The study aims to evaluate the clinical performance of Cention-Forte (CF) material in the restoration of pulpotomized second primary molars compared to conventional stainless steel crowns (SSC), and also to assess the restorations' antibacterial effect on salivary cariogenic bacterial count.
A two-arm randomized controlled clinical trial. A total of 40 healthy cooperative children aged 5-9 years, will be selected from the Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Egypt. Each child selected will have second primary molar with occluso-proximal carious lesions indicated for pulpotomy. Written informed consent will be obtained from their guardians. After the MTA pulpotomy procedure, participants will be randomly allocated into two groups according to the restoration used. Group I (test group n=20) will receive Cention Forte material, while group II (control group n=20) will receive conventional SSC. Using Modified Ryge's Criteria, the clinical performance of the restorations will be evaluated at 1 week and then after 3, 6 and 12 months for marginal adaptation, proximal contact, retention, gross fracture, occlusal wear, surface roughness and secondary caries. Periapical radiographs will be taken at baseline and after 6 and 12 months. Also, the antibacterial effect of the restorations on salivary cariogenic bacterial count will be assessed at baseline and after 1 week, 1 month and 3 months. Plaque and Gingival index scores as well as parental and child's satisfaction will be recorded. Data will be collected, tabulated, and statistically analysed to obtain the results and conclusions of this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Cention forte material will be used as a final restoration for pulpotomized second primary molars
The control group using the gold standard stainless steel crown (SSC) as a final restoration for pulpotomized second primary molars
Faculty of Dentistry, Alexandria University
Alexandria, Egypt
Faculty of Pharmacy, Alexandria University
Alexandria, Egypt
Clinical performance of the restorations using Modified Ryge's Criteria
The clinical evaluation of the two restorations will be done using parameters of marginal adaptation, proximal contact, retention, gross fracture, occlusal wear, surface roughness, and secondary caries as per the modified United States Public Health Service (USPHS) Ryge's criteria. Scores for the modified Ryge's criteria are as follow: * alpha: represents the ideal or excellent condition of a restoration * bravo: indicates a clinically acceptable restoration with minor defects * charlie: indicates restoration is unacceptable clinically and should be replaced
Time frame: One year
The antibacterial effect of both restorations on salivary cariogenic bacterial count.
The saliva samples will be collected to assess microbiological colony count of S.mutan and lactobacilli at baseline, after 1 week, 1 month and 3 months.
Time frame: 3 months
Radiographic success of pulpotomized second primary molars in both groups
The success of pulpotomy procedure will be assessed radiographically using digital periapical xray after 6 and 12 months.
Time frame: One year
Gingival index
Gingival health will be assessed clinically at baseline, then after 3, 6 and 12 months using the gingival index score: Scores for the index indicate: 0: normal gingival 1. mild inflammation, sllight change in colour and slight edema. No bleeding on probing 2. Moderate inflammation: redness, edema and glazing. Bleeding on probing. 3. Severe inflammation: marked redness, edema and ulcerations. Tendency towards spontaneous bleeding
Time frame: One year
Plaque index
Gingival health will be assessed clinically using plaque index at baseline, then after 3, 6 and 12 months. Plaque index scores indicate: 0: No plaque 1. A film of plaque adhering to the free gingival margin and adjacent area of the tooth. The plaque may be seen in-situ only after application of disclosing solution or by using the probe on the tooth surface 2. Moderate accumulation of soft deposits within the gingival pocket, or the tooth and gingival margin which can be seen by the naked eye 3. Abundance of soft matter within the gingival pocket and/or on the tooth and gingival margin.
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Time frame: One year
Child satisfaction
The patient's perception of the treatment will be assessed by using the Facial Image Scale (FIS) that represents satisfaction, indifference, or dissatisfaction. A few minutes will be spent before each procedure to establish rapport with the child and to obtain some notion of the child's understanding of the meaning of those schematic facial expressions. After treatment, the child will be instructed to choose the face that best represented how he/she felt during the procedure.
Time frame: Over one year
Parental satisfaction
Parental satisfaction level will be assessed immediately after the procedure with 5-point Likert scale where 1-very dissatisfied; 2-dissatisfied; 3-neutrally satisfied; 4-satisfied; 5-very satisfied. Parents will be asked to rate their satisfaction regarding appearance, color, size, durability, and overall satisfaction for the restoration/crown.
Time frame: Over one year