Root Caries Excavation with Air Water/powder Prophylaxis Device for ART Restorations

NCT ID: NCT04822246

Last Updated: 2024-12-06

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-30

Study Completion Date

2025-12-31

Brief Summary

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The main objective of this RCT is to compare the efficacy of a powder/water jet prophylaxis device and conventional hand excavation in excavating root surface caries, with regard to restoration survival/success in older adults.

The secondary outcome of this RCT is to assess the participants' treatment preferences for the received treatment with regard to the procedures involved and in the invasiveness of the procedures carried out during the ART restoration.

Detailed Description

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Conditions

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Dental Caries Extending Into Dentin Root Caries

Keywords

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Root caries Elders Atraumatic restorative treatment Glass-ionomer cement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Single-blind, RCT
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Control: Hand instrumentation for caries excavation

Hand instrumentation for caries excavation

Group Type OTHER

Control: Hand instrumentation for caries excavation

Intervention Type PROCEDURE

An enamel hatchet will be used to create access to the carious lesion and then removal of soft carious tissue will be undertaken with excavators. Excavation will be stopped when some resistance to excavation will be felt and the cavity will be then conditioned with polyacrylic acid for 20 s, washed and dried with cotton pellets. A high-viscosity glass-ionomer cement will be used to restore the cavity. Moisture control will be achieved with the use of cotton wool rolls. A chair-side assistant will hand-mix the glass-ionomer according to manufacturers' instructions and it will be placed in the cavity using the "press-finger" technique whenever the type of cavity allows it. In the case of root restorations, a glove coated with petroleum jelly will be used similarly to the "press-finger" technique to better condense the material into the cavity. Excess material will be removed; the restoration will be coated with petroleum jelly. No local anaesthetic will be used to provide ART treatment.

Intervention 1: EMS Airflow device for caries excavation

Powder/water jet prophylaxis device (EMS Airflow) for caries excavation

Group Type EXPERIMENTAL

Intervention 1: EMS Airflow device for caries excavation

Intervention Type PROCEDURE

An enamel hatchet will first be used to gain access into the cavity. Then the powder-water prophylaxis device will be used for the removal of soft carious tissue with the sodium bicarbonate powder-water jet. Excavation will be stopped when the colour of the lesion begins to darken and all the soft deposits are evacuated. The excavation will be done intermittently allowing sufficient time to check with hand instrument the surface hardness of the lesion. If the lesion is still soft excavation will be continued until the surface is hard suitable for restoring. The cavity will be then rinsed with copious water spray to evacuate all the powder-water material. The restoration procedure with a glass-ionomer cement will be done following the same procedures as in the control group.

Intervention 2: Hand excavation + EMS Airflow device for caries excavation

Hand excavation and Powder/ jet prophylaxis device (EMS Airflow) for caries excavation

Group Type EXPERIMENTAL

Intervention 2: Hand excavation + EMS Airflow device for caries excavation

Intervention Type PROCEDURE

The participants allocated to this group will have the caries excavated as described for the control group. Then prior to filling the excavated cavity, the procedure of sodium bicarbonate powder-water jet irrigation as described for the intervention group #1 will be performed to condition the prepared excavated cavity. Then the restorative procedure will be completed with the restorative material and procedures as described for the previous groups.

Interventions

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Control: Hand instrumentation for caries excavation

An enamel hatchet will be used to create access to the carious lesion and then removal of soft carious tissue will be undertaken with excavators. Excavation will be stopped when some resistance to excavation will be felt and the cavity will be then conditioned with polyacrylic acid for 20 s, washed and dried with cotton pellets. A high-viscosity glass-ionomer cement will be used to restore the cavity. Moisture control will be achieved with the use of cotton wool rolls. A chair-side assistant will hand-mix the glass-ionomer according to manufacturers' instructions and it will be placed in the cavity using the "press-finger" technique whenever the type of cavity allows it. In the case of root restorations, a glove coated with petroleum jelly will be used similarly to the "press-finger" technique to better condense the material into the cavity. Excess material will be removed; the restoration will be coated with petroleum jelly. No local anaesthetic will be used to provide ART treatment.

Intervention Type PROCEDURE

Intervention 1: EMS Airflow device for caries excavation

An enamel hatchet will first be used to gain access into the cavity. Then the powder-water prophylaxis device will be used for the removal of soft carious tissue with the sodium bicarbonate powder-water jet. Excavation will be stopped when the colour of the lesion begins to darken and all the soft deposits are evacuated. The excavation will be done intermittently allowing sufficient time to check with hand instrument the surface hardness of the lesion. If the lesion is still soft excavation will be continued until the surface is hard suitable for restoring. The cavity will be then rinsed with copious water spray to evacuate all the powder-water material. The restoration procedure with a glass-ionomer cement will be done following the same procedures as in the control group.

Intervention Type PROCEDURE

Intervention 2: Hand excavation + EMS Airflow device for caries excavation

The participants allocated to this group will have the caries excavated as described for the control group. Then prior to filling the excavated cavity, the procedure of sodium bicarbonate powder-water jet irrigation as described for the intervention group #1 will be performed to condition the prepared excavated cavity. Then the restorative procedure will be completed with the restorative material and procedures as described for the previous groups.

Intervention Type PROCEDURE

Other Intervention Names

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Hand instrumentation for caries excavation Powder/water jet prophylaxis device (EMS Airflow) for caries excavation Hand excavation and Powder/ jet prophylaxis device (EMS Airflow) for caries excavation

Eligibility Criteria

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Inclusion Criteria

* Adults ≥65 years
* Dentinal root caries lesions with no painful symptomology
* Can follow instructions for oral hygiene
* Not dependent for care for their ADLs.

Exclusion Criteria

* Symptomatic carious teeth
* Non-carious attrition, erosion or abrasion cavities
* Periodontally compromised teeth with Grade 3 mobility, and active signs of infections.
* Not willing or able to sign informed consent

Post-hoc exclusion:

* Participant withdraws consent
* Medical reasons.
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Murali Srinivasan, Dr. med. dent., BDS, MDS, MBA, MAS

OTHER

Sponsor Role lead

Responsible Party

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Murali Srinivasan, Dr. med. dent., BDS, MDS, MBA, MAS

Prof.

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Clinic of General, Special care, and Geriatric Dentistry, Center for Dental Medicine, University of Zurich

Zurich, , Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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UZH_ABS_2021_4

Identifier Type: -

Identifier Source: org_study_id