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Postoperative Hypersensitivity Randomized Comparative Effectiveness Research Trial (POH RCERT)

Primary Purpose

Dental Caries

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Restoration with a dentin bonding agent (DBA)
Restoration with a resin modified glass ionomer liner (RMGI)
Sponsored by
Pearl Network
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dental Caries focused on measuring Dental caries, Resin based composite, Hypersensitivity, Teeth, Dentistry, Practice-based research network

Eligibility Criteria

15 Years - 60 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Presence of solely adult dentition ages 15 to 60 (The upper age of 60 years is selected since the pulp space is limited and POH is less likely above this age).
  2. Presence of one or more permanent posterior teeth (in different quadrants, with third molars excluded) with the clinical diagnosis of new Class I caries extending into dentin with or without radiographic confirmation. Up to 4 teeth (one per quadrant) may be enrolled. If there is more than one occlusal lesion in a quadrant that meets the inclusion criteria the patient is not eligible for inclusion in the study. Only one tooth per quadrant can be treated during the 4 weeks of this study.
  3. Lesion depth, if visible on radiograph, must be ≤1/2 the distance from the Dento-Enamel Junction (DEJ) to the pulp and the radiograph cannot be more than 9 months old.
  4. The tooth must be in occlusion with a natural tooth.
  5. A resin-based composite restoration would be the standard of care for the lesion.
  6. The tooth must be free of evidence of a pulpitis (no report of lingering pain associated with any stimulus).
  7. Subjects must be available for contact for at least four weeks post-treatment.
  8. Subjects willing and able to understand and sign the IRB-approved informed consent form and for individuals under the age of 18, the parental / guardian assent form.
  9. Subject's baseline score on the NPAS must be ≥3 for air and/or cold stimulation but not exhibit pain lasting more than approximately four seconds which is known as "lingering pain"
  10. Gingival Index of less than or equal to 2.

Exclusion Criteria:

  1. Individuals in which the second molars are not fully erupted.
  2. Teeth with a mobility of 2 or greater, or inflamed gingival tissues.
  3. Existing restoration(s) on the same tooth.
  4. Teeth that have been clinically assessed to be fractured.
  5. Tooth is an abutment for a removable partial denture.
  6. Tooth with subgingival calculus, unless removed during the treatment visit.
  7. Subjects undergoing active orthodontic treatment. Use of retainers is allowed.
  8. Subjects currently enrolled in or who have completed in the past month a tooth bleaching program.
  9. Subjects with prior reaction or inability to tolerate any of the dental products being used, such as severe topical or hypersensitivity reaction.
  10. Subjects under treatment for medical disorders including: dementia, Parkinson's disease, severe depression, severe anxiety, and any other medical condition that, in the opinion of the P-I, would affect the subject's judgment of postoperative hypersensitivity and ability to understand the informed consent process.
  11. Subjects in another ongoing dental research study.

Sites / Locations

  • Phoenix Pediatric Dental
  • Watson and Niven Dental Partnership
  • Jana A. Ikeda, DDS, PC
  • Maryann Lehmann, D.D.S.
  • Oracare Research
  • Complete Dental Arts, P.C.
  • Creative Smiles Dental Care
  • Peggy Richardson, DDS, MS
  • Kokomo Oral Implantology
  • Corridor Kids Pediatric Dentistry
  • Community Dental - Biddeford Center
  • Cheryl F, Callahan, DDS, PA
  • Oral Medicine - Tufts School of Dental Medicine
  • Frank A Dahlstrom,DMD,PC
  • Oral Health Center
  • Small Smiles Dental Center of Springfield, LLC
  • Keith A Hudson DDS PC
  • Minnesota Dentalcare
  • Eric Hirschfeld, D.D.S.
  • Bordentown Family Dental
  • Scott B Schaffer, DMD
  • Gentle Dental Care, LLC
  • Dr. Howard Spielman
  • Barry G. Dale, DMD
  • Cynthia Jetter, DMD
  • Bay Dental PC
  • Eric Leibowitz DDS
  • Queens Comprehensive Dental Services
  • Gilberto Nunez DDS LLC
  • Kay T. Oen, DDS
  • East Avenue Dentistry PLLC
  • James R. Keenan, DDS, PC
  • Janice K. Pliszczak, DDS
  • Susan D. Bernstein, DDS
  • Laurence H Stone, DDS
  • Dr. Jeannette Abboud-Niemczyk
  • Allan J Horowitz, DMD
  • Dr. Julie Ann Barna
  • Salvation Army Dental Center
  • Elizabeth W. Galloway
  • MEHOP

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Restoration with a dentin bonding agent (DBA)

Restoration with a resin modified glass ionomer liner (RMGI)

Arm Description

Restoration with a dentin bonding agent (DBA) and hybrid resin-based composite: Use of a self-etch DBA Clearfil SE Bond followed by Herculite Ultra resin-based composite (Sybron/Kerr), comprising a state-of-the-art bonding and restoration system for cervical lesions.

