Glass Ionomer Cement Sealant in the Prevention of Post-eruptive Fractures in Molars Affected by MIH

NCT ID: NCT03870958

Last Updated: 2020-09-16

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

195 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-20

Study Completion Date

2021-12-20

Brief Summary

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This trial will compare the application of Glass Ionomer Cement (GIC) sealant with no-intervention for the most clinically- and cost-effective strategy for managing MIH molars without post-eruptive breakdown, in a school setting, using low-technology and child-friendly dental techniques. Methods/Design: This two-arm, parallel group, patient-randomized controlled, superiority trial will have treatment provided in schools. Schoolchildren (age 6-9), presenting at least one MIH molar (n molars = 195,) will have random allocation to treatment with or without the application of a GIC sealant (GC Fuji TRIAGE®, GC Europe, Leuven, Belgium). Baseline measures and outcome data will be assessed through participant report and clinical examination. The primary outcome is the presence of post-eruptive fracture and development of caries lesions. Secondary outcomes are: (1) self-reported dental hypersensitivity; (2) oral health-related-quality of life, reported by children; (3) plaque index, (4) gingival health, (5) caries status (according to ICCMS scores) in primary and permanent teeth; (6) the incremental cost-effectiveness. A trained and calibrated examiner will evaluate the treated teeth every six months post treatment for a period of 36 months. Kaplan-Meier and Cox regression tests will be used to investigate the primary outcome. The Logistic Regression and Poisson Regression Analysis will be used to analyze the secondary outcomes (α=5%).

Detailed Description

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Background: Molar-Incisor Hypomineralisation (MIH) is defined as a qualitative defect that occurs during the mineralization phase of enamel of at least one first permanent molar. The opacities vary in size and color and are demarcated by healthy enamel. MIH molars present lower mechanical properties when compared to non-affected molars, due to the enamel's decreased mineralization. Allied to that, patients often report dental hypersensitivity, which impairs the mechanical removal of dental plaque; therefore, those molars are more prone to post-eruptive fractures and present higher risk of developing dental caries. This trial will compare the application of Glass Ionomer Cement (GIC) sealant with no-intervention for the most clinically- and cost-effective strategy for managing MIH molars without post-eruptive breakdown, in a school setting, using low-technology and child-friendly dental techniques. Methods/Design: This two-arm, parallel group, patient-randomized controlled, superiority trial will have treatment provided in schools. Schoolchildren (age 6-9), presenting at least one MIH molar (n molars = 195,) will have random allocation to treatment with or without the application of a GIC sealant (GC Fuji TRIAGE®, GC Europe, Leuven, Belgium). Baseline measures and outcome data will be assessed through participant report and clinical examination. The primary outcome is the presence of post-eruptive fracture and development of caries lesions. Secondary outcomes are: (1) self-reported dental hypersensitivity; (2) oral health-related-quality of life, reported by children; (3) plaque index, (4) gingival health, (5) caries status (according to ICCMS scores) in primary and permanent teeth; (6) the incremental cost-effectiveness. A trained and calibrated examiner will evaluate the treated teeth every six months post treatment for a period of 36 months. Kaplan-Meier and Cox regression tests will be used to investigate the primary outcome. The Logistic Regression and Poisson Regression Analysis will be used to analyze the secondary outcomes (α=5%).

Conditions

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Molar Incisor Hypomineralization

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This two-arm, parallel group, patient-randomized controlled, superiority trial will have treatment provided in schools. Schoolchildren (age 6-9), presenting at least one MIH molar (n molars = 195,) will have random allocation to treatment with or without the application of a GIC sealant (GC Fuji TRIAGE®, GC Europe, Leuven, Belgium).
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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GIC sealant (GC Fuji TRIAGE®)

Children allocated to this group will receive the same dietary advices and brushing instructions. Additionally, all MIH molars from will receive a GIC sealant (GC Fuji TRIAGE®, GC Europe, Leuven, Belgium).

Group Type EXPERIMENTAL

GIC sealant (GC Fuji TRIAGE®)

Intervention Type PROCEDURE

Children allocated to this group will receive the same dietary advices and brushing instructions. Additionally, all MIH molars from will receive a GIC sealant (GC Fuji TRIAGE®, GC Europe, Leuven, Belgium).

Control

Children allocated to this group will receive the same dietary advices and brushing instructions described in the control arm.

