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Direct Pulp Capping in Primary Molars

Phase 3
Completed
Conditions
Direct Pulp Capping
Interventions
Other: Mineral trioxide aggregate (MTA)
Other: Hard setting Calcium Hydroxide (Dycal)
Registration Number
NCT05530954
Lead Sponsor
Mansoura University
Brief Summary

The purpose of this study is to Assess the effect of MTA and hard setting Calcium Hydroxide (Dycal) on the clinical and radiographic outcome of direct pulp capping in primary molars and evaluate overall success rate of direct pulp capping in primary molars.

Detailed Description

After informed consent, baseline clinical and radiographic assessment will be obtained and recorded in patient examination sheet.

Participants who met the inclusion criteria were randomly allocated to two groups (n = 26/group, N = 52 in total) according to the capping martials using the envelope randomization method.

2 study groups according to capping material that will be used (Dycal or MTA) and each group will be divided to 2 subgroups according to site of exposure axial or pulpal.

All patients were recalled and their treated molars were evaluated clinically and radiographically at 3months, 6months, 9months ,12months follow up periods.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
52
Inclusion Criteria
  • Cooperative child and compliant parent.
  • Complete physical and mental health.
  • Children who are known to be healthy and free from systemic diseases.
  • Primary molars with deep carious lesions leading to pathological exposure but with no signs or symptoms of irreversible pulpitis or necrosis such as spontaneous pain, tenderness to percussion, abscess, fistula, periodontal tissue swelling, or abnormal tooth mobility.
Exclusion Criteria
  • A deep carious lesion in close proximity to the pulp with an intact lamina dura.
  • Absence of widening of periodontal membrane space or radiolucency at the furcation and periapical region.
  • Absence of pulpal calcifications, obliteration of the pulp and root canal, or internal/external root resorption.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mineral trioxide aggregate (MTA)Mineral trioxide aggregate (MTA)* where the pulp tissue is exposed during final caries removal, hemostasis will be achieved by cavity irrigation with sterile saline solution for up to 4 minutes till control of bleeding * Teeth with pulp exposure less than 1mm in diameter surrounded by sound dentin will be candidates for direct pulp capping * Following the removal of the saline, the exposed pulp will be irrigated with 17% EDTA solution (Prevest Direct, India) for 1 minute * According to site of exposure, the groups will be further subdivided into Group A (n=13) with exposure in pulpal floor and Group B (n=13) with exposure in axial wall of the cavity. * Exposed pulp will be covered with fast set MTA paste after cavity dryness with sterile cotton pellet then the tooth will be restored with Self-cured glass ionomer restorative material (SDI Riva self-cure, Australia) and tooth will be covered by stainless steel crown
Hard setting Calcium Hydroxide (Dycal)Hard setting Calcium Hydroxide (Dycal)* where the pulp tissue is exposed during final caries removal, hemostasis will be achieved by cavity irrigation with sterile saline solution for up to 4 minutes till control of bleeding * Teeth with pulp exposure less than 1mm in diameter surrounded by sound dentin will be candidates for direct pulp capping * Following the removal of the saline, the exposed pulp will be irrigated with 17% EDTA solution (Prevest Direct, India) for 1 minute * According to site of exposure, the groups will be further subdivided into Group A (n=13) with exposure in pulpal floor and Group B (n=13) with exposure in axial wall of the cavity. * Exposed pulp will be covered with Dycal paste after cavity dryness with sterile cotton pellet then the tooth will be restored with Self-cured glass ionomer restorative material (SDI Riva self-cure, Australia) and tooth will be covered by stainless steel crown
Primary Outcome Measures
NameTimeMethod
clinical success of direct pulp capping treatment after 3 months follow up3 months

Presence of any of these clinical findings will be considered failure:

pain on mastication or spontaneous pain, as reported by the patient, without clinical evidence of plaque retention around the crown margin denoting bad oral hygiene.

pain on percussion on clinical examination . non-physiologic mobility. fistula or sinus tract.

radiographic success of direct pulp capping treatment after 9 months follow up9 months follow up

the absence of the following radiographic findings indicate the success of capping material in pulp therapy:

* pathological internal or external root resorption.

* PDL widening.

* inter-radicular radiolucency formation postoperatively.

* periapical radiolucency formation postoperatively.

radiographic success of direct pulp capping treatment after 12 months follow up12 months follow up

the absence of the following radiographic findings indicate the success of capping material in pulp therapy:

* pathological internal or external root resorption.

* PDL widening.

* inter-radicular radiolucency formation postoperatively.

* periapical radiolucency formation postoperatively.

clinical success of direct pulp capping treatment after 6 months follow up6 months follow up

Presence of any of these clinical findings will be considered failure:

pain on mastication or spontaneous pain, as reported by the patient, without clinical evidence of plaque retention around the crown margin denoting bad oral hygiene.

pain on percussion on clinical examination . non-physiologic mobility. fistula or sinus tract.

clinical success of direct pulp capping treatment after 12 months follow up12 months follow up

Presence of any of these clinical findings will be considered failure:

pain on mastication or spontaneous pain, as reported by the patient, without clinical evidence of plaque retention around the crown margin denoting bad oral hygiene.

pain on percussion on clinical examination . non-physiologic mobility. fistula or sinus tract.

clinical success of direct pulp capping treatment after 9 months follow up9 months follow up

Presence of any of these clinical findings will be considered failure:

pain on mastication or spontaneous pain, as reported by the patient, without clinical evidence of plaque retention around the crown margin denoting bad oral hygiene.

pain on percussion on clinical examination . non-physiologic mobility. fistula or sinus tract.

radiographic success of direct pulp capping treatment after 3 months follow up3 months follow up

the absence of the following radiographic findings indicate the success of capping material in pulp therapy:

* pathological internal or external root resorption.

* PDL widening.

* inter-radicular radiolucency formation postoperatively.

* periapical radiolucency formation postoperatively.

radiographic success of direct pulp capping treatment after 6 months follow up6 months follow up

the absence of the following radiographic findings indicate the success of capping material in pulp therapy:

* pathological internal or external root resorption.

* PDL widening.

* inter-radicular radiolucency formation postoperatively.

* periapical radiolucency formation postoperatively.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Outpatient clinic of the Department of Pediatric Dentistry, Faculty of Dentistry- Mansoura University

🇪🇬

Mansoura, Egypt

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