Effect of Caffeic Acid Phenethyl Ester as a Matrix Metalloproteinase Inhibitor: Randomized Controlled Clinical Trial

April 15, 2016 updated by: Prof. Dr. Mine Dundar Comlekoglu, Ege University

Professor, Ege University Faculty of Dentistry

Matrix metalloproteinases (MMPs); activated by the application of adhesive systems on dentin cause degradation of the collagen proteins and loss of bond strength in adhesive restorations. Caffeic acid phenethyl ester (CAPE) showed inhibitory activities on dentinal MMPs. It is hypothesised that dentin pretreatment with CAPE, as an MMP inhibitor, would be beneficial for the bonding of resin material and tooth substrate over the course of time. This study evaluated the effect of 5 % CAPE pretreatment on the microtensile bond strength of a nanohybrid resin restoration applied with total-etch or self-etch adhesive systems on 10 patients (12-18 yrs). Two standard cavities (3 x 3 x 4 mm) prepared on the occlusal surfaces of one of the two premolar teeth in each patient were randomly assigned into four treatment groups (n=10); 5% CAPE pretreatment and total-etch adhesive (TC), Total-etch adhesive (control) (T), 5% CAPE pretreatment and self-etch adhesive (SC), Self-etch adhesive (control) (S) followed by restoration and 3 months of intra-oral functioning. After teeth extraction, the specimens were stored in distilled water+thymol solution at 4°C to inhibit microbial growth and used in one week period. Dentin-composite sticks were obtained from each restoration for µTBS tests and scanning electron microscopy (SEM) evaluation. Failure mode analysis was performed microscopically. Data were analysed statistically using Repeated Measure ANOVA (p < 0.05). Dentin pretreatment with CAPE solution (5%) for 60 seconds significantly increased the composite resin restorations' bond strengths to dentin applied with either total-etch or self-etch adhesive system. Thus it can be used as an MMP inhibitor prior to the the resin restorations. However further long term clinical studies are needed to support the use of CAPE pretreatment along with self-etch and total-etch adhesive systems.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The aim of the present study was to evaluate the effect of caffeic acid phenethyl ester (CAPE) pretreatment used as matrix metalloproteinase (MMP) inhibitor on microtensile bond strength (µTBS) of nanohybrid resin restorations applied with total-etch or self-etch adhesive systems. A total of 10 patients aged between 12 and 18 years old (4 males, 6 females, mean age:15) received 40 composite restorations. The patients who had contralateral pairs of caries-free premolars which were planned to be extracted for orthodontic treatment were enrolled in the study. This study was performed with a protocol approved by the Ethical Committee for Clinical Studies, Faculty of Medicine, University of Ege, Izmir, Turkey (04.10.2012; no:12-8/6). The treatments were performed after the informed consents were received both from the parents and the patients. Included teeth were in function and no anomalies were found neither in teeth nor in occlusion. Two standard cavities (3 x 3 x 4 mm) with continuous enamel cavosurface margins were prepared on the occlusal surfaces of each premolar tooth.Totally four cavities in each patient were randomly assigned into four treatment groups (n=10); Group TC: CAPE and total-etch adhesive (Syntac; Ivoclar Vivadent AG), Group T: Total-etch adhesive (control), Group SC: CAPE and self-etch adhesive (AdheSE; Ivoclar Vivadent AG), Group S: Self-etch adhesive (control). All cavities were restored incrementally with a nano-filled hybrid composite resin (Tetric-N-Ceram, Ivoclar Vivadent AG) in which polymerization in each layer was performed for 40 seconds with a light-curing unit (BluePhase Ivoclar Vivadent AG) exceeding an energy output of 500mw/sec.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
10

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

12 years to 18 years (ADULT, CHILD)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:I

  • Occlusally functioning teeth without any anomalies
  • Good oral hygiene
  • No systemical disorders
  • No periodontal diseases
  • No allergic reactions to the dental materials

Exclusion Criteria:

  • Patients not eligible for premolar teeth extraction for orthodontic treatment
  • Poor oral hygiene
  • Non-functioning premolar teeth to be included
  • Patients having systemical disorders, periodontal diseases or allergic reactions to dental materials

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: PREVENTION
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
ACTIVE_COMPARATOR: self-etch adhesive
application of self-etch adhesive on cavities.
Drug: self-etch adhesive
comparator use of total-etch adhesive
Other Names:
  • adhesive
EXPERIMENTAL: CAPE-S
CAPE before self-etch adhesive
Drug: CAPE-S
experimental group
Other Names:
  • CAPE solution
ACTIVE_COMPARATOR: total-etch adhesive
total-etch adhesive on cavities.
Drug: total-etch adhesive
comparator use of total-etch adhesive
Other Names:
  • adhesive
EXPERIMENTAL: CAPE-T
CAPE before total-etch adhesive application
Drug: CAPE-T
experimental group
Other Names:
  • CAPE solution

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Determination of structural integrity of hybrid layer in forty restorations on 10 patients using scanning electron microscopy after application of different adhesive strategies and a matrix metalloproteinase inhibitor.
Time Frame: 2 years
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ege University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 1, 2013

Primary Completion (ACTUAL)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2015

Study Completion (ACTUAL)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 1, 2015

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 3, 2016

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 15, 2016

First Posted (ESTIMATE)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 20, 2016

Study Record Updates

Last Update Posted (ESTIMATE)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 20, 2016

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 15, 2016

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2016

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 04.10.2012; no:12-8/6

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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