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Regeneration of Pulp-Dentin Development in Teeth With Necrotic Pulps and Immature Roots

Information source: The University of Texas Health Science Center at San Antonio
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Tooth Necrosis

Intervention: Triple Antibiotic Paste (Drug); Standard Treatment (Other)

Phase: Phase 1

Status: Recruiting

Sponsored by: Kenneth Hargreaves

Official(s) and/or principal investigator(s):
Kenneth Hargreaves, DDS, PhD, Study Chair, Affiliation: University of Texas

Overall contact:
Erin Locke, RN, Phone: 210-567-0895, Email: locke@uthscsa.edu

Summary

This multi-center exploratory clinical trial is a randomized trial designed to test whether a regenerative endodontic procedure using tissue engineering principles (REGENDO), or a revascularization (REVASC) endodontic procedure, in comparison to standard apexification treatment using a mineral trioxide aggregate barrier (apexification; APEX), produces a significantly better composite clinical outcome for the treatment of immature permanent teeth with pulpal necrosis.

Clinical Details

Official title: Regeneration of Pulp-Dentin Development in Teeth With Necrotic Pulps and Immature Roots

Study design: Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Tooth Survival

Secondary outcome: Positive pulpal response

Detailed description: This is a multi-center randomized clinical trial designed to test whether a regenerative endodontic procedure using tissue engineering principles (REGENDO), or a revascularization (REVASC) endodontic procedure, when compared to the standard apexification treatment using mineral trioxide aggregate barrier-MTA apexification (APEX), produces a significantly better composite clinical outcome for the treatment of immature permanent teeth with pulpal necrosis. This study will use an antibiotic mixture called Triple Antibiotic Paste (TAP), consisting of ciprofloxacin, metronidazole and minocycline, in the tooth for disinfection of the root canal in study arms REGENDO and REVASC. The FDA has issued an Investigational New Drug (IND) number allowing use of the triple antibiotic mixture in this trial. Other dental materials used in this study have already been FDA approved for use in humans to provide a matrix for the promotion of tissue growth in the root canal space. The study will also attempt to identify the type of bacteria within the root canal space and surrounding tissues by analyzing a small sample collected on a cotton-tip applicator. This clinical trial hopes to determine which of the three treatment methods helps the tooth to grow stronger and survive for at least two years after treatment.

Eligibility

Minimum age: 6 Years. Maximum age: 20 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Age 6-20

- Participant has a permanent tooth with a necrotic pulp (as defined by lack of

responsiveness to both electrical pulp tests and cold [EndoIce] tests). If the tooth was traumatized, then pulpal necrosis is defined as either: 1) no response to both electrical pulp test and cold [EndoIce] test by three months after trauma, or 2) presence of a periapical lesion, or 3) radiographic evidence of root resorption, or 4) discoloration of the crown.

- Tooth in question is restorable (as defined by Class A or Class B using Samet and

Jotkowitz classification) without the need of a stainless steel crown.

- Incomplete (i. e., immature) root development defined by apical foramen ≥1. 0mm (each

foramina >1. 0mm for multi-rooted teeth).

- At least 5 mm of root development (CEJ to radiographic apex).

- Willing and able to provide informed assent/consent.

- Legal guardian willing and able to provide informed consent.

Exclusion Criteria:

- No access to telephone for study contacts.

- Unable to comprehend study materials in English or Spanish.

- Subject not available for follow up at 12 or 24 months.

- Previous allergic response to ciprofloxacin, metronidazole or minocycline or any

materials used in the study.

- History of systemic diseases with altered immune function including diabetes,

immunodeficiency, leukemia, Addison's or Cushing's disease.

- History of taking immunosuppressants or chemotherapeutic agents including

glucocorticoids in the past 3 months.

- Clinical or radiographic evidence of root fracture or alveolar fracture.

- Tooth in question received prior endodontic obturation.

- Tooth in question has class III mobility or dens invaginatus.

- Tooth in question has a history of avulsion with extra-oral dry time longer than 1

hour.

- Clinical judgement (with documentation of the reason)

- Radiographic or clinical identification of ankylosis (replacement resorption) or

inflammatory (infection-related) root resorption.

Locations and Contacts

Erin Locke, RN, Phone: 210-567-0895, Email: locke@uthscsa.edu

Loma Linda University, Loma Linda, California 92350, United States; Recruiting
Mahmoud Torabinejad, DMD, MSD, PhD, Phone: 909-558-4681, Email: mtorabinejad@llu.edu
Mahmoud Torabinejad, DMD,MSD,PhD, Principal Investigator

University of Maryland, Baltimore, Maryland 21201, United States; Recruiting
Ashraf F Fouad, BDS, DDS, MS, Phone: 410-706-7047, Email: AFouad@Umaryland.edu
Gianpiera Ceresoli-Borroni, Phone: 410-706-7155, Email: GCeresoli@umaryland.edu
Ashraf F Fouad, BDS,DDS,MS, Principal Investigator

University of Texas Health Science Center, San Antonio, Texas 78229, United States; Recruiting
Erin Locke, RN, Phone: 210-567-0895, Email: locke@uthscsa.edu
Anibal Diogenes, DDS, PhD, Principal Investigator

Additional Information

Starting date: September 2014
Last updated: March 17, 2015

Page last updated: August 23, 2015

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