3D-Printed Versus Band-and-Loop Versus Denovo Space Maintainers in Primary Dentition.
3D-Printed Custom Versus Conventional Band-and-Loop Versus Chairside Denovo Space Maintainers in the Primary Dentition: A Randomized Controlled Trial Protocol
Purpose of the Study When a child loses a "baby" molar early due to a cavity or injury, the surrounding teeth can shift into the empty space. This often blocks the permanent adult tooth from growing in correctly. To prevent this, dentists use a small metal device called a space maintainer.
This study aims to find out which of three different types of space maintainers lasts the longest, is most comfortable for the child, and is most efficient for the dental office to provide.
The Three Study Groups
Children in this study are randomly assigned to one of three groups:
- 3D-Printed Custom Group: The dentist takes a digital picture (scan) of the child's mouth instead of a traditional mold. A custom-fit appliance is then 3D-printed using a specialized, medical-grade clear material.
- Conventional Band-and-Loop Group: This is the traditional method. The dentist takes a physical mold of the teeth, which is sent to a laboratory. The child usually has to return for a second appointment a week later to have the metal appliance glued into place.
- Denovo Chairside Group: This uses a kit of pre-made metal parts. The dentist selects the best fit and assembles the appliance right at the chairside, allowing it to be placed during a single visit.
What is Being Measured?
Researchers are following the children for 12 months to track:
Survival: Which appliance stays glued in and doesn't break most effectively?
Time: How much time does the dentist spend making and fitting the appliance?
Comfort: How much discomfort or pain did the child feel during the process?
Health: Does the appliance cause any irritation to the gums or surrounding teeth?
Who Can Participate? The study includes children between the ages of 5 and 10 who have lost at least one primary (baby) molar early and need a space maintainer to protect their future adult smile.
Importance of This Research By comparing these three methods, this study helps dentists understand if newer technologies, like 3D printing or pre-made kits, are better or more convenient than the traditional lab-made metal loops used for decades. This information will help families choose the best treatment for their children.
Visão geral do estudo
Status
Descrição detalhada
Clinical Workflow and Device Fabrication
The trial compares three distinct manufacturing and clinical delivery pathways for pediatric space maintenance:
3D-Printed Custom Workflow (Experimental Arm)
Data Acquisition: Digital impressions are captured using a high-precision intraoral scanner (3Shape TRIOS).
Design Phase: The STL files are imported into CAD software (exocad), where a custom space maintainer is designed with a specific focus on anatomical adaptation to the abutment tooth and the edentulous ridge.
Manufacturing: Appliances are fabricated via Stereolithography (SLA) using a Form 3B+ printer with BioMed Clear Resin. Post-processing includes a 20-minute isopropyl alcohol wash and 60 minutes of UV curing at 60°C to ensure biocompatibility and optimal mechanical properties.
Delivery: The printed appliance is bonded using a light-cured orthodontic adhesive.
Conventional Band-and-Loop Workflow (Active Comparator)
Clinical Phase: Traditional alginate impressions are taken and poured with dental stone to create a physical working model.
Laboratory Phase: A stainless steel band (3M Unitek) is fitted to the abutment tooth on the model. A 0.036-inch stainless steel wire is contoured to the ridge and silver-soldered to the band.
Delivery: The appliance is polished and cemented in a subsequent clinical appointment using glass ionomer cement.
- Denovo Chairside Workflow (Active Comparator)
Selection: A prefabricated kit (Denovo Dental) is used to select a band size that fits the abutment tooth.
Assembly: A pre-formed wire loop is selected and adjusted for length at the chairside. The loop is mechanically secured to the band using the system's specialized crimping and locking mechanism, eliminating the need for soldering or laboratory delays.
Delivery: The assembled appliance is cemented during the same appointment as the initial measurement.
Randomization and Standardization Participants are allocated 1:1:1 using a computer-generated randomization sequence. To ensure consistency, all clinical procedures-including tooth preparation, scanning, and cementation-are performed by a group of calibrated pediatric dentists following a standardized protocol. For the 3D-printed group, resin batches and printer calibration are monitored weekly to ensure material integrity.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: MURAD A ALRASHIDI, Pediatric Orthodontist
- Número de telefone: +966 55 302 2773
- E-mail: MU.ALRASHIDI@qu.edu.sa
Locais de estudo
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Al-Qassim Region
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Buraidah, Al-Qassim Region, Arábia Saudita, 52571
- Qassim University
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Contato:
- MURAD ALRASHIDI, BDS, MSC
- Número de telefone: +966 55 302 2773
- E-mail: MU.ALRASHIDI@qu.edu.sa
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Children aged 5 to 10 years
- Premature unilateral loss of at least one primary first or second molar
- Radiographically confirmed developing permanent successor at Nolla developmental stage 4 to 7
- Parent or legal guardian able and willing to provide written informed consent, and child able to provide age-appropriate assent
Exclusion Criteria:
- Systemic disease affecting bone metabolism or tooth development
- Clinically significant mesiodistal space loss at screening, defined as greater than 3 mm
- Poor oral hygiene precluding band placement, defined as a full-mouth plaque score greater than 50%
- Known allergy or hypersensitivity to stainless steel or resin components
- Current participation in another interventional clinical trial
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Prevenção
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: 3D-Printed Custom Space Maintainer
Participants in this arm receive a custom-designed space maintainer fabricated through a fully digital workflow.
