Tissue Characterization in Teeth Treated With a Regeneration Protocol

NCT ID: NCT00881907

Last Updated: 2016-02-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: EARLY_PHASE1
• Total Enrollment: 1 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-03-31
• Study Completion Date: 2014-03-31

Brief Summary

The purpose of the investigators study is to characterize the composition of the hard and soft tissues present in root canals of teeth previously diagnosed with necrotic pulps and incomplete root formation and treated with a triple antibiotic regeneration protocol. The investigators hypothesis is that treatment of teeth with necrotic pulps and immature apices with triple antibiotic paste will stimulate continued root formation by the deposition of dentin at the root apices. The primary outcome measure will be histological identification of mineralized tissue and adherent cells in the apical third of these teeth.

Detailed Description

'Regeneration' as referred to in this protocol refers to the stimulation of continued root formation by the deposition of apical tissues subsequent to disinfection of a necrotic root canal and its contents and creation of a scaffold upon which cells can proliferate. While the proposed treatment protocol is currently being used in clinical practice and has been shown to be successful in case reports and case series, the nature of the proliferating apical tissues remains unknown. Thus, this study is uniquely positioned to address a critical gap in knowledge in the regeneration of a functional pulp-dentin complex. Moreover, results obtained from pediatric cases may well provide the essential foundation of knowledge for endodontists to apply this knowledge to the more difficult situation of regenerating the pulp-dentin complex of the full mature permanent tooth.

Conditions

Pulp Necrosis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Group A

Group A subjects will be asked to attend a recall visit 2 months following completion of the treatment visits.

Group Type: EXPERIMENTAL

Triple Antibiotic Paste

Intervention Type: DRUG

ciprofloxacin, metronidazole \& minocycline mixed to a 1:1:1 powder used as a intracanal medicament for disinfection and cell proliferation.

Group B

Group B subjects will be asked to attend a recall visit at 4 months following completion of the treatment visits.

Group Type: EXPERIMENTAL

Triple Antibiotic Paste

Intervention Type: DRUG

ciprofloxacin, metronidazole \& minocycline mixed to a 1:1:1 powder used as a intracanal medicament for disinfection and cell proliferation.

Group C

Group C subjects will be asked to attend a recall visit at 6 months following completion of the treatment visits.

Group Type: EXPERIMENTAL

Triple Antibiotic Paste

Intervention Type: DRUG

ciprofloxacin, metronidazole \& minocycline mixed to a 1:1:1 powder used as a intracanal medicament for disinfection and cell proliferation.

Interventions

Triple Antibiotic Paste

ciprofloxacin, metronidazole \& minocycline mixed to a 1:1:1 powder used as a intracanal medicament for disinfection and cell proliferation.

Intervention Type: DRUG

Triple Antibiotic Paste

ciprofloxacin, metronidazole \& minocycline mixed to a 1:1:1 powder used as a intracanal medicament for disinfection and cell proliferation.

Intervention Type: DRUG

Triple Antibiotic Paste

ciprofloxacin, metronidazole \& minocycline mixed to a 1:1:1 powder used as a intracanal medicament for disinfection and cell proliferation.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Healthy volunteers ages 10-60 with a non-restorable (as determined by referring dentist), permanent tooth with a necrotic pulp and incomplete root development.
• Persons who seem to be cooperative with dental treatment and able to indicate willingness to obtain treatment and participate in the study and who are capable of verbally expressing dissent.
• Parents who express understanding of study treatments and consent to treatment for their child of the regenerative procedure.
• Healthy patients (ASA Class I or II physical status) with no systemic health problems that may interfere with healing and cell growth.

• Permanent tooth with necrotic pulp and immature root development, scheduled for extraction due to non-restorability.
• Clinically confirmed necrotic pulp that will be confirmed with common endodontic pulp vitality tests (No response to cold or electric pulp test).
• Clinically confirmed immature root development that will be assessed radiographically to confirm the non-restorability as diagnosed by the referring dentist.

Exclusion Criteria

• Parents and patients unable to give consent or express dissent.
• Patients who are unwilling to undergo the dental treatment.
• Patients affected by temporomandibular joint disorders.
• Patients affected by known orofacial pain disorders.
• Patients with ASA Class III or IV physical status (Immuno-compromised patients including patients who self-report that they are an HIV carrier, undergoing steroid therapy or chemotherapy, or those who self-report with genetic or systemic diseases that could result in reduced immune response).

• Teeth with vertical cracks that extend below the cemento-enamel junction.
• Teeth that cannot be isolated using a rubber dam.
• Teeth with non-odontogenic pathology.
• Teeth whose apices are fully developed, as determined radiographically and correlated with dental age of patient.

• Minimum Eligible Age: 10 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

The University of Texas Health Science Center at San Antonio

OTHER

Sponsor Role: lead

Responsible Party

Kenneth Hargreaves

Chair, Department of Endodontics

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kenneth M Hargreaves, DDS,PhD

Role: PRINCIPAL_INVESTIGATOR

University of Texas

Locations

University of Texas Health Science Center

San Antonio, Texas, United States

Countries

United States

Other Identifiers

HSC20090152H

Identifier Type: -

Identifier Source: org_study_id