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Dental Caries in ChildrenNCT06068244

3D-printed Crowns Versus Zirconia Crowns for Primary Molars

A study testing 3D printed crowns and Zirconia crowns in people with Dental Caries in Children, run by Ain Shams 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 aim of the present study is to compare between 3D-printed crowns and prefabricated zirconia crowns for restoring pulpally-treated primary molars regarding the following aspects: 1. Read more about this study

Who is it for?
Ages 4 to 7 yearsHealthy volunteers can take part
Conditions the study is for
Dental Caries in Children
What is being tested?
3D printed crowns and Zirconia crowns
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
1 siteEgypt
Study dates
1 Jul 2023to 30 Nov 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 4 to 7 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Children included in the study should stratify to the following criteria:
  • Age range of children from 4 -7 years.
  • Having at least one vital primary molar with deep carious lesion indicated for pulpotomy or pulpectomy.
  • The expected exfoliation date of the selected primary teeth must be more than 12 months from the start date of the study.

Who cannot join

  • a) Uncooperative children who needs sedation or general anesthesia. b) Children with physical, intellectual disability or medical conditions that may complicate treatment.
  • Teeth with poor prognosis due to the presence of an abscess or a sinus, mobility or advanced bone resorption.
  • Presence of internal or external root resorption.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Ain shams university

    Cairo

Other trials in Egypt

About this study

Official title: 3D-Printed Crowns Versus Prefabricated Zirconia Crowns for the Restoration of Pulpally-treated Primary Molars; Randomized Clinical Trial and In-Vitro Study

The aim of the present study is to compare between 3D-printed crowns and prefabricated zirconia crowns for restoring pulpally-treated primary molars regarding the following aspects:

  1. In vivo: Evaluate the clinical outcome of 3D printed crowns in comparison to prefabricated zirconia crowns in pulpally-treated primary molars as well as parent satisfaction.
  2. In vitro:

Comparative analysis of fracture resistance and marginal gap of 3D printed crowns and prefabricated zirconia crowns

Read the detailed description

in vitro part :

All selected primary molars should fulfill the following criteria:

  1. Freshly extracted molars with at least three sound walls.
  2. Retain at least one third of their roots Teeth preparation All soft tissue debris will be removed with a hand scaler and teeth will be disinfected, and then stored in distilled water at 4 degrees Celsius until the start of the study.

Pulpotomy procedures will be performed to the extracted molars and the molars will be filled. Then, they will be randomly allocated into two groups.

Group 1: Will receive 3D-printed crowns Group 2: Will receive prefabricated zirconia crowns The specimens will be embedded perpendicularly in Polyvinyl chloride (PVC) cubes with the occlusal surface parallel to the ground using acrylic resin extending 2mm below the cementoenamel junction.

Evaluations: teeth in both groups will be evaluated for the following:

  1. Marginal gap: Precementation measurements of the cervical vertical marginal discrepancies will be performed before cementation., Four optical images for each specimen will be captured using a stereomicroscope (Wild 400, Switzerland) at a 32× magnification. Images will then be transferred to the computer software for image analysis.
  2. Fracture Resistance:

An axial loading condition through the functional cusp will be defined in the mechanical failure description. Failure-to-fracture strength will be tested with a universal testing machine (LLOYD machine) at a 0.5 mm/sec crosshead speed. Application of a round-end vertical loading tip on the occlusal third of a specimen fixed into a loading apparatus as functional loading simulation.

in vivo part : Teeth will be polished using a polishing paste and brush, and dried before being examined.

A dental mirror will be used for clinical examination under light emitting diode (LED) illumination to confirm the fulfillment of the inclusion criteria of the patient's selection.

  • The molars will be randomly allocated into two equal treatment groups 23/each):
  1. Group 1: 3D-printed crowns
  2. Group 2: prefabricated zirconia crowns Pulpotomy procedure for both groups: <!-- -->
  3. Local anesthesia will be administered.
  4. Teeth will undergo pulpotomy procedure' as follows:
  • Caries removal will be done using a large size 4 round bur, mounted onto a high-speed hand piece with constant coolant.
  • All access cavity walls will be flared to allow complete exposure of the pulp chamber, and easy undisturbed access to the canals, followed by removal of all the soft pulpal tissue tags by a sharp spoon shaped excavator.
  • Bleeding control will be done using moist cotton pellet with gentle pressure.
  • Formocresol will be applied using a cotton pellet for 3-5 mins, for fixation.
  • The pulp chamber will be filled with re-inforced zinc oxide and eugenol that will be mixed according to manufacturer's instructions.
  • Analgesics will be prescribed to the patient to be taken when needed.