This involves an intraoral scan (3Shape TRIOS) and CAD design (exocad).
The appliance is 3D-printed using stereolithography (SLA) technology (Formlabs Form 3B+) with BioMed Clear Resin, a biocompatible photopolymer.
The appliance is bonded to the abutment tooth using a light-cured orthodontic adhesive during a single or subsequent clinical visit.
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A digitally designed, monolithic space maintainer.
The workflow involves an intraoral scan (3Shape TRIOS) and CAD design (exocad).
The device is fabricated using stereolithography (SLA) technology (Formlabs Form 3B+) with BioMed Clear Resin.
It is bonded to the abutment tooth using a light-cured orthodontic adhesive
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Comparador Ativo: Conventional Band-and-Loop
This arm represents the current clinical reference standard.
Fabrication follows a traditional analog workflow beginning with an alginate impression and stone model.
A stainless steel band (3M Unitek) is fitted to the model, and a stainless steel wire (0.036-inch) is hand-contoured and silver-soldered to the band.
The completed appliance is polished and cemented using glass ionomer cement in a second clinical appointment.
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The traditional clinical reference standard.
It is fabricated using an analog workflow: an alginate impression is taken to create a stone model, a stainless steel band (3M Unitek) is fitted to the model, and a 0.036-inch stainless steel wire is hand-contoured and silver-soldered to the band.
The appliance is polished and cemented with glass ionomer cement.
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|
Comparador Ativo: Denovo Chairside Space Maintainer
This arm utilizes a prefabricated, chairside system (Denovo Dental) designed for single-visit delivery.
A pre-sized stainless steel band is selected and fitted directly to the patient's tooth.
A pre-formed wire loop is then adjusted for the appropriate span and mechanically secured to the band using a specialized crimping and locking tool, eliminating the need for laboratory soldering.
The appliance is cemented during the same appointment as the initial fitting.
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A prefabricated, stainless steel space maintainer system (Denovo Dental) designed for immediate application.
A pre-sized band is selected and fitted directly to the patient's tooth.
A pre-formed wire loop is adjusted for length at the chairside and mechanically secured to the band using a specialized crimping and locking tool, requiring no laboratory soldering.
It is cemented during the initial appointment.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Appliance Survival Rate
Prazo: At 12 months from baseline
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This measures the clinical longevity and "success" of the appliance.
A "failure" is recorded if the appliance becomes completely or partially dislodged (cement failure), suffers a structural fracture, or causes significant soft-tissue trauma requiring its removal.
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At 12 months from baseline
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Space Maintenance Effectiveness:
Prazo: At 12 month from baseline
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Measured as the change in the mesiodistal dimension of the extraction space (in millimeters).
Digital calipers or software will compare the initial space at baseline to the space remaining at the end of the study.
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At 12 month from baseline
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Clinical and Laboratory Time (Efficiency)
Prazo: At baseline
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Researchers will record the active working time (in minutes) for each stage of fabrication.
This includes chairside time (scanning or impressions and fitting) and laboratory time (3D printing and post-processing, manual soldering, or chairside assembly).
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At baseline
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Gingival Health (Löe and Silness Index):
Prazo: Baseline, at 6 months, and at 12 months.
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A clinical assessment of the soft tissue surrounding the abutment tooth.
It will be scored from 0 (normal) to 3 (severe inflammation/bleeding) to determine if any material or design causes more irritation than others.
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Baseline, at 6 months, and at 12 months.
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: MURAD ALRASHIDI, BDS, MSC, Qassim University
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 26-20-3
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Prazo de Compartilhamento de IPD
Critérios de acesso de compartilhamento IPD
Tipo de informação de suporte de compartilhamento de IPD
- PROTOCOLO DE ESTUDO
- SEIVA
- CIF
- ANALYTIC_CODE
- CSR
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