Clinical, Radiographic and Patient Acceptance Evaluation of LASER Compared to Formocresol Pulpotomies inPrimary Molars

December 31, 2023 updated by: Dina Hamdy, Ain Shams University

Clinical, Radiographic and Patient's Acceptance

The goal of this clinical trial was to compare the clinical and radiographic success of laser versus formocresol pulpotomy in primary molars. The main questions it aimed to answer was:

• Does laser pulpotomy has higher clinical and radiographic success rate as formocresol pulpotomy in primary molars?

Participants were selected according to eligibility criteria to undergo pulpotomy for their lower primary molars under local anesthesia using one of the following techniques:

  • Group 1: Formocresol
  • Group 2: Diode laser Group 3: Er:CrYSGG laser Clinical and radiographic follow up were performed for 18 months

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

In all teeth, local anaesthesia was administered using 7.0 mg/kg 4% articane + 1: 100,000 epinephrine (with a maximum total dosage of 500 mg)

- Rubber dam isolation was done.

Access cavity preparation:

  • In all groups, caries removal was done with a sterile #330 high-speed bur, and coronal access cavity preparation was done with a sterile #4 high-speed round bur using high speed hand piece and water coolant. The access cavity was then refined using a sterile high-speed fissure bur. LASER operating parameters: Figure (10)

    • Wavelength: 2780 nm
    • Repetition rate: 15 Hz
    • Water spray: 80
    • Air : 60
    • Emission mode: Free-running pulsed
    • Tip: MZ 10- 6 mm, Zip Tip
    • Average power: 8 Watt The coronal pulp was amputated by a sterile sharp excavator, the amputated sites were rinsed with water. Hemorrhage was controlled by placing sterile, saline- wetted cotton pellets on the radicular pulp stumps under slight pressure (Thompson et al., 2001) for 5 min for primary hemostasis ( J Dent Res 84(12) 2005). At this stage, the achievement of complete hemostasis was an inclusion criterion. If bleeding recommenced afterwards, partial pulpectomy was performed and the tooth was excluded from the study.
  • After achieving complete haemostasis pulp stumps were treated according to each group: Group1: (control group)
  • A cotton pellet that was moistened with 1:5 diluted bottle of FC (Formacresol, PREVEST DenPro, Digiana, Jammu, India) was placed over the pulp stumps for 5 minutes. After removal of the cotton, the fixed pulp stumps were capped with reinforced zinc oxide and eugenol base (Zinconol, PREVEST DenPro, Digiana, Jammu, India). Group2: (Diode LASER group)
  • All patients, parents and clinical staff were requested to wear appropriate eye protection goggles during laser application, Figure (12). After achieving hemostasis, pulp stumps was treated with Diode LASER (980 nm).If hemostasis was not achieved, the process was repeated one more time until adequate hemostasis was achieved, Figure (15, 16). Diode LASER radiation (wavelength 980 nm) was delivered to the canal orifices with a special handpiece and fiber glass of 200 μm diameter, Figure (13), the parameters were set at: Figure (14) Emission mode: Pulsed contact mode Time: 2 seconds. Power: 2 Watt power with average power of 1 Watt and total energy of one spot, corresponding to two minutes and 31 seconds exposure was 4.0 J/cm 2. Group3: (Erbium:Chromium,YSGG LASER group) Pulp tissues in this group were treated with Erbium:Chromium,YSGG LASER (2780 nμ). (Waterlase Biolase®, Biolase, Inc., San Clemente, California, USA) Once the pulp chamber was opened, the laser tip was placed into the pulp chamber using for approximately 15 seconds. In most instances, this was repeated three times. If hemostasis was not achieved, the process was repeated one more time until adequate hemostasis was achieved. Er: Cr, YSGG LASER radiation (wavelength 2780 nμ) was delivered with a special handpiece, and a tip: MZ 10- 6 mm, Zip Tip, to the canal orifices.

LASER operating parameters:

  • Wavelength: 2780 nm
  • Repetition rate: 50 Hz
  • Water spray: 1
  • Air : 20
  • Emission mode: Free-running pulsed In all groups, reinforced zinc oxide eugenol cement was placed over the pulp stumps, and the tooth was restored with a stainless steel crown. Preoperative and postoperative as well as follow up periapical radiographs at 6, 12 and18 months were obtained by standardized paralleling technique and exposure time of 0.25 seconds. An XCP film holder (Super Bite, Hawe Neos DentalSA, Switzerland) was used. Digital radiographs were obtained and scanned using size 0 phosphostimulable phosphor plates [X mind AC (de Gotzen, Italy) and Fona-Scaneo, phosphor plate scanner, respectively.

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.
36

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

  • Child

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • 1. Clinical criteria One or more primary teeth indicated for pulpotomy due to carious pulp exposure. No spontaneous pain No swelling No tenderness to percussion No pathological mobility No sinus tract opening No initially unsuccessful hemorrhage control. 2. Radiographic criteria Teeth without inter-radicular radiolucency No loss of lamina dura or widened periodontal ligament space No physiologic root resorption of more than one-third.

Exclusion Criteria:

  • Clinical mobility Spontaneous pain Swelling Tenderness to percussion Pathological mobility Non restorable teeth. Teeth with necrotic pulp. Pre-operative radiographic pathology such as resorption, periradicular or furcal radiolucency, a widened periodontal ligament space, or physiological root resorption of more than one-third. Parents / Patients not willing to be a part of the study. Any kind of medical history contraindicating the pulp treatment.

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: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

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.
Experimental: Diode laser
Procedure: Diode laser
Active Comparator: Formocresol
Procedure: Formocresol
Experimental: Er:CrYSGG
Procedure: Er:CrYSGG

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
Measure Description
Time Frame
Clinical and radiographic success
Time Frame: 18 months

Clinical success criteria:

  1. Restoration intact;
  2. No pain or tenderness;
  3. No mobility;
  4. No swelling;
  5. No fistula;
  6. No gingival inflammation-represented by pain, redness, or bleeding-around the tooth/crown. Radiographic success at follow-up visits should meet the following criteria:

1. No external root resorption; 2. No internal root resorption; 3. No inter-radicular bone resorption. 4. No Widening of the periodontal ligament space. 5. No periapical bone resorption.
18 months

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.
Ain Shams University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Dina Hamdy, Ain shams 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 (Actual)

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.
December 20, 2015

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.
December 30, 2017

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.
February 15, 2018

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).
December 31, 2023

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.
December 31, 2023

First Posted (Actual)

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.
January 11, 2024

Study Record Updates

Last Update Posted (Actual)

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.
January 11, 2024

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.
December 31, 2023

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.
December 1, 2023

More Information

Terms related to this study

Keywords

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.
  • FDASU-RecD061519

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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