Cell-free Autologous Regenerative Endodontics Treatment for Teeth With Periapical Lesions (CARETT)

NCT ID: NCT05305417

Last Updated: 2022-03-31

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

228 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-31

Study Completion Date

2025-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Conventional endodontic treatment has been the treatment of choice for the management of signs and symptoms of mature permanent teeth with pulpal necrosis and periapical lesion with predictable and favorable results. However, treatment outcomes have not shown improvement or innovation in decades. The main objective of this study is to evaluate the clinical effectiveness of a regenerative endodontic procedure (cell-free and autologous protocol) versus conventional endodontics in the resolution of signs and symptoms of periapical lesion and pulp vitality-sensitivity in mature permanent teeth with a diagnosis of pulpal necrosis and periapical lesion.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conventional endodontic treatment has been an effective treatment option for decades to treat signs and symptoms in mature permanent teeth with a diagnosis of apical lesion due to pulpal necrosis, allowing the teeth to be kept in the mouth free of signs/symptoms but devitalized. The clinical effectiveness of conventional treatment in this type of case is ≥80%, with some variations according to different studies. Despite advances and modifications in treatment protocols, this therapy has not shown improvements or innovations in its results in recent decades. The Regenerative Endodontics alternative is postulated as a biologically based endodontic treatment option that allows to resolve the signs and symptoms along with dental revitalization through the regeneration of the pulpal connective tissue, generating a substantive possibility of innovation and improvements to the therapy of conventional endodontics.

Various regenerative endodontic protocols have been proposed to achieve pulp tissue regeneration, from sophisticated techniques that involve cell transplantation, provision of scaffolds and/or signaling molecules, or simpler protocols that appeal to the autologous capacity of the organism to regenerate tissue. lost.

The main objective of this study is to evaluate the clinical effectiveness of a cell-free regenerative endodontic procedure with the contribution of an autologous scaffold (L-PRF) versus conventional endodontics in the recovery of signs of periapical lesion and pulp vitality-sensitivity in mature permanent teeth with diagnosis of pulpal necrosis and periapical lesion.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Periapical Diseases Pulp Necroses

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Regenerative Endodontics Permanent Dentition Pulp Necroses Periapical Diseases Root Canal Filling Material

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Participants don´t know wich intervention receive Investigator (outcome evaluator) don´t know wich intervention evaluate Outcomes Assessor (statistics) don´t know wich arm data evaluate

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Regenerative Endodontic Treatment

This treatment consists of obturated the root canal preparations under an biological-based protocol using autologous biological elements and bioactive materials that allows restore the connective pulp-like tissue within the canals.

Group Type EXPERIMENTAL

Autologous Regenerative Endodontic Treatment

Intervention Type PROCEDURE

The intervention consist in achieve an access to the teeth root canal system, do a chemico-mechanical preparation each root canal for to be obturated with an autologous biological scaffold and bioactive biomaterials to maintain teeth free of signs/symptoms caused by pulp necroses and periapical lesions

Conventional root canal treatment

This treatment consist on obturated the root canal preparations under the conventional protocol with an inert biomaterials like guttapercha and endodontics cements to seal the root canals.

Group Type ACTIVE_COMPARATOR

Conventional Root Canal Treatment

Intervention Type PROCEDURE

The intervention consist in achieve an access to the teeth root canal system, do a chemico-mechanical preparation each root canal for to be obturated with an inert biomaterial to maintain teeth free of signs/symptoms caused by pulp necroses and periapical lesions

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Autologous Regenerative Endodontic Treatment

The intervention consist in achieve an access to the teeth root canal system, do a chemico-mechanical preparation each root canal for to be obturated with an autologous biological scaffold and bioactive biomaterials to maintain teeth free of signs/symptoms caused by pulp necroses and periapical lesions

Intervention Type PROCEDURE

Conventional Root Canal Treatment

The intervention consist in achieve an access to the teeth root canal system, do a chemico-mechanical preparation each root canal for to be obturated with an inert biomaterial to maintain teeth free of signs/symptoms caused by pulp necroses and periapical lesions

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Pulp revascularization Pulp revitalization Pulp regeneration Endodontically-treated Teeth

