Dental Caries Clinical Trial
Official title:
Clinical Study to Evaluate the Safety and Performance of the Calcivis System for Identifying Active Demineralization on Tooth Surfaces
This is a prospective, multi-centre clinical study to evaluate the safety and performance of
the Calcivis Caries Activity Imaging System. Dentists will identify tooth surfaces as either
sound (inactive) or unsound (active caries lesion present) according to ICDAS staging
(International Caries Detection and Assessment System). Images of the tooth surface will be
taken with the Calcivis System immediately before and after application of a disclosing
solution containing a bioluminescent protein. Presence or absence of elevated luminescence on
the images will indicate activity / inactivity of the presence or absence of active
demineralisation on the tooth surfaces.
The study will be deemed a success if there is 70% agreement and above between:
1. elevated luminescence and the presence of active caries as determined by the dentists,
and
2. absence of luminescence and the determination of a sound tooth surface by the dentists.
Dental caries (tooth decay) is a significant clinical and public health problem. The
development of caries lesions involves a net mineral loss of dental tissue, which can lead to
progressive loss of tooth structure and associated pain and disease. Detecting, assessing,
diagnosis and treating such lesions are core activities in dentistry. Currently the main
detection and diagnosis aids are visual inspection and the used of a probe, together with
X-ray images. Determination of the activity status of a lesion (how likely it is to progress)
is required to assess treatment needs. Currently methods are problematic and involve the
clinicians' subjective assessment and / or monitoring of lesions progression over a number of
visits.
A previous clinical study on the prototype of the Calcivis System has been conducted. The
results concluded that the Calcivis System was safe for use and the level of agreement
between elevated luminescence and areas of expected activity was above 70% and not due to
chance (NCT02098304).
This prospective, multi-centre clinical study has been designed to assess the safety and
performance of the Calcivis System. The device under evaluation comprises a hand-held
customized intra-oral camera which takes images of a lesion on a tooth surface immediately
before and after application of a disclosing solution which contains a bioluminescent
photo-protein. The photo-protein detects free calcium ions on the tooth surface and produces
a light signal if the caries lesion is active.
For the clinical study, patients identified by the Investigator from those attending routine
dental appointments, who meet all the inclusion and exclusion criteria will be approached to
discuss their possible participation in the study. Patients will be given a Patient
Information Sheet to read and time to consider their participation in the study. If they are
happy to participate they will attend for two Study Visits, 7 to 14 days apart. Written
informed consent will be taken before any study procedures are conducted. As children under
the age of 16 are included in this study, parent / guardian consent will be taken where
appropriate.
At study Visit 1, demographics, relevant medications and oral hygiene data will be collected.
The dentist will carry out an oral examination and the tooth / teeth identified as per
inclusion / exclusion criteria, will be cleaned with prophy paste, rinsed with tap water and
a 3-in-1 air / water spray before being air dried and staged as per ICDAS coding. Reference
intra-oral photographs will be taken of each tooth. The tooth / teeth surfaces will again be
air dried before imaging with the Calcivis System, immediately before and after application
of the disclosing solution. A maximum of one sound (unrestored, accessible, free smooth
surface of a canine or incisor, away from the gingival margin with no visible caries lesion)
and one unsound (erupting or erupted molar or premolar with a visible lesion deemed to be
active, in a plaque stagnation area) tooth will be imaged per patient. after imaging is
completed, patients rinse out with tap water. Adverse events will be collected throughout.
The dentist will then share the Calcivis images of the teeth with the patient. Post imaging
questionnaires will be completed by each patient at the end of Study Visit 1 and user
questionnaires completed by the dental team at the end of each Study Visit 1 day.
Patients will return for (Study Visit 2), 7 to 14 days after Visit 1, when a final oral
examination will take place. Any adverse events observed or volunteered by the patient will
be recorded.
The study images will be independently reviewed by another dentist, for agreement between
expected lesion activity / inactive teeth and the Calcivis System.
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