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The goal of this randomized controlled clinical trial is to to evaluate the clinical performance and radiographic success of BioFlex crowns versus SSCs using Hall Technique in primary dentition. The main questions it aims to answer are:
Does bioflex crowns have the same clinical performance and radiographic success of stainless steel crowns when placed using Hall Technique?
will bioflex crowns alter the occlusal vertical dimensions or affect the tempomandibular joint?
If there is a comparison group: Researchers will compare bioflex crown to stainless steel crown to see of the bioflex crowns are effective as stainless steel crowns when placed using hall technique
Participants will recieve bioflex crown and stainless steel crown according to randomization and they will be followed up immediately after treatment, after 2 weeks , after 1 months , after 3 months , after 6 months and after 12 months
The study will be a double-armed randomized controlled clinical trial, with parallel design. A total of 74 pediatric patients aged 4-8 years will be selected from the Pediatric Dentistry Outpatient Clinic, Faculty of Dentistry, Alexandria University, Egypt. Participants will be allocated into 2 groups according to the type of crown used. Group I (study group) will be treated with BioFlex crowns using Hall technique, while Group II (control group) will be treated with the SSCs using Hall technique. Clinical and radiographic success of both crowns will be assessed. The function of the temporomandibular joint (TMJ) will be evaluated using the Helkimo Clinical Dysfunction Index (Di) and the AAPD questionnaire. The Occlusovertical dimension measurements will also be evaluated using the Van der Zee and Van Amerongen method. Plaque and gingival health will be recorded using plaque and gingival indices, and the satisfaction level of the child will be assessed using the Facial Image Scale (FIS), while the satisfaction level of parents will be assessed using questionnaire.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| bioflex crown using hall technique | Experimental | bioflex crown using the hall technique |
|
| stainless steel crowns using hall technique | Active Comparator | stainless steel crown using the hall technique |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bioflex crown using hall technique | Other | crowns assessment |
| |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the clinical performance of BioFlex crowns versus SSCs using HT. | clinical evaluation of crown performance Success:
Minor Failures:
Major Failures: • Reversible or irreversible pulpitis or dental fistula/abscess, requiring pulpotomy, pulpectomy or extraction. | 12 months |
| To evaluate the radiographic success of BioFlex crowns versus SSCs using HT. | radiographic evaluation using digital xrays • Teeth will be considered radiographically successful if they show no evidence of:
| 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Temporomandibular joint function assessment | The Helkimo Clinical Dysfunction Index (modified version) assesses TMJ dysfunction based on: Maximum Opening: 0 = ≥35 mm
Deflection During Opening: 0 = <2 mm
Impaired TMJ Function: 0 = no impairment
Pain in TMJ: 0 = no pain
Muscle Pain (Temporalis & Masseter): 0 = no pain
Score Classification: 0 = no dysfunction 1-4 = mild dysfunction 5-9 = moderate dysfunction 9 = serious dysfunction The AAPD guidelines are used for assessing TMJ symptoms, asking about difficulty opening the mouth, pain, muscle pain in the temporalis and masseter, sounds, and jaw-related injuries. Responses are yes/no. |
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Inclusion Criteria:
- Primary molar teeth with occlusal or occlusoproximal carious lesions into dentin (ICDAS codes: 3-5).
Exclusion Criteria: Teeth will be excluded if they exhibit:
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| Name | Affiliation | Role |
|---|---|---|
| yousra ramadan, Ms | Alexandria University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dentistry Alexandria University | Alexandria | Egypt |
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The study was a two arm, parallel group, randomized controlled clinical trial. Allocation ratio is intended to be 1:1.
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statistician was blinded
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| stainless steel crown using hall technique |
| Other |
crown assessment |
|
| 6 months |
| Changes in the occlusal vertical dimensions | The assessment of the OVD will be performed according to a Modified version of van der Zee and van Amerongen method The cusp tip of the left maxillary canine was marked using a pencil on the lower canine in the maximum intercuspation, and its distance to the mandibular canine cusp tip was measured using a UNC-15 probe and used as the overbite score | 1 month |
| Dental plaque assessment | Criteria for scoring plaque index (Silness and Löe) 0 No plaque
| 12 months |
| gingival health assessment | Criteria for scoring gingival index (Löe and Silness) 0 Healthy (No gingivitis.).
| 12 months |
| Parental satisfaction assessment | • The satisfaction level of parent/legal guardian will be assessed as performed immediately post-operative, in addition to problems that the child might be facing, such as bleeding around the crown, sensitivity, and food lodgment using questionnaire Parental satisfaction will be assessed on a Likert type scale from 1 to 5 using the seven following variables: shade, size, shape, retