Noncarious Cervical Lesion Treatment Outcomes

Completed · Phase 3

Conditions studied: Noncarious Cervical Lesions

In brief

The overall objective of this three-armed randomized clinical trial (RCT) is to determine the comparative efficacy of three treatments for hypersensitive noncarious cervical lesions (NCLs): chemoactive dentifrice use, dentin bonding agent (DBA) with sealing, and flowable resin-based composite restoration. The primary outcomes of this study are the reduction/elimination of hypersensitivity and the effect of treatment as measured by patient-reported outcomes. Secondary outcomes, as determined by laboratory evaluation of intraoral replicas of pre- and posttreatment NCL surfaces, are tubule occlusion, retention of resin coating, retention of restoration, and change in lesion size. Outcomes will be ascertained via the following specific aims: Specific Aim 1: To compare the reduction of hypersensitivity of study teeth by both measurement and by patient-reported outcomes among three treatment groups. Specific Aim 2: To recruit subjects with teeth with hypersensitive NCLs, measure baseline sensitivity and subject quality of life, administer one of three different treatments to each of three randomized groups of subjects, and determine immediate posttreatment hypersensitivity. Specific Aim 3: To compare the degree of tubule occlusion before and after the three treatments and to associate these findings with posttreatment hypersensitivity, patient-reported outcomes, and restoration retention. Treatment of NCLs remains controversial. Few studies have compared treatment methods or their financial implications. This RCT will determine the reduction of NCL hypersensitivity and patient-reported outcomes over a 6-month period for each of three different treatments. This will be the first practice-based research network RCT to combine objective clinical assessment of NCL treatment patient-reported outcomes with laboratory examination of dentin tubule occlusion and lesion size.

Key facts

Study ID: NCT00867997
Run by: Pearl Network
People needed: 304
Starts: 2009-03-01
Expected to finish: 2012-02-01
Last updated by the study team: 2012-02-29

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

A premolar or first molar with an NCL and hypersensitivity of ≥3 as indicated by the subject on the Numeric Pain Assessment Scale (2008 NCCN) with standardized air blast stimulation with no other tooth exhibiting hypersensitivity (≥2 as indicated by the subject on the NPAS) in the same quadrant. If the patient has a tooth in more than one quadrant that meet these criteria then the quadrant selected will be that containing the tooth with the highest hypersensitivity reading. If the sensitivities are the same the quadrant with the lesion with the greatest depth would be selected. If the sensitivities and depth are the same the quadrant with the most convenient restorative access will be selected.
Teeth with NCL depth of at least 1 mm as measured by placing a periodontal probe (e.g.) into the deepest part of the cervical lesion
Teeth free of mesial, distal, or buccal restorations (to avoid confounding hypersensitivity)
Teeth with mobility of <1 mm when manipulated between blunt instruments
Subject able to follow the study protocol and willing to return for all evaluation appointments
Subject able to comprehend and sign the written consent form
Subject 18 years of age or older

You may not qualify if…

Subject who has a medical condition that could interfere with reliable pain reporting
Subject who is taking a medication that could interfere with reliable pain reporting
Subject who has taken an analgesic medication (narcotic, NSAID, acetaminophen, salicylic acid) within 24 hr pretreatment
Subject who is undergoing active orthodontic treatment
Subject with any of the following: a) Hypersensitive teeth with carious lesions; b) Hypersensitive teeth with buccal vertical cracks in enamel; c) Hypersensitive teeth with an irreversible pulpitis (pain lasting more than 5 sec after stimulation); d) Hypersensitive teeth with full crowns; e) Hypersensitive teeth with partial denture clasps on the facial surface; f) Evidence of inflamed gingival tissue and bleeding on probing in the sextant being considered for treatment as part of the study (the etiology of these lesion is closely related to excessive or improper brushing perhaps with an abrasive dentifrice and there is almost never accumulated plaque associated with the NCL)

Where it is running

Maryann Lehmann, DDS — Darien, Connecticut, United States
Ahmad Soolari, D.M.D. — Potomac, Maryland, United States
Oral Health Center — Southborough, Massachusetts, United States
Scott B Schaffer, DMD — Clark, New Jersey, United States
Gentle Dental Care, LLC — Edison, New Jersey, United States
Dr. Howard Spielman — Plainsboro, New Jersey, United States
Drs. Martin & Ferraiolo — Totowa, New Jersey, United States
Cynthia Jetter, DMD — Voorhees Township, New Jersey, United States
Bay Dental PC — Brooklyn, New York, United States
Ying Wong, DDS — New York, New York, United States
Martin Man, DMD — New York, New York, United States
Kay T. Oen, DDS — Port Chester, New York, United States
Janice K. Pliszczak, DDS — Syracuse, New York, United States
Susan D. Bernstein, DDS — Cincinnati, Ohio, United States
Dr. Jeannette Abboud-Niemczyk — Drexel Hill, Pennsylvania, United States
Allan J Horowitz, DMD — King of Prussia, Pennsylvania, United States
Dr. Julie Ann Barna — Lewisburg, Pennsylvania, United States

Full record on ClinicalTrials.gov

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