Bioactive Versus Non-Bioactive Restorative System in Deep Carious Molars

Dental Caries Clinical Trial

Official title:

Outcome of Bioactive Versus Non-Bioactive System for Restoration of Deep Carious Molars Using Selective Caries Removal Technique: 18 Months Randomized Clinical Trial

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06348953
• Other study ID #: Bioactive restorative system
• Status: Not yet recruiting
• Phase: N/A
• Start date: April 2024
• Est. completion date: November 2025

Study information

• Verified date: April 2024
• Source: Cairo University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This research study delves into the effectiveness of bioactive and non-bioactive restorative systems in deep carious permanent molars treated with selective caries removal. Selective caries removal techniques aim to preserve as much healthy tooth structure as possible while effectively eliminating carious tissue. The study investigates how the choice of restorative material influences the outcomes of selective caries removal procedures in deep carious lesions. By assessing factors such as restoration integrity, pulpal response, and long-term success rates, the research seeks to provide evidence-based insights into the comparative performance of bioactive and non-bioactive restorative systems in this clinical context.

Description:

Deep carious lesions in permanent molars present a significant challenge in restorative dentistry. Traditional approaches to caries removal often involve the removal of excessive healthy tooth structure, leading to weakened teeth and potential pulp exposure. Selective caries removal techniques aim to preserve as much healthy tooth structure as possible while effectively eliminating carious tissue, offering a conservative alternative to traditional methods. In recent years, bioactive restorative materials have emerged as promising alternatives to conventional non-bioactive materials. Bioactive materials are designed to interact with the biological environment, promoting remineralization and potentially enhancing the longevity of restorations. However, limited evidence exists comparing the efficacy of bioactive and non-bioactive restorative systems in deep carious lesions treated with selective caries removal. This study is designed as a prospective, randomized controlled trial. Patients presenting with deep carious lesions in permanent molars will be randomly allocated to receive either a bioactive or non-bioactive restorative system following selective caries removal. Baseline demographic and clinical data will be recorded for each participant. Clinical evaluations will be conducted at regular intervals over a follow-up period of months. Outcome measures will include restoration integrity (e.g retention, marginal adaptation), pulpal response (e.g., sensitivity, vitality).

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 60
• Est. completion date: November 2025
• Est. primary completion date: November 2025
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 40 Years

Eligibility

Inclusion Criteria:

• young adult patients (age: 18-40 years) of both genders.
• Able to tolerate necessary restorative procedures.
• Willing to sign the informed consent.
• Accepts the follow-up period.
• Posterior permanent tooth with occlusal proximal deep carious lesion.
• Radiographically (bitewing radiograph) extending to the inner 1/3 of dentine (D3) with a radiopaque layer between the carious lesion and the pulp chamber.
• Sensible teeth according to cold pulp test.

Exclusion criteria:

• Allergy to any restorative materials.
• Patients undergoing orthodontic treatment with fixed appliances.
• Pregnant women.
• Patients with debilitating systemic diseases
• Teeth with previous restorations.
• Spontaneous pain or prolonged pain (more than 15 s) after sensitivity test (cold test), which would indicate irreversible pulpitis.
• Negative sensibility tests, periapical radiolucencies and sensitivity to axial or lateral percussion.
• Mobile teeth, indicating periodontal disease or trauma.
• External or internal resorption.
• Cervical carious lesions.

Related Conditions & MeSH terms

• Caries; Dentin
• Deep Caries
• Dental Caries
• Dental Diseases
• Dental Restoration Failure of Marginal Integrity
• Stomatognathic Diseases
• Teeth; Lesion
• Tooth Decay
• Tooth Demineralization
• Tooth Diseases

Intervention

Other:
• selective caries removal and conventional non-bioactive restorative system
conventional dental restorative adhesive and resin based composite
• selective caries removal and bioactive restorative system
bioactive dental restorative resin based system

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Cairo University

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Biological properties - Post Operative Hypersensitivity and Vitality-Success rate%-Scoring system:Ordinal1-5	excellent(No hypersensitivity,normal vitality; good(Minor hypersensitivity for a limited time,normal vitality; satisfactory(Moderate hypersensitivity-Delayed/mild sensitivity;no subjective complaints,no treatment needed; unsatisfactory(Intense hypersensitivity-Delayed with minor subjective symptoms-No detectable sensitivity-Intervention necessary but not replacement; poor(Intense, acute pulpitis or non-vital tooth-Endodontic treatment is necessary and restoration replacement	18 months
Secondary	Functional properties - fracture&retention-marginal adaptation-Radiographic Examination"when applicable"-Scoring system Ordinal 1-5	excellent Frac&Ret:No fractures /Cracks Marginal Adaptation:Harmonious outline,no gaps,white or discolored lines Radiograph:No pathology,harmonious transition between restoration &Tooth; good Frac&Ret:Small hairline crack Marginal Adaptation:Marginal gap(<150 µm),white line-Small marginal fracture removable by polishing-Slight ditching,slight step/flashes,minor irregularities Radiograph:Acceptable material excess present-Positive/negative step present at margin <150 µm; satisfactory Fract and Ret:Two or more or larger hairline cracks and/or material chip fracture not affecting the marginal integrity or approximal contact Marginal Adaptation:Gap<250µm not removable-Several small marginal fractures-Major irregularities,ditching or flash,steps Radiograph:Marginal gap<250 µm-Negative steps visible<250 ?m-No adverse effects Noticed-Poor radiopacity of filling	18 months
Secondary	Biological properties (Recurrence of caries (CAR), erosion, abfraction- Scoring system Ordinal 1-5)	= excellent (No secondary or primary caries); = good (Small and localized 1.Demineralization 2. Erosion or 3. Abfraction); = satisfactory (Larger areas of 1.Demineralisation 2. Erosion or 3. Abrasion/abfraction, dentine not exposed) (Only preventive measures necessary); = unsatisfactory (Caries with cavitation and suspected undermining caries) (Erosion in Dentine) (Abrasion/abfraction in dentine) (Localized and accessible can be repaired).; = poor (Deep caries or exposed dentine that is not accessible for repair of restoration)	18 months
Secondary	Success or Failure	Binary Outcome Success (Score 1,2&3) Failure (Score 4 &5)	18 months