Evaluation of Different Methods for the Diagnosis of Primary Caries Lesions

Phase 1

• Conditions: Caries Class II
• Interventions: Procedure: Visual Inspection; Radiation: BWX Radiographic Assessment; Device: Assessment of the iTero Element 5D scan

• Registration Number: NCT04900246
• Lead Sponsor: University of Nove de Julho

Brief Summary

According to the World Health Organization (WHO), dental caries is considered one of the major pediatric health problems worldwide, due to its high prevalence and incidence. Therefore, the early diagnosis of caries lesions is a fundamental procedure for building the treatment plan, aiming at prevention, minimal intervention and the promotion of oral health. The present study aims to evaluate, through a randomized and controlled clinical study, which is the best strategy for diagnosing primary caries lesions located in the interproximal region in individuals aged from 4 to 10 years. Diagnostic methods will be analyzed and compared: visual clinical examination using the International Caries Detection and Assessment System (ICDAS), iTero Element 5D System (intraoral scanner with NIRI technology) and bitewing radiography (BWX). All evaluations will be carried out by 02 examiners. The examiners will be trained and calibrated to use the visual and radiographic criteria, and also to use the iTero 5D intraoral scanner, following the manufacturer's guidance.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-05-11
• Study First Submitted QC: 2021-05-20
• Study First Posted: 2021-05-25
• Status Verified: 2021-11
• Last Update Submitted: 2021-11-18
• Last Update Posted: 2021-12-01
• Study Start: 2022-01-20
• Primary Completion: 2022-06-20
• Study Completion: 2022-08-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• Patients of both sexes who seek dental treatment at the Dentistry Clinic of Universidade Metropolitana de Santos.
• Be between 04 and 10 years old;
• Good general health;
• Present at least two tooth surfaces that can be included in the study.

Exclusion Criteria

• Dental surfaces with proximal restorations;
• Surfaces with evident proximal cavities (marginal crest break);
• Absence of adjacent tooth (absence of proximal contact).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Visual Inspection + BWX Radiographic Assessment + Assessment of the iTero Element 5D scan	Visual Inspection	In this group, the evaluations will follow this order. First the visual inspection, then the bitewing X-ray assessment and, lastly, the iTero assessment.
Visual Inspection + BWX Radiographic Assessment + Assessment of the iTero Element 5D scan	Assessment of the iTero Element 5D scan	In this group, the evaluations will follow this order. First the visual inspection, then the bitewing X-ray assessment and, lastly, the iTero assessment.
Visual Inspection + Assessment of the iTero Element 5D scan + BWX Radiographic Evaluation	BWX Radiographic Assessment	In this group, the evaluations will follow this order. First the visual inspection, then the iTero assessment and, lastly, the bitewing X-ray assessment.
Visual Inspection + BWX Radiographic Assessment + Assessment of the iTero Element 5D scan	BWX Radiographic Assessment	In this group, the evaluations will follow this order. First the visual inspection, then the bitewing X-ray assessment and, lastly, the iTero assessment.
Visual Inspection + Assessment of the iTero Element 5D scan + BWX Radiographic Evaluation	Visual Inspection	In this group, the evaluations will follow this order. First the visual inspection, then the iTero assessment and, lastly, the bitewing X-ray assessment.
Visual Inspection + Assessment of the iTero Element 5D scan + BWX Radiographic Evaluation	Assessment of the iTero Element 5D scan	In this group, the evaluations will follow this order. First the visual inspection, then the iTero assessment and, lastly, the bitewing X-ray assessment.

Primary Outcome Measures

Name	Time	Method
Diagnosis of primary caries lesions through the iTero Element 5D scan	Baseline.	For the diagnosis through scanning, the iTero 5D (Align Technology) equipment featuring NIRI Technology will be used. The Infrared Imaging Technology (NIRI) is a diagnostic tool that allows the detection of interproximal and occlusal caries in several stages, from the initial enamel caries to lesions in the amelo-dentin junction, without the use of ionizing radiation. Infrared is the region of the electromagnetic spectrum between 0.7 and 2.0 micrometers (µm). The iTero Element 5D imaging system uses wavelength light (= 850 nm) in an electromagnetic spectrum that, in interaction with the hard tooth tissue, provides additional data on its structure.
Diagnosis of primary caries lesions through visual inspection (ICDAS)	Baseline.	For the visual inspection of caries, the International Caries Detection and Assessment System (ICDAS) evaluation system will be used. Complete ICDAS has seven categories, the first for healthy teeth (code 0) and the next two for limited enamel caries, white/brown stain (codes 1 and 2). The following two categories (codes 3 and 4) are considered to be caries that extend to the enamel without exposed dentin. And the two remaining categories (codes 5 and 6), are considered caries with exposed dentin.
Diagnosis of primary caries lesions BWX Radiographic Assessment	Baseline.	For this diagnosis, participants will be radiographed with a digital X-ray device (DIOX-602, Micro Imagem, Indaiatuba, Brazil) with a regulation of 60 kV and 2 mA and exposure time of 0.10s. The technique used will be the interproximal/bitewing (BWX), with the FIT T1 Digital Sensor (external dimensions: 36.7mm x 24.3mm/sensitive area dimensions: 30.0mm x 20.0mm - 600mm²) and the sockets will be standardized with use of Han-Shin radiographic positioners (Jon, São Paulo, Brazil).