Cost-efficacy Between ART and Composite Resin Restorations in Primary Molars
7 de diciembre de 2018 actualizado por: Daniela Prócida Raggio, University of Sao Paulo
Difference of Cost-efficacy Between Atraumatic Restoration Treatment (ART) and Composite Resin Restorations in Primary Molars: A Randomized Clinical Trial
The aim of this randomized clinical trial study is to compare the longevity of Atraumatic Restorative Treatment (ART) using high viscosity GIC and Conventional Treatment using composite resin under rubber dam isolation and local anesthesia (CT) in primary molars.
As secondary outcomes, cost-efficacy, self-reported discomfort and cooperation will also be tested.
Children aging between 3 to 6 years old presenting at least one occlusal and/or occlusoproximal cavity will be randomly assigned to one of two groups according to the dental treatment: ART (experimental group) or CT (control group).
The dental treatment will be performed at a dental care trailer located in a Public School in Barueri (São Paulo, Brazil).
The unit of analysis for randomization will be the child.
A number of 204 teeth presenting occlusal cavities and 240 teeth presenting occlusoproximal cavities were set after sample size calculation.
The primary outcome will be the restorations' longevity, which will be assessed after 6, 12, 18 and 24 months by two evaluators through clinical examination according to Frencken et al. (1998) criteria for occlusal restorations and Roeleveld et al. (2006) criteria for occlusoproximal restorations.
The time spent during the dental treatment and all materials used will be considered for estimating the cost-efficacy of each treatment.
The individual's discomfort will be also measured after each dental procedure using the Facial Scale of Wong-Baker.
Cooperation will be assessed by the operator using a 5-point scale.
Descripción general del estudio
Estado
Desconocido
Condiciones
Intervención / Tratamiento
Descripción detallada
Research setting
The study will be performed in a dental care trailer which simulated a regular dental office and it is located inside a public school of the city Barueri (São Paulo, Brazil).
Sample size calculation
For sample size calculation, data regarding longevity of CT in occlusal and occlusoproximal restorations after 2 years were extracted from the literature as 86% for occlusal and 60% for occlusoproximal restorations. A difference of 15% and 20% between the longevity of CT and ART was set as non-inferiority limit. Considering the level of significance as 5%, power as 80% and adding 40% due to the study design (cluster per child), a number of 204 occlusal restorations and 240 occlusoproximal restorations will be needed.
Randomization
The child will be the unit of randomization which means that all eligible teeth of a participant will be treated according the same restorative approach. Randomization list will be obtained using blocks of 4, 6 and 8 generated by software Sealed Envelope Ltd. Opaque, sealed and sequentially numbered envelopes will be used for randomizing all participants immediately before restorative treatments' beginning.
Allocation concealment
To assure allocation concealment, the participant will be randomized immediately before the treatment. When two or more cavities is available, preventing the finalization of the treatment in only one session, breach of allocation concealment will be signalized in the participants' record.
Blinding
Due to differences between the techniques, it will be not possible to blind operators, participants and evaluators.
Operators
All operators will be masters or PhD students from the Pediatric Dentistry Department, Faculty of Dentistry, University of São Paulo, previously trained. All procedures will be performed with the assistance of a dental student previously trained to manipulate all restorative materials.
Tipo de estudio
Intervencionista
Inscripción (Anticipado)
428
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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São Paulo
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Barueri, São Paulo, Brasil
- Complexo Educacional Carlos Osmarinho de Lima - Trailer USP
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
3 años a 6 años (Niño)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Children aging between 3 and 6 years
- presenting good health conditions
- whose parents or legal guardians accept and sign the consent form
- with at least one occlusal or occlusal proximal caries lesion in primary molars
- only occlusal and/or occlusal-proximal surfaces with caries lesions with dentin involvement
Exclusion Criteria:
- severe behavioral issues
- presence of fistula or abscess near the selected tooth
- presence of pulp exposure in the selected tooth
- presence of mobility in the selected tooth
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Comparador activo: Conventional Treatment
Occlusal and occlusoproximal composite resin restorations in primary molars (rubber dam isolation + Adhesive system + composite resin Filtek z350)
|
Occlusal and occlusoproximal composite resin restorations in primary molars using the Scotchbond Multi-purpose adhesive system and the Filtek Z-350 composite resin wil be performed.
Local anesthesia will be used.
Absolute isolation will be performed using rubber dam and clamp.
Removal of unsupported enamel will be performed using a round bur.
Infected carious tissue will be removed with hand instruments.
The cavity will be etched using 37% phosphoric acid for 15 seconds followed by rising and drying for the same amount of time.
The cavity will be restored with composite resin.
Occlusion will be checked.
an adapted matrix strip with a wooden wedge will be used to assure appropriate contour.
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Experimental: ART using Fuji IX
Occlusal and occlusoproximal ART restorations in primary molars with GIC Fuji IX
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Occlusal and occlusoproximal ART restorations in primary molars using the high viscosity GIC Fuji IX will be performed under relative isolation.
No local anesthesia will be used.
Infected carious tissue will be removed with hand instruments, and the cavities restored with GIC.
After the press-finger technique, the excess of material will be removed and occlusion will be checked.
For occlusoproximal restoration, an adapted matrix strip with a wooden wedge will be used to assure appropriate contour.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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The restoration survival
Periodo de tiempo: Every 6 months up to 24 months.
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The treatments will be classified as successful when they present a clinical satisfactory aspect.
Otherwise, "minor failures" will be analyzed.
"Minor failures" are those in which there is a defect in the restoration/crown, but it does not interfere with the tooth health.
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Every 6 months up to 24 months.
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Cost-efficacy assessment
Periodo de tiempo: Through study completion, an average of 24 months
|
Treatment costs = professional costs + procedure costs.
If the restorative treatment requires repairs, the additional cost of it will also be considered. |
Through study completion, an average of 24 months
|
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Child self-reported discomfort
Periodo de tiempo: Immediately after treatment
|
The acceptability 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, each one expressing different facial countenance.
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 or she felt during the treatment.
This answer should be given solely by the child, which means, no parental or professional interferences.
The facial scale of Wong-Baker will be applied right after the end of each restorative treatment session.
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Immediately after treatment
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Cooperation
Periodo de tiempo: Immediately after treatment
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Cooperation will be evaluated by the operator immediately after the end of the treatment using a 5-point scale: 1- Good behaviour, 2- Reasonable behaviour, 3- Indiferent, 4- Bad behaviour, 5- Really bad behaviour.
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Immediately after treatment
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Silla de estudio: Daniela P Raggio, PhD, University of Sao Paulo
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
1 de noviembre de 2015
Finalización primaria (Actual)
10 de junio de 2018
Finalización del estudio (Anticipado)
10 de diciembre de 2019
Fechas de registro del estudio
Enviado por primera vez
21 de septiembre de 2015
Primero enviado que cumplió con los criterios de control de calidad
25 de septiembre de 2015
Publicado por primera vez (Estimar)
29 de septiembre de 2015
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
11 de diciembre de 2018
Última actualización enviada que cumplió con los criterios de control de calidad
7 de diciembre de 2018
Última verificación
1 de diciembre de 2018
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- RECART
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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