Group Type ACTIVE_COMPARATOR

Control

Intervention Type PROCEDURE

Children allocated to this group will receive the same dietary advices and brushing instructions.

Interventions

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GIC sealant (GC Fuji TRIAGE®)

Children allocated to this group will receive the same dietary advices and brushing instructions. Additionally, all MIH molars from will receive a GIC sealant (GC Fuji TRIAGE®, GC Europe, Leuven, Belgium).

Intervention Type PROCEDURE

Control

Children allocated to this group will receive the same dietary advices and brushing instructions.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* children whose parents or legal guardians accept and sign the informed consent form; -children who assent to participate into the research;
* aged between 6 and 9 years;
* exhibiting good general health conditions and cooperative behavior;
* presenting at least one MIH molar.

Exclusion Criteria

* children presenting health conditions that impair the dental treatment, or children undergoing orthodontic treatment;
* MIH molars that present opacities not located on the occlusal surface, with post-eruptive breakdown, with the occlusal surface totally or partial covered by a gingival operculum, with caries dentine lesion (ICCMS score C), restorations or sealants.
Minimum Eligible Age

6 Years

Maximum Eligible Age

9 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Isabel Cristina Olegário da Costa

OTHER

Sponsor Role lead

University of Guadalajara

OTHER

Sponsor Role collaborator

University of Dublin, Trinity College

OTHER

Sponsor Role collaborator

Academic Centre for Dentistry in Amsterdam

OTHER

Sponsor Role collaborator

Responsible Party

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Isabel Cristina Olegário da Costa

PhD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Daniela Hesse, Professor

Role: STUDY_CHAIR

Academic Centre for Dentistry in Amsterdam

Isaac M Pedroza Uribe, MSc

Role: PRINCIPAL_INVESTIGATOR

University of Guadalajara

Locations

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Isaac Murisi Pedroza

Guadalajara, Jalisco, Mexico

Site Status

Countries

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Mexico

References

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Ghanim A, Marino R, Manton DJ. Validity and reproducibility testing of the Molar Incisor Hypomineralisation (MIH) Index. Int J Paediatr Dent. 2019 Jan;29(1):6-13. doi: 10.1111/ipd.12433. Epub 2018 Oct 22.

Reference Type BACKGROUND
PMID: 30350324 (View on PubMed)

Folayan MO, Chukwumah NM, Popoola BO, Temilola DO, Onyejaka NK, Oyedele TA, Lawal FB. Developmental defects of the enamel and its impact on the oral health quality of life of children resident in Southwest Nigeria. BMC Oral Health. 2018 Sep 27;18(1):160. doi: 10.1186/s12903-018-0622-3.

Reference Type BACKGROUND
PMID: 30261858 (View on PubMed)

Ebel M, Bekes K, Klode C, Hirsch C. The severity and degree of hypomineralisation in teeth and its influence on oral hygiene and caries prevalence in children. Int J Paediatr Dent. 2018 Nov;28(6):648-657. doi: 10.1111/ipd.12425. Epub 2018 Sep 23.

Reference Type BACKGROUND
PMID: 30246468 (View on PubMed)

Velandia LM, Alvarez LV, Mejia LP, Rodriguez MJ. Oral health-related quality of life in Colombian children with Molar-Incisor Hypomineralization. Acta Odontol Latinoam. 2018 Jun;31(1):38-44.

Reference Type BACKGROUND
PMID: 30056465 (View on PubMed)

Fragelli CMB, Souza JF, Bussaneli DG, Jeremias F, Santos-Pinto LD, Cordeiro RCL. Survival of sealants in molars affected by molar-incisor hypomineralization: 18-month follow-up. Braz Oral Res. 2017 Apr 27;31:e30. doi: 10.1590/1807-3107BOR-2017.vol31.0030.

Reference Type BACKGROUND
PMID: 28489117 (View on PubMed)

Schraverus MS, Olegario IC, Bonifacio CC, Gonzalez APR, Pedroza M, Hesse D. Glass Ionomer Sealants Can Prevent Dental Caries but Cannot Prevent Posteruptive Breakdown on Molars Affected by Molar Incisor Hypomineralization: One-Year Results of a Randomized Clinical Trial. Caries Res. 2021;55(4):301-309. doi: 10.1159/000516266. Epub 2021 Jun 9.

Reference Type DERIVED
PMID: 34107492 (View on PubMed)

Other Identifiers

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MIHMex

Identifier Type: -

Identifier Source: org_study_id

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