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Male or female (18-60y) systemically healthy or chronic disease controlled
* Uniradicular or multiradicular permanent mature teeth
* Teeth with diagnosis of pulp necrosis (negative response to thermal-cold pulp test) and sings or symptoms (clinical-radiographic) of periapical lesion.
* Root anatomy with curvatures ≤ 30°
* Feasibility of adhesive tooth restoration (direct or indirect)
* Voluntary participation under informed consent

Exclusion Criteria

* Pregnant or lactating woman
* Signs of moderate or severe periodontal disease
* Teeth with signs of radicular fracture (vertical or horizontal), signs of root resorption (endo-exo)
* teeth with impossibility of good prognosis of coronary rehabilitation by direct or indirect adhesive technique
* Teeth that to treat can not to be correctly isolate with rubber dam
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Universidad de Valparaiso

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Alicia Caro, MSC, DDS

Role: STUDY_DIRECTOR

Department of Endodontics, Faculty of Dentistry, University of Valparaíso, Chile.

Juan Caro, DDS

Role: PRINCIPAL_INVESTIGATOR

Department of Endodontics, Faculty of Dentistry, University of Valparaíso, Chile.

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Juan Caro, DDS

Role: CONTACT

Phone: +56975242484

Email: [email protected]

References

Explore related publications, articles, or registry entries linked to this study.

Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN. Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Endod. 2021 Jun;47(6):873-882. doi: 10.1016/j.joen.2021.03.015. Epub 2021 Mar 31.

Reference Type BACKGROUND
PMID: 33811981 (View on PubMed)

Marquis VL, Dao T, Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto Study. Phase III: initial treatment. J Endod. 2006 Apr;32(4):299-306. doi: 10.1016/j.joen.2005.10.050.

Reference Type BACKGROUND
PMID: 16554199 (View on PubMed)

Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod. 2003 Dec;29(12):787-93. doi: 10.1097/00004770-200312000-00001.

Reference Type BACKGROUND
PMID: 14686806 (View on PubMed)

Farzaneh M, Abitbol S, Lawrence HP, Friedman S; Toronto Study. Treatment outcome in endodontics-the Toronto Study. Phase II: initial treatment. J Endod. 2004 May;30(5):302-9. doi: 10.1097/00004770-200405000-00002.

Reference Type BACKGROUND
PMID: 15107640 (View on PubMed)

Moazami F, Sahebi S, Sobhnamayan F, Alipour A. Success rate of nonsurgical endodontic treatment of nonvital teeth with variable periradicular lesions. Iran Endod J. 2011 Summer;6(3):119-24. Epub 2011 Aug 15.

Reference Type BACKGROUND
PMID: 23130063 (View on PubMed)

Paredes-Vieyra J, Enriquez FJ. Success rate of single- versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial. J Endod. 2012 Sep;38(9):1164-9. doi: 10.1016/j.joen.2012.05.021. Epub 2012 Jul 26.

Reference Type BACKGROUND
PMID: 22892729 (View on PubMed)

Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature -- Part 2. Influence of clinical factors. Int Endod J. 2008 Jan;41(1):6-31. doi: 10.1111/j.1365-2591.2007.01323.x. Epub 2007 Oct 10.

Reference Type BACKGROUND
PMID: 17931388 (View on PubMed)

Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature - part 1. Effects of study characteristics on probability of success. Int Endod J. 2007 Dec;40(12):921-39. doi: 10.1111/j.1365-2591.2007.01322.x. Epub 2007 Oct 10.

Reference Type BACKGROUND
PMID: 17931389 (View on PubMed)

Diogenes A, Ruparel NB. Regenerative Endodontic Procedures: Clinical Outcomes. Dent Clin North Am. 2017 Jan;61(1):111-125. doi: 10.1016/j.cden.2016.08.004.

Reference Type BACKGROUND
PMID: 27912813 (View on PubMed)

Widbiller M, Eidt A, Lindner SR, Hiller KA, Schweikl H, Buchalla W, Galler KM. Dentine matrix proteins: isolation and effects on human pulp cells. Int Endod J. 2018 May;51 Suppl 4:e278-e290. doi: 10.1111/iej.12754. Epub 2017 Mar 14.

