- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02617940
Efficacy of Sealants in Cavitated Enamel Lesions on Occlusal Surfaces in Children (SLM1661)
Effectiveness of Sealants in Cavitated Enamel Lesions on Occlusal Surfaces of Primary and Permanent Molars in Children
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Sao Paulo, Brazil, 05508000
- Jose Carlos Pettorossi Imparato
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- parents or legal guardians accept and sign the informed consent form.
- children must have at least one molar with caries lesion classified as ICDAS active score 3.
Exclusion Criteria:
- children with special needs and/or systemic diseases with oral impairment.
- teeth with spontaneous painful symptoms or necrotized and teeth presenting restorations, sealants, cavitated caries lesions in dentin or other types of formation defects.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: fissure sealant
single placement of resin-based sealant on occlusal surface and oral hygiene orientation
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Surfaces allocated to this group will be treated with resin-based sealant (FluroShield®, Dentsply, United States of America) according to the manufacturer's instructions. Initially, local anesthesia and rubber dam adaptation will be performed. Then, 37% phosphoric acid will be applied on the surface for 30 seconds, followed by spray of water/air for at least 15 seconds. The sealant will be dispensed on the occlusal surface and light cured for 20 seconds (Optilight Max, Gnatus, Brazil). |
PLACEBO_COMPARATOR: oral hygiene orientation
single application of water on occlusal surface and oral hygiene orientation
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Surfaces allocated to this group will be treated with sterile water application, as a placebo, without anesthesia and rubber dam.
The active treatment in this group will be only oral hygiene orientations.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sealants clinical efficacy
Time Frame: Every 6 months up to 12 months
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The clinical evaluation will be performed by one blinded examiner.
If the surface is sealed, the examiner will classify it according to described by Pardi et al. (2005); if the surface is without material, the examiner will use the International Caries Detection and Assessment System (ICDAS) criteria (Ismail et al., 2007).
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Every 6 months up to 12 months
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Sealants radiographic efficacy
Time Frame: Every 6 months up to 12 months
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The radiographic evaluation will be performed by two blinded examiners, which will evaluate the four patients' radiographies independently, two by two, without knowing the chronological order of them.
The efficacy of the treatment will be related to the presence or absence of increasing radiolucent area.
They will also classify each radiograph using Ekstrand criteria (Ekstrand et al., 1997) and analyze them in a software (ImageJ 1.49, National Institute of Health, United States of America) in order to make the radiographic subtraction.
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Every 6 months up to 12 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sealants and oral hygiene orientation costs
Time Frame: Baseline
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Treatment costs will be calculated for each treatment technique considering professional costs and procedure costs.
In order to calculate the professional cost, the time spent in each session will be converted in hours and multiplied by the medium income of the dentist per hour as related by the Brazilian Ministry of Labour and Employment.
To estimate the procedure cost, it will be considered both variable cost, which includes electricity and equipment depreciation, and materials cost.
To calculate the equipment depreciation (peripherals, dental chair and instrumental), we will consider their price, the lifespan of five years and a monthly use of 160 hours, resulting in an estimate value per hour.
All materials used in each procedure will have their quantity registered.
Prices will be inferences from the market value converted in US Dollars.
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Baseline
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Sealants cost-efficacy
Time Frame: Through study completion (12 months)
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The costs of each treatment procedure will be calculated and compared with threshold values for intervention cost-effectiveness by region, determined by World Health Organization (http://www.who.int/choice/costs/CER_levels/en/).
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Through study completion (12 months)
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Impact on children's quality of life of sealants or oral hygiene orientation
Time Frame: 6 and 12 months
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The oral health related to quality of life will be measured using a validated questionnaire according to the children's age.
The Early Childhood Oral Health Impact Scale (ECOHIS) will be applied with 4-5 years old children and Child Perceptions Questionnaire will be used for 6-9 (CPQ8-10) years old children.
They will be applied immediately before the procedure and on 6 months follow-up
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6 and 12 months
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Children self-reported discomfort
Time Frame: Baseline
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The discomfort of each type of treatment will be evaluated using the facial scale of Wong-Baker (Wong, Baker, 1998).
This scale indicates the discomfort of an individual who has to choose among six faces.
The first image is a smiling happy face, indicating no discomfort, followed by gradually less cheerful expressions, up to the last one which is a very sad face covered by tears, indicating great discomfort.
The participant will be asked to choose the face that is more similar to how he/she felt during the treatment immediately after the procedure.
This answer should be given solely by the child, which means no parental or professional interferences.
