Dental Pulp Disease Clinical Trial
— RotaPulpOfficial title:
Comparison Between Manual and Rotatory Instrumentation Pulpectomy Treatments in Primary Mandibular Molars
In this study, the aim is to compare manual and rotatory pulpectomy techniques on 100 primary mandibular molars on children between the ages of 4 and 8 years. The plan is to conduct a randomized controlled trial with a 1:1 ratio for group allocation at a teaching university pediatric dentistry clinic between January 2021 and December 2021. Two manual systems, as well as two rotary systems, will be randomly assigned. The adult manual system used will be K-file and the adult rotary system will be K3. The pediatric manual system used in this study will be Kedo-SH, while the pediatric rotary system will be Kedo-S. The observed outcome measures in this study are the following: 1) instrumentation and filling time; 2) filling quality by radiographic evaluation; 3) postoperative pain levels using the visual analog scale at 12 and 24 hours; and 4) frequency of complications (e.g. fistulas, thinning of the mesiodistal walls, periapical or furcation radiolucency) after a 3-, 6-, 9-, and 12-month follow-up.
Status | Recruiting |
Enrollment | 100 |
Est. completion date | July 15, 2022 |
Est. primary completion date | December 15, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 4 Years to 8 Years |
Eligibility | Inclusion Criteria: 1. Patients between 4 to 8 years old. 2. Both genders. 3. Patients with an indication for pulpectomy for mandibular molars, based on the of Kuo and colleagues criteria (2006). 4. Patients requiring pulpectomy in posterior teeth. 5. Adequate dental structure of the crown. 6. Patients with a remnant structure of at least two-thirds of the root. 7. Patients with a medical file at the Pediatric Dentistry Clinic, Universidad Latinoamericana, Campus Valle. 8. Patients with signed informed consent. Exclusion Criteria: 1. Patients requiring pulpotomy, extraction, or pulp regeneration therapy. 2. Patients who are older than 9 years. 3. An unrestorable tooth. 4. Internal resorption in the roots visible on radiographs. 5. Teeth with mechanical or carious perforations of the floor of the pulp chamber. 6. Excessive pathologic root resorption involving more than a third of the root. 7. Excessive pathologic loss of bone support, with loss of the normal periodontal attachment. 8. Presence of a dentigerous or follicular cyst. 9. Periapical or interradicular lesion involving the crypt of the developing permanent successor. 10. Patients with the diagnosis of molar incisor hypomineralization (MIH). 11. Patient's whose legal guardian does not provide their informed consent to participate in this study. 12. Uncooperative patients. Elimination criteria a. Patients who do not complete the treatment or radiographic follow-up at least at a cut-off point. |
Country | Name | City | State |
---|---|---|---|
Mexico | Clínica de Odontopediatría | Mexico City |
Lead Sponsor | Collaborator |
---|---|
Universidad de Guanajuato | Universidad Latinoamericana, University Medical Center Groningen |
Mexico,
Aïem E, Joseph C, Garcia A, Smaïl-Faugeron V, Muller-Bolla M. Caries removal strategies for deep carious lesions in primary teeth: Systematic review. Int J Paediatr Dent. 2020 Jul;30(4):392-404. doi: 10.1111/ipd.12616. Epub 2020 Feb 18. — View Citation
Anusavice KJ. Present and future approaches for the control of caries. J Dent Educ. 2005 May;69(5):538-54. Review. — View Citation
Casas MJ, Kenny DJ, Johnston DH, Judd PL. Long-term outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Pediatr Dent. 2004 Jan-Feb;26(1):44-8. — View Citation
Crespo S, Cortes O, Garcia C, Perez L. Comparison between rotary and manual instrumentation in primary teeth. J Clin Pediatr Dent. 2008 Summer;32(4):295-8. — View Citation
Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol. 2017 Mar;44 Suppl 18:S94-S105. doi: 10.1111/jcpe.12677. Review. — View Citation
Fuks AB. Pulp therapy for the primary and young permanent dentitions. Dent Clin North Am. 2000 Jul;44(3):571-96, vii. Review. — View Citation
Fuks, A.B., Guelmann, M., Kupietzky, A. (2012). Current developments in pulp therapy for primary teeth. Endodontic Topics, 23, 50-72. https://doi.org/10.1111/etp.12003
Hecksher F, Vidigal B, Coelho P, Otoni D, Alvarenga C, Nunes E. Endodontic Treatment in Artificial Deciduous Teeth through Manual and Mechanical Instrumentation: A Pilot Study. Int J Clin Pediatr Dent. 2019 Jan-Feb;12(1):15-17. doi: 10.5005/jp-journals-10 — View Citation
Kaur, R., Singh, R., Sethi, K., Garg, S., Miglani, S. (2014). Review article irrigating solutions in Pediatric Dentistry: literature review and update. J Adv Med Dent Sci, 2, 104- 115.