Restoration with a resin modified glass ionomer liner (RMGI) (Vitrebond LC, placed on the pulpal floor at a thickness of approximately 0.5 mm) followed by application of a two step self etch DBA and nanofilled resin based composite (RBC).

Outcomes

Primary Outcome Measures

Hypersensitivity
To compare the reduction of hypersensitivity of study teeth by clinical measurement (air drying) and by patient-reported outcomes among the two treatment groups at three points in time: prior to restoration and at one and four weeks postrestoration.

Secondary Outcome Measures

Preoperative caries stage
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Lesion depth
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Dentin caries activity
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Preparation depth
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Sleep bruxism status
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.

Full Information

First Posted
October 19, 2010
Last Updated
September 18, 2014
Sponsor
Pearl Network
Collaborators
National Institute of Dental and Craniofacial Research (NIDCR)
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1. Study Identification

Unique Protocol Identification Number
NCT01268605
Brief Title
Postoperative Hypersensitivity Randomized Comparative Effectiveness Research Trial
Acronym
POH RCERT
Official Title
Resin Based Composite Occlusal Restoration Postoperative Hypersensitivity: Randomized Comparative Effectiveness Research Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
September 2010 (undefined)
Primary Completion Date
April 2012 (Actual)
Study Completion Date
April 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pearl Network
Collaborators
National Institute of Dental and Craniofacial Research (NIDCR)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Postoperative hypersensitivity (POH) is a problem for many patients as determined by the recent Practitioners Engaged in Applied Research and Learning (PEARL) study of POH following occlusal caries restoration. The objectives of this two-armed randomized comparative effectiveness research trial (RCERT) are to determine whether adding a resin modified glass ionomer liner (RMGI) reduces POH in dentin bonded Class I resin based composite (RBC) restorations, and to identify other factors (putative risk factors) that are associated with increased POH. The primary outcome of this study is the reduction/elimination of restoration POH as measured by clinical assessment (air stream) and patient-reports. Outcomes will be ascertained via the following specific aims: Specific Aim 1: To compare the reduction of hypersensitivity of study teeth by clinical measurement (air drying) and by patient-reported outcomes among the two treatment groups at three points in time: prior to restoration and at one and four weeks postrestoration. Specific Aim 2: To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed American Dental Association (ADA) Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dental Caries
Keywords
Dental caries, Resin based composite, Hypersensitivity, Teeth, Dentistry, Practice-based research network