Intervention Group 1:

  1. Crown reduction: The teeth will be prepared using taper diamond bur with round end for buccal, lingual, mesial, and distal wall for 0.8- 1 mm, producing a chamfer margin circumferentially, and then, reduction of the occlusal surface will be done using a round wheel to produce occlusal clearance of 1.5 mm.
  2. Impression for the preparation will be taken using putty and light poly vinyl siloxane material.
  3. The impression will be sent to the lab and the patient will be dismissed.
  4. The preparation will be optically scanned in the lab and the crown will be digitally designed using computer designing software.
  5. The crown will be printed using 3D printer.
  6. The 3D printed crown will be cemented in the 2nd visit.

Control: Group 2:

  1. Crown reduction:
  • In order to compensate for the thickness of zirconia crown, reduction will be performed on the mesial, distal, buccal and lingual surfaces of the tooth for 0.7-1.75mm. Reduction will be performed using fine needle stone in the beginning to free the contact from the adjacent teeth then followed by reduction of the other surfaces using a diamond stone.
  • Reduction of the occlusal surface will be performed using a flame stone or wheel stone to produce occlusal clearance of 1.5- 2 mm.
  • All line angles will be checked to remove any sharp line angles.
  1. Selection of the matching size from zirconia crowns will be made taking into consideration that the preparation must be free from any undercuts to avoid crown fracture.
  2. After checking the selected size of the crowns, it will be removed, dried and cemented to the tooth using resin cement.

Method of evaluation:

After cementation , at baseline ,3rd ,6th and 12th months evaluation of the crowns will be performed clinically using the modified U.S. Public Health Service criteria for retention, marginal integrity and gingival health for both groups. Also, parental satisfaction will be evaluated at end of the study using 5-point likert scale.

Being tested
3D printed crowns, Zirconia crowns
Keywords
"zirconia crowns", "pulpotomy", "3 dimension printed crowns"

What participants receive

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

  • 3D printed crownsOther

    3D printed crowns

  • Zirconia crownsOther

    Nu smile zirconia crowns

Study groups in NCT06068244
Study groupRoleWhat they receive
3D printed crownsExperimentalParticipants received 3D printed resin crowns
Receives: Other: 3D printed crowns
Zirconia crownsActive comparatorParticipants received ready made zirconia crowns
Receives: Other: Zirconia crowns

What is being measured

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

  1. Gingival health (gingival index)

    Gingival index and plaque index

    A gingival index, based on the Loe and Silness scoring criteria (1963). It will be measured by gently inserting the tip of a periodontal probe into the sulcus surrounding each tooth. Scoring as followed:

    0 = Normal (Absence of inflammation)

    1. = Mild gingivitis (slight change in color, slight edema. No bleeding on probing)
    2. = Moderate gingivitis (redness, edema and glazing. Bleeding on probing)
    3. = Severe gingivitis (marked redness and edema; ulceration; tendency to spontaneous bleeding)
    • Gingival index and plaque index.

    Measured: 1 year follow up for vivo part only

  2. plaque index

    Plaque index (PI) (Silness and Loe) PI 0: No observable plaque PI 1: A thin film of plaque is detected at the gingival margin by running a probe or explorer across the tooth surfaces PI 2: A moderate amount of plaque is detected along the gingival margin. Plaque is visible clinically.

    PI 3: Heavy plaque accumulation is detected at the gingival margin and in the interdental Plaque index (PI) (Silness and Loe) PI 0: No observable plaque PI 1: A thin film of plaque is detected at the gingival margin by running a probe or explorer across the tooth surfaces PI 2: A moderate amount of plaque is detected along the gingival margin. Plaque is visible clinically.

    PI 3: Heavy plaque accumulation is detected at the gingival margin and in the interdental

    Measured: 1year follow up

  3. Marginal integrity

    by visual inspection and explorer Alfa: Explorer does not catch or has one way catch when drawn across the restoration/tooth interface.

    Bravo: Explorer falls into crevice when drawn across the restoration/tooth interface, Dentin is not exposed; clinically acceptable.

    Charlie: Dentin or base is exposed along the margin; clinically unacceptable.