Kher, M.S., Rao, A. Pulp therapy in primary teeth. Clin Dent Rev 4, 16 (2020). https://doi.org/10.1007/s41894-020-00081-z
Lopes-Fatturi, Aluhê, Souza, Juliana Feltrin de, Menezes, José Vitor Nogara Borges, Fraiz, Fabian Calixto, & Assunção, Luciana Reichert da Silva. (2020). A Survival Analysis of Different Pulp Therapies in Decayed Primary Teeth. Pesquisa Brasileira em Odon
Manchanda S, Sardana D, Yiu CKY. A systematic review and meta-analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. Int Endod J. 2020 Mar;53(3):333-353. doi: 10.11 — View Citation
Muller-Bolla M, Garcia A, Aïem E, Doméjean S. Dentists' decisions for deep carious lesions management in primary teeth. Int J Paediatr Dent. 2020 Sep;30(5):578-586. doi: 10.1111/ipd.12639. Epub 2020 Apr 7. — View Citation
Ochoa-Romero T, Mendez-Gonzalez V, Flores-Reyes H, Pozos-Guillen AJ. Comparison between rotary and manual techniques on duration of instrumentation and obturation times in primary teeth. J Clin Pediatr Dent. 2011 Summer;35(4):359-63. — View Citation
Panchal V, Jeevanandan G, Erulappan SM. Comparison between the Effectiveness of Rotary and Manual Instrumentation in Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent. 2019 Jul-Aug;12(4):340-346. doi: 10.5005/jp-journals-10005-1637. Review. — View Citation
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005 Sep;83(9):661-9. Epub 2005 Sep 30. — View Citation
Pozos-Guillen A, Garcia-Flores A, Esparza-Villalpando V, Garrocho-Rangel A. Intracanal irrigants for pulpectomy in primary teeth: a systematic review and meta-analysis. Int J Paediatr Dent. 2016 Nov;26(6):412-425. doi: 10.1111/ipd.12228. Epub 2016 Feb 22. — View Citation
Pulp Therapy for Primary and Immature Permanent Teeth. Pediatr Dent. 2017 Sep 15;39(6):325-333. — View Citation
Rawson TH, Rayes S, Strizich G, Salazar CR. Longitudinal Study Comparing Pulpectomy and Pulpotomy Treatments for Primary Molars of Alaska Native Children. Pediatr Dent. 2019 May 15;41(3):214-220. — View Citation
Taylor GD, Vernazza CR, Abdulmohsen B. Success of endodontic management of compromised first permanent molars in children: A systematic review. Int J Paediatr Dent. 2020 May;30(3):370-380. doi: 10.1111/ipd.12599. Epub 2019 Dec 13. — View Citation
Young DA, Nový BB, Zeller GG, Hale R, Hart TC, Truelove EL; American Dental Association Council on Scientific Affairs; American Dental Association Council on Scientific Affairs. The American Dental Association Caries Classification System for clinical pra — View Citation
* Note: There are 21 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Instrumentation time | The time needed to shape the root canal. | Minutes; intraoperative time. | |
Primary | Obturation time | Time needed to obturate the root canals. | Minutes, intraoperative time. | |
Primary | Filling quality | Radiographic evaluation of the root canal filling. | Immediately after surgical procedure. | |
Primary | Postoperative pain | Pain resulting from the surgical procedure, evaluated with the visual analog pain scale (range, 1 to 10; the higher the score the worst the outcome). | 12 hours | |
Primary | Postoperative pain | Pain resulting from the surgical procedure, evaluated with the visual analog pain scale (range, 1 to 10; the higher the score the worst the outcome). | 24 hours | |
Secondary | Complications secondary to procedure | Frequency of fistulas, thinning of the mesiodistal walls, periapical or furcation radiolucency, among other possible complications | 3-months | |
Secondary | Complications secondary to procedure | Frequency of fistulas, thinning of the mesiodistal walls, periapical or furcation radiolucency, among other possible complications | 6-months | |
Secondary | Complications secondary to procedure | Frequency of fistulas, thinning of the mesiodistal walls, periapical or furcation radiolucency, among other possible complications | 9-months | |
Secondary | Complications secondary to procedure | Frequency of fistulas, thinning of the mesiodistal walls, periapical or furcation radiolucency, among other possible complications | 12-months |
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