Medical Management of Caries in the Primary Dentition Using Silver Nitrate

NCT ID: NCT02604134

Last Updated: 2019-07-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

EARLY_PHASE1

Total Enrollment

122 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-31

Study Completion Date

2018-08-21

Brief Summary

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This pilot trial compares conventional restorations with a new strategy based on the medical management of caries using silver nitrate and fluoride varnish with no restorations.

Detailed Description

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This is a two-arm, parallel group, patient-randomized controlled pilot trial. Children with at least one primary tooth where caries extends into dentine. Children will be randomized and treated according to one of two treatment approaches;(1) conventional caries management with best practice prevention, or (2) medical management of caries using silver nitrate with best practice prevention.

Baseline measures and outcome data (at treatment/review during two year follow-up) are assessed through direct reporting, clinical examination including blinded radiographic assessment, and child/parent questionnaires.

Conditions

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Dental Caries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
the radiographic progression of caries is assessed by a masked investigator

Study Groups

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conventional treatment group

The child will receive a prophylaxis and fluoride varnish. Parents will fill out a parent and a child questionnaire.

Group Type OTHER

Prophylaxis

Intervention Type PROCEDURE

A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.

Fluoride varnish

Intervention Type DRUG

Fluoride varnish is a highly concentrated form of fluoride which is applied to the tooth's surface, by a dentist, dental hygienist or other health care professional, as a type of topical fluoride therapy.

Silver Nitrate group

The child will receive a prophylaxis, then silver nitrate and then fluoride varnish. Parents will fill out a parent and a child questionnaire.

Group Type OTHER

Prophylaxis

Intervention Type PROCEDURE

A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.

Fluoride varnish

Intervention Type DRUG

Fluoride varnish is a highly concentrated form of fluoride which is applied to the tooth's surface, by a dentist, dental hygienist or other health care professional, as a type of topical fluoride therapy.

Silver Nitrate

Intervention Type DRUG

a small amount will be applied to the tooth via a cotton applicator. Silver nitrate is a colorless, odorless, transparent solution used as an escharotic, dehydrating and sclerosing agent.

Interventions

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Prophylaxis

A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.

Intervention Type PROCEDURE

Fluoride varnish

Fluoride varnish is a highly concentrated form of fluoride which is applied to the tooth's surface, by a dentist, dental hygienist or other health care professional, as a type of topical fluoride therapy.

Intervention Type DRUG

Silver Nitrate

a small amount will be applied to the tooth via a cotton applicator. Silver nitrate is a colorless, odorless, transparent solution used as an escharotic, dehydrating and sclerosing agent.

Intervention Type DRUG

Other Intervention Names

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Prophy Fluoride

Eligibility Criteria

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Inclusion Criteria

* Presense of one or more cavitated carious lesions in the primary dentition, extending into dentin but not encroaching on the pulp.
* Absense of any spontaneous or elicited pain due to caries, or signs of pulpal infection in response to any of the carious lesions in the primary dentition to be included in the study

Exclusion Criteria

* Hereditary developmental defects of the teeth such as Amelogenesis Imperfecta and Dentinogenesis Imperfecta
* Medical conditions that prevent treatment of the child in the outpatient clinic. These conditions include severe bleeding disorders, cardiac problems and mental disabilities that prevent child from communication with the research team.
* Known allergy/sensitivity to any of the dental materials.
Minimum Eligible Age

2 Years

Maximum Eligible Age

11 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Delta Dental of Iowa

OTHER

Sponsor Role collaborator

Arwa Owais

OTHER

Sponsor Role lead

Responsible Party

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Arwa Owais

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Arwa I Owais, BDS, MS

Role: PRINCIPAL_INVESTIGATOR

Associate Profesor in Pediatric Dentistry

MIchael Kanellis, DDS, MS

Role: PRINCIPAL_INVESTIGATOR

Professor in Pediatric Dentistry & Dean for Patient Cares

Locations

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UIowa

Iowa City, Iowa, United States

Site Status

Countries

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United States

References

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Duffin S. Back to the future: the medical management of caries introduction. J Calif Dent Assoc. 2012 Nov;40(11):852-8.

Reference Type BACKGROUND
PMID: 23270129 (View on PubMed)

Klein U, Kanellis MJ, Drake D. Effects of four anticaries agents on lesion depth progression in an in vitro caries model. Pediatr Dent. 1999 May-Jun;21(3):176-80.

Reference Type BACKGROUND
PMID: 10355008 (View on PubMed)

Peng JJ, Botelho MG, Matinlinna JP. Silver compounds used in dentistry for caries management: a review. J Dent. 2012 Jul;40(7):531-41. doi: 10.1016/j.jdent.2012.03.009. Epub 2012 Apr 3.

Reference Type BACKGROUND
PMID: 22484380 (View on PubMed)

Schwendicke F, Stolpe M, Innes N. Conventional treatment, Hall Technique or immediate pulpotomy for carious primary molars: a cost-effectiveness analysis. Int Endod J. 2016 Sep;49(9):817-826. doi: 10.1111/iej.12537. Epub 2015 Sep 19.

Reference Type BACKGROUND
PMID: 26331379 (View on PubMed)

Innes NP, Stewart M. The Hall Technique, a Simplified Method for Placing Stainless Steel Crowns on Primary Molars, may be as Successful as Traditionally Placed Crowns. J Evid Based Dent Pract. 2015 Jun;15(2):70-2. doi: 10.1016/j.jebdp.2015.03.008. Epub 2015 Mar 28. No abstract available.

Reference Type BACKGROUND
PMID: 25987388 (View on PubMed)

Keightley A, Clarkson J, Maguire A, Speed C, Innes N. Participant recruitment to FiCTION, a primary dental care trial - survey of facilitators and barriers. Br Dent J. 2014 Nov;217(10):E22. doi: 10.1038/sj.bdj.2014.1009.

Reference Type BACKGROUND
PMID: 25415040 (View on PubMed)

Santamaria R, Innes N. Trial shows partial caries removal is an effective technique in primary molars. Evid Based Dent. 2014 Sep;15(3):81-2. doi: 10.1038/sj.ebd.6401044.

Reference Type BACKGROUND
PMID: 25343394 (View on PubMed)

Santamaria RM, Innes NP, Machiulskiene V, Evans DJ, Splieth CH. Caries management strategies for primary molars: 1-yr randomized control trial results. J Dent Res. 2014 Nov;93(11):1062-9. doi: 10.1177/0022034514550717. Epub 2014 Sep 12.

Reference Type BACKGROUND
PMID: 25216660 (View on PubMed)

Lamont T, Schwendicke F, Innes N. Why we need a core outcome set for trials of interventions for prevention and management of caries. Evid Based Dent. 2015 Sep;16(3):66-8. doi: 10.1038/sj.ebd.6401109. No abstract available.

Reference Type RESULT
PMID: 26492796 (View on PubMed)

Schwendicke F, Lamont T, Innes N. Outcomes in Trials for Management of Caries Lesions (OuTMaC): protocol. Trials. 2015 Sep 7;16:397. doi: 10.1186/s13063-015-0927-3.

Reference Type RESULT
PMID: 26346538 (View on PubMed)

Other Identifiers

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201406792

Identifier Type: -

Identifier Source: org_study_id

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