    Measured: 1yeat follow up

  4. crown retention

    Alpha: Bonded Bravo: Debonded Charlie: Lost

    Measured: one year follow up

  5. In vitro marginal gap

    micrometers

    Measured: Immediately after samples preparation

  6. in vitro fracture resistance

    newton

    Measured: Immediately after samples preparation

Secondary outcomes (1)
  1. parent satisfaction

    5-point likert scale.1-very dissatisfied; 2-dissatisfied; 3-neutrally satisfied; 4-satisfied; 5-very satisfied.

    Measured: immediately after cementation of crowns

Timeline

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

  1. First posted5 Oct 2023
  2. Study start1 Jul 2023
  3. Primary completion30 Nov 2024
  4. Study completion30 Nov 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
Single blind
Who is masked
Outcomes assessor
Enrolment
46 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06068244
Sponsor's protocol ID
PED23-1D
Status last verified
Feb 2025
First submitted
8 Sep 2023
Last updated
5 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Hamrah MH, Mokhtari S, Hosseini Z, Khosrozadeh M, Hosseini S, Ghafary ES, Hamrah MH, Narges Tavana. Evaluation of the Clinical, Child, and Parental Satisfaction with Zirconia Crowns in Maxillary Primary Incisors: A Systematic Review. Int J Dent. 2021 Jul 5;2021:7877728. doi: 10.1155/2021/7877728. eCollection 2021.

    PubMed 34285695
  • Al-Halabi MN, Bshara N, Nassar JA, Comisi JC, Rizk CK. Clinical Performance of Two Types of Primary Molar Indirect Crowns Fabricated by 3D Printer and CAD/CAM for Rehabilitation of Large Carious Primary Molars. Eur J Dent. 2021 Jul;15(3):463-468. doi: 10.1055/s-0040-1721905. Epub 2021 Feb 3.

    PubMed 33535245
  • Abuelniel G, Eltawil S. Clinical and Radiographic Evaluation of Stainless Steel versus Zirconia Crowns on Primary Molars: Randomized Controlled Trial. Egypt Dent J. 2018;64(2):977-89.

  • Mathew MG, Roopa KB, Soni AJ, Khan MM, Kauser A. Evaluation of Clinical Success, Parental and Child Satisfaction of Stainless Steel Crowns and Zirconia Crowns in Primary Molars. J Family Med Prim Care. 2020 Mar 26;9(3):1418-1423. doi: 10.4103/jfmpc.jfmpc_1006_19. eCollection 2020 Mar.

    PubMed 32509626
  • Ludwig KH, Fontana M, Vinson LA, Platt JA, Dean JA. The success of stainless steel crowns placed with the Hall technique: a retrospective study. J Am Dent Assoc. 2014 Dec;145(12):1248-53. doi: 10.14219/jada.2014.89.

    PubMed 25429038
  • Attari N, Roberts JF. Restoration of primary teeth with crowns: a systematic review of the literature. Eur Arch Paediatr Dent. 2006 Jun;7(2):58-62; discussion 63. doi: 10.1007/BF03320816.

    PubMed 17140529
  • Abdulhadi B, Abdullah M, Alaki S, Alamoudi N, Attar M. Clinical evaluation between zirconia crowns and stainless steel crowns in primary molars teeth. J Pediatr Dent. 2017;5(1):21.

  • Ashima G, Sarabjot KB, Gauba K, Mittal HC. Zirconia crowns for rehabilitation of decayed primary incisors: an esthetic alternative. J Clin Pediatr Dent. 2014 Fall;39(1):18-22. doi: 10.17796/jcpd.39.1.t6725r5566u4330g.

    PubMed 25631720
  • Schweiger J, Edelhoff D, Guth JF. 3D Printing in Digital Prosthetic Dentistry: An Overview of Recent Developments in Additive Manufacturing. J Clin Med. 2021 May 7;10(9):2010. doi: 10.3390/jcm10092010.

    PubMed 34067212

Questions about this trial

What is this clinical trial studying?

A study testing 3D printed crowns and Zirconia crowns in people with Dental Caries in Children, run by Ain Shams 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 4 inclusion and 3 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 5 Feb 2025. 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.

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?

Gingival health (gingival index) (time frame: 1 year follow up for vivo part only). The study lists 6 primary outcomes in all. 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 NCT06068244, 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 5 Feb 2025; AzTrials last refreshed its copy on 6 Nov 2026.

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