Reference Type BACKGROUND
PMID: 28211068 (View on PubMed)

Galler KM, Buchalla W, Hiller KA, Federlin M, Eidt A, Schiefersteiner M, Schmalz G. Influence of root canal disinfectants on growth factor release from dentin. J Endod. 2015 Mar;41(3):363-8. doi: 10.1016/j.joen.2014.11.021. Epub 2015 Jan 13.

Reference Type BACKGROUND
PMID: 25595468 (View on PubMed)

Galler KM, D'Souza RN, Federlin M, Cavender AC, Hartgerink JD, Hecker S, Schmalz G. Dentin conditioning codetermines cell fate in regenerative endodontics. J Endod. 2011 Nov;37(11):1536-41. doi: 10.1016/j.joen.2011.08.027.

Reference Type BACKGROUND
PMID: 22000458 (View on PubMed)

Smith AJ, Scheven BA, Takahashi Y, Ferracane JL, Shelton RM, Cooper PR. Dentine as a bioactive extracellular matrix. Arch Oral Biol. 2012 Feb;57(2):109-21. doi: 10.1016/j.archoralbio.2011.07.008.

Reference Type BACKGROUND
PMID: 21855856 (View on PubMed)

Galler KM. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J. 2016 Oct;49(10):926-36. doi: 10.1111/iej.12606. Epub 2016 Feb 1.

Reference Type BACKGROUND
PMID: 26715631 (View on PubMed)

Ducret M, Fabre H, Celle A, Mallein-Gerin F, Perrier-Groult E, Alliot-Licht B, Farges JC. Current challenges in human tooth revitalization. Biomed Mater Eng. 2017;28(s1):S159-S168. doi: 10.3233/BME-171637.

Reference Type BACKGROUND
PMID: 28372291 (View on PubMed)

Chrepa V, Henry MA, Daniel BJ, Diogenes A. Delivery of Apical Mesenchymal Stem Cells into Root Canals of Mature Teeth. J Dent Res. 2015 Dec;94(12):1653-9. doi: 10.1177/0022034515596527. Epub 2015 Jul 20.

Reference Type BACKGROUND
PMID: 26195498 (View on PubMed)

Arslan H, Ahmed HMA, Sahin Y, Doganay Yildiz E, Gundogdu EC, Guven Y, Khalilov R. Regenerative Endodontic Procedures in Necrotic Mature Teeth with Periapical Radiolucencies: A Preliminary Randomized Clinical Study. J Endod. 2019 Jul;45(7):863-872. doi: 10.1016/j.joen.2019.04.005. Epub 2019 May 31.

Reference Type BACKGROUND
PMID: 31155298 (View on PubMed)

Jha P, Virdi MS, Nain S. A Regenerative Approach for Root Canal Treatment of Mature Permanent Teeth: Comparative Evaluation with 18 Months Follow-up. Int J Clin Pediatr Dent. 2019 May-Jun;12(3):182-188. doi: 10.5005/jp-journals-10005-1616.

Reference Type BACKGROUND
PMID: 31708612 (View on PubMed)

Brizuela C, Meza G, Urrejola D, Quezada MA, Concha G, Ramirez V, Angelopoulos I, Cadiz MI, Tapia-Limonchi R, Khoury M. Cell-Based Regenerative Endodontics for Treatment of Periapical Lesions: A Randomized, Controlled Phase I/II Clinical Trial. J Dent Res. 2020 May;99(5):523-529. doi: 10.1177/0022034520913242. Epub 2020 Mar 23.

Reference Type BACKGROUND
PMID: 32202965 (View on PubMed)

About I. Proceedings of the Pulp Biology and Regeneration Group Symposium 2019: Bridging Basic and Translational Research in Pulp Biology-Developing Technologies for Regenerating Vital Dental Tissues. J Endod. 2020 Sep;46(9S):S1. doi: 10.1016/j.joen.2020.06.018. No abstract available.

Reference Type BACKGROUND
PMID: 32950179 (View on PubMed)

He L, Kim SG, Gong Q, Zhong J, Wang S, Zhou X, Ye L, Ling J, Mao JJ. Regenerative Endodontics for Adult Patients. J Endod. 2017 Sep;43(9S):S57-S64. doi: 10.1016/j.joen.2017.06.012.

Reference Type BACKGROUND
PMID: 28844305 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

211

Identifier Type: -

Identifier Source: org_study_id