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
341 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Restoration with a dentin bonding agent (DBA)
Arm Type
Active Comparator
Arm Description
Restoration with a dentin bonding agent (DBA) and hybrid resin-based composite: Use of a self-etch DBA Clearfil SE Bond followed by Herculite Ultra resin-based composite (Sybron/Kerr), comprising a state-of-the-art bonding and restoration system for cervical lesions.
Arm Title
Restoration with a resin modified glass ionomer liner (RMGI)
Arm Type
Active Comparator
Arm Description
Restoration with a resin modified glass ionomer liner (RMGI) (Vitrebond LC, placed on the pulpal floor at a thickness of approximately 0.5 mm) followed by application of a two step self etch DBA and nanofilled resin based composite (RBC).
Intervention Type
Procedure
Intervention Name(s)
Restoration with a dentin bonding agent (DBA)
Intervention Description
Restoration with a dentin bonding agent (DBA) and hybrid resin-based composite: Use of a self-etch DBA Clearfil SE Bond followed by Herculite Ultra resin-based composite (Sybron/Kerr), comprising a state-of-the-art bonding and restoration system for cervical lesions.
Intervention Type
Procedure
Intervention Name(s)
Restoration with a resin modified glass ionomer liner (RMGI)
Intervention Description
Restoration with a resin modified glass ionomer liner (RMGI) (Vitrebond LC, placed on the pulpal floor at a thickness of approximately 0.5 mm) followed by application of a two step self etch DBA and nanofilled resin based composite (RBC).
Primary Outcome Measure Information:
Title
Hypersensitivity
Description
To compare the reduction of hypersensitivity of study teeth by clinical measurement (air drying) and by patient-reported outcomes among the two treatment groups at three points in time: prior to restoration and at one and four weeks postrestoration.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Preoperative caries stage
Description
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Time Frame
Baseline
Title
Lesion depth
Description
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Time Frame
Baseline
Title
Dentin caries activity
Description
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Time Frame
Baseline
Title
Preparation depth
Description
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Time Frame
Baseline
Title
Sleep bruxism status
Description
To identify putative risk factors for POH (or factors associated with differences in POH) including: preoperative caries stage measured by the proposed ADA Caries Classification System (CCS), lesion depth as measured on the preoperative radiograph, dentin caries activity ranked on opening the lesion, preparation depth, and patient sleep bruxism status.
Time Frame
Baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
15 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Presence of solely adult dentition ages 15 to 60 (The upper age of 60 years is selected since the pulp space is limited and POH is less likely above this age). Presence of one or more permanent posterior teeth (in different quadrants, with third molars excluded) with the clinical diagnosis of new Class I caries extending into dentin with or without radiographic confirmation. Up to 4 teeth (one per quadrant) may be enrolled. If there is more than one occlusal lesion in a quadrant that meets the inclusion criteria the patient is not eligible for inclusion in the study. Only one tooth per quadrant can be treated during the 4 weeks of this study. Lesion depth, if visible on radiograph, must be ≤1/2 the distance from the Dento-Enamel Junction (DEJ) to the pulp and the radiograph cannot be more than 9 months old. The tooth must be in occlusion with a natural tooth. A resin-based composite restoration would be the standard of care for the lesion. The tooth must be free of evidence of a pulpitis (no report of lingering pain associated with any stimulus). Subjects must be available for contact for at least four weeks post-treatment. Subjects willing and able to understand and sign the IRB-approved informed consent form and for individuals under the age of 18, the parental / guardian assent form. Subject's baseline score on the NPAS must be ≥3 for air and/or cold stimulation but not exhibit pain lasting more than approximately four seconds which is known as "lingering pain" Gingival Index of less than or equal to 2. Exclusion Criteria: Individuals in which the second molars are not fully erupted. Teeth with a mobility of 2 or greater, or inflamed gingival tissues. Existing restoration(s) on the same tooth. Teeth that have been clinically assessed to be fractured. Tooth is an abutment for a removable partial denture. Tooth with subgingival calculus, unless removed during the treatment visit. Subjects undergoing active orthodontic treatment. Use of retainers is allowed. Subjects currently enrolled in or who have completed in the past month a tooth bleaching program. Subjects with prior reaction or inability to tolerate any of the dental products being used, such as severe topical or hypersensitivity reaction. Subjects under treatment for medical disorders including: dementia, Parkinson's disease, severe depression, severe anxiety, and any other medical condition that, in the opinion of the P-I, would affect the subject's judgment of postoperative hypersensitivity and ability to understand the informed consent process. Subjects in another ongoing dental research study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frederick A Curro, DMD, Phd