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Baseline
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Parents' reported satisfaction with treatment
Time Frame: 6 months
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The parents'/guardians' satisfaction with treatment will be evaluated using a questionnaire.
It will be applied only at the 6-months follow-up.
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6 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Jose CP Imparato, PhD, Faculty Sao Leopoldo Mandic Campinas
Publications and helpful links
General Publications
- Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007 Jun;35(3):170-8. doi: 10.1111/j.1600-0528.2007.00347.x.
- Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho VC, Shi X. Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007868. doi: 10.1002/14651858.CD007868.pub2.
- Erdemir U, Sancakli HS, Yaman BC, Ozel S, Yucel T, Yildiz E. Clinical comparison of a flowable composite and fissure sealant: a 24-month split-mouth, randomized, and controlled study. J Dent. 2014 Feb;42(2):149-57. doi: 10.1016/j.jdent.2013.11.015. Epub 2013 Dec 1.
- Ahovuo-Saloranta A, Forss H, Walsh T, Hiiri A, Nordblad A, Makela M, Worthington HV. Sealants for preventing dental decay in the permanent teeth. Cochrane Database Syst Rev. 2013 Mar 28;(3):CD001830. doi: 10.1002/14651858.CD001830.pub4.
- Morales-Chavez MC, Nualart-Grollmus ZC. Retention of a resin-based sealant and a glass ionomer used as a fissure sealant in children with special needs. J Clin Exp Dent. 2014 Dec 1;6(5):e551-5. doi: 10.4317/jced.51688. eCollection 2014 Dec.
- Ricketts DN, Ekstrand KR, Martignon S, Ellwood R, Alatsaris M, Nugent Z. Accuracy and reproducibility of conventional radiographic assessment and subtraction radiography in detecting demineralization in occlusal surfaces. Caries Res. 2007;41(2):121-8. doi: 10.1159/000098045.
- Hilgert LA, Leal SC, Mulder J, Creugers NH, Frencken JE. Caries-preventive Effect of Supervised Toothbrushing and Sealants. J Dent Res. 2015 Sep;94(9):1218-24. doi: 10.1177/0022034515592857. Epub 2015 Jun 26.
- Schwendicke F, Jager AM, Paris S, Hsu LY, Tu YK. Treating pit-and-fissure caries: a systematic review and network meta-analysis. J Dent Res. 2015 Apr;94(4):522-33. doi: 10.1177/0022034515571184. Epub 2015 Feb 20.
- Guedes RS, Piovesan C, Floriano I, Emmanuelli B, Braga MM, Ekstrand KR, Ardenghi TM, Mendes FM. Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation: a 2-year cohort study. Int J Paediatr Dent. 2016 Mar;26(2):116-24. doi: 10.1111/ipd.12166. Epub 2015 Apr 28.
- Liu BY, Lo EC, Chu CH, Lin HC. Randomized trial on fluorides and sealants for fissure caries prevention. J Dent Res. 2012 Aug;91(8):753-8. doi: 10.1177/0022034512452278. Epub 2012 Jun 26.
- Mendes FM, Braga MM. Caries detection in primary teeth is less challenging than in permanent teeth. Dent Hypotheses 4: 17-20, 2013.
- Martins-Junior PA, Vieira-Andrade RG, Correa-Faria P, Oliveira-Ferreira F, Marques LS, Ramos-Jorge ML. Impact of early childhood caries on the oral health-related quality of life of preschool children and their parents. Caries Res. 2013;47(3):211-8. doi: 10.1159/000345534. Epub 2012 Dec 13.
- Barbosa Tde S, Gaviao MB. [Quality of life and oral health in children - Part II: Brazilian version of the Child Perceptions Questionnaire]. Cien Saude Colet. 2011 Jul;16(7):3267-76. doi: 10.1590/s1413-81232011000800026. Portuguese.
- Wong DL, Baker CM. Smiling faces as anchor for pain intensity scales. Pain. 2001 Jan;89(2-3):295-300. doi: 10.1016/s0304-3959(00)00375-4. No abstract available.
- Pardi V, Pereira AC, Ambrosano GM, Meneghim Mde C. Clinical evaluation of three different materials used as pit and fissure sealant: 24-months results. J Clin Pediatr Dent. 2005 Winter;29(2):133-7. doi: 10.17796/jcpd.29.2.e44h17387x324345.
- Ekstrand KR, Ricketts DN, Kidd EA. Reproducibility and accuracy of three methods for assessment of demineralization depth of the occlusal surface: an in vitro examination. Caries Res. 1997;31(3):224-31. doi: 10.1159/000262404.
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- SLM1
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