Multicenter Trial Comparing One-step Partial Caries Removal to Complete Caries Removal for the Treatment of Deep Carious Lesions in Permanent Teeth. (DECAT : DEep CAries Treatment). (DECAT)
Deep Caries
About this trial
This is an interventional treatment trial for Deep Caries focused on measuring Deep carious lesion, incomplete caries removal, antibacterial adhesive system, dental composite resin, pulp vitality preservation, randomized controlled trial
Eligibility Criteria
Inclusion Criteria:
Randomization n°1 - Partial versus complete caries removal
Patient-related criteria:
- Patient consulting in one of the multicenter trial centers
- Male and female aged 8-80 (inclusive),
- Affiliated to a social security regimen
- Able to tolerate necessary restorative procedures
- Provide informed consent
- Accepts the three-year follow-up period
Tooth related criteria:
- Mature permanent posterior tooth
- Tooth with vital pulp according to pulp-sensitivity tests
- Tooth with a deep (primary or secondary) at least proximal and/or occlusal carious lesion presenting a residual dentin thickness with no continuity between the carious cavity and the pulp chamber.
- In case of proximal lesions, the proximal cervical limit must allow proper placement of a waterproof dental dam (confirmed by a bitewing X-ray radiograph)
- Tooth requiring a direct partial restorative treatment.
Randomization n°2 - Antibacterial vs. non antibacterial adhesive application
Tooth has been assigned a treatment by randomization n°1.
Exclusion Criteria:
Randomization n°1 - Partial versus complete caries removal
Patient-related criteria:
- Person under guardianship, pregnant or nursing woman,
- Risk of infectious endocarditis,
- Patient who has an implanted Cardiac Pacemaker/Defibrillator
- Patient with severe periodontal disease (pocket depth ≥5mm and/or mobility type IV),
- Poor oral hygiene (abundance of soft matter within the gingival pocket and/or on the tooth and gingival margin = score 3 [Silness and Loe, 1964],
- Allergy to any of the materials and/or anaesthetic used,
- Uncooperative patients.
Tooth related criteria:
- Nocturnal pain causing insomnia,
- Tooth suffering dentin hypersensitivity (sharp sudden pain of short duration pain arising from exposed dentin (erosion and/or gingival recession), typically in response to external stimuli (air blast hypersensitivity [Schiff et al., 1994], tactile hypersensitivity),
- Sensitivity to axial or lateral percussion;
- Radiolucent apical image,
- Condensing osteitis,
- Tooth having an external or internal resorption,
- Tooth having suffered trauma,
- Tooth with a carious cervical lesion,
- Tooth with an occlusal wear associated to a dentine exposure,
- Tooth supporting clasp of a removable partial denture (RPD).
- Tooth with defects of mineralization that once the treated tooth could come into contact of the carried out restoration
Randomization n°2 - Antibacterial vs. non antibacterial adhesive application
- Tooth with pulp exposure after randomization n°1 requiring endodontic treatment (pulp exposure > 2 mm² and/or haemostasis not obtained).
Sites / Locations
- Hôpital EstaingRecruiting
- Hôpital Albert ChenevierRecruiting
- Cabinet LibéralRecruiting
- Hôpital Charles FoixRecruiting
- CHU LilleRecruiting
- Service de consultations et traitements dentairesRecruiting
- Hôpital de la TimoneRecruiting
- CHRU de NantesRecruiting
- CHU NiceRecruiting
- APAH Rothschild- GarancièreRecruiting
- Groupe Hospitalier Pitié SalpétrièreRecruiting
- Cabinet LibéralRecruiting
- Hopital Xavier ArnozanRecruiting
- CHRU RennesRecruiting
- CHRU ToulouseRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Active Comparator
Experimental
Active Comparator
Partial excavation
Complete excavation
Antibacterial dental adhesive
Conventional dental adhesive
patients receiving after excavation (in case of absence of pulp exposure after excavation necessitating endodontic treatment) antibacterial adhesive or non-antibacterial adhesive
patients receiving after excavation (in case of absence of pulp exposure after excavation necessitating endodontic treatment) antibacterial adhesive or non-antibacterial adhesive
patients with prior partial or complete caries removal (excepted patients with a pulp exposure after excavation necessitating endodontic treatment)
patients with prior partial or complete caries removal (excepted patients with a pulp exposure after excavation necessitating endodontic treatment)