Organizational Affiliation
NYU Langone Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Phoenix Pediatric Dental
City
Phoeniz
State/Province
Arizona
ZIP/Postal Code
85015
Country
United States
Facility Name
Watson and Niven Dental Partnership
City
Newport Beach
State/Province
California
ZIP/Postal Code
92660
Country
United States
Facility Name
Jana A. Ikeda, DDS, PC
City
Boulder
State/Province
Colorado
ZIP/Postal Code
80305
Country
United States
Facility Name
Maryann Lehmann, D.D.S.
City
Darien
State/Province
Connecticut
ZIP/Postal Code
06820
Country
United States
Facility Name
Oracare Research
City
Sanford
State/Province
Florida
ZIP/Postal Code
32771
Country
United States
Facility Name
Complete Dental Arts, P.C.
City
Newnan
State/Province
Georgia
ZIP/Postal Code
30265
Country
United States
Facility Name
Creative Smiles Dental Care
City
Champaign
State/Province
Illinois
ZIP/Postal Code
61820
Country
United States
Facility Name
Peggy Richardson, DDS, MS
City
Tinley Park
State/Province
Illinois
ZIP/Postal Code
60477
Country
United States
Facility Name
Kokomo Oral Implantology
City
Kokomo
State/Province
Indiana
ZIP/Postal Code
46901
Country
United States
Facility Name
Corridor Kids Pediatric Dentistry
City
North Liberty
State/Province
Iowa
ZIP/Postal Code
52317
Country
United States
Facility Name
Community Dental - Biddeford Center
City
Biddeford
State/Province
Maine
ZIP/Postal Code
04005
Country
United States
Facility Name
Cheryl F, Callahan, DDS, PA
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20850
Country
United States
Facility Name
Oral Medicine - Tufts School of Dental Medicine
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Frank A Dahlstrom,DMD,PC
City
Dennis
State/Province
Massachusetts
ZIP/Postal Code
02638
Country
United States
Facility Name
Oral Health Center
City
Southborough
State/Province
Massachusetts
ZIP/Postal Code
01772
Country
United States
Facility Name
Small Smiles Dental Center of Springfield, LLC
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01128
Country
United States
Facility Name
Keith A Hudson DDS PC
City
Franklin
State/Province
Michigan
ZIP/Postal Code
48025
Country
United States
Facility Name
Minnesota Dentalcare
City
Richfield
State/Province
Minnesota
ZIP/Postal Code
55423
Country
United States
Facility Name
Eric Hirschfeld, D.D.S.
City
Conway
State/Province
New Hampshire
ZIP/Postal Code
03818
Country
United States
Facility Name
Bordentown Family Dental
City
Bordentown
State/Province
New Jersey
ZIP/Postal Code
08505
Country
United States
Facility Name
Scott B Schaffer, DMD
City
Clark
State/Province
New Jersey
ZIP/Postal Code
07066
Country
United States
Facility Name
Gentle Dental Care, LLC
City
Edison
State/Province
New Jersey
ZIP/Postal Code
08820
Country
United States
Facility Name
Dr. Howard Spielman
City
Plainsboro
State/Province
New Jersey
ZIP/Postal Code
08536
Country
United States
Facility Name
Barry G. Dale, DMD
City
Tenafly
State/Province
New Jersey
ZIP/Postal Code
07670
Country
United States
Facility Name
Cynthia Jetter, DMD
City
Voorhees
State/Province
New Jersey
ZIP/Postal Code
08043
Country
United States
Facility Name
Bay Dental PC
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11229
Country
United States
Facility Name
Eric Leibowitz DDS
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11230
Country
United States
Facility Name
Queens Comprehensive Dental Services
City
Forest Hills
State/Province
New York
ZIP/Postal Code
11375
Country
United States
Facility Name
Gilberto Nunez DDS LLC
City
Kingston
State/Province
New York
ZIP/Postal Code
12401
Country
United States
Facility Name
Kay T. Oen, DDS
City
Port Chester
State/Province
New York
ZIP/Postal Code
10573
Country
United States
Facility Name
East Avenue Dentistry PLLC
City
Rochester
State/Province
New York
ZIP/Postal Code
14610
Country
United States
Facility Name
James R. Keenan, DDS, PC
City
Rockaway Beach
State/Province
New York
ZIP/Postal Code
11693
Country
United States
Facility Name
Janice K. Pliszczak, DDS
City
Syracuse
State/Province
New York
ZIP/Postal Code
13215
Country
United States
Facility Name
Susan D. Bernstein, DDS
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45231
Country
United States
Facility Name
Laurence H Stone, DDS
City
Doylestown
State/Province
Pennsylvania
ZIP/Postal Code
18902
Country
United States
Facility Name
Dr. Jeannette Abboud-Niemczyk
City
Drexel Hill
State/Province
Pennsylvania
ZIP/Postal Code
19026
Country
United States
Facility Name
Allan J Horowitz, DMD
City
King of Prussia
State/Province
Pennsylvania
ZIP/Postal Code
19406
Country
United States
Facility Name
Dr. Julie Ann Barna
City
Lewisburg
State/Province
Pennsylvania
ZIP/Postal Code
17837
Country
United States
Facility Name
Salvation Army Dental Center
City
Oil City
State/Province
Pennsylvania
ZIP/Postal Code
16301
Country
United States
Facility Name
Elizabeth W. Galloway
City
Hilton Head Island
State/Province
South Carolina
ZIP/Postal Code
29928
Country
United States
Facility Name
MEHOP
City
Bay City
State/Province
Texas
ZIP/Postal Code
77414
Country
United States

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Postoperative Hypersensitivity Randomized Comparative Effectiveness Research Trial

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