indian J Dent Res. 2013 Jul-Aug;24(4):488-92. doi: 10.4103/0970-9290.118393.

    PubMed 24047844

Questions about this trial

What is this clinical trial studying?

A study testing Traditional Escavation, Excavation with Sodium Hypochlorite Gel 2.5%. and Excavation with Papacarie Duo in people with Dental Caries, run by Damascus University at 1 site in Syria.

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 5 inclusion and 5 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 9 Jul 2024. 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 Syria. 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.

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?

Success in caries removal by a detecting dye (time frame: After procedure completion, which is expected to be within 20 minutes on average.). 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 NCT05733923, which also lists 9 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 9 Jul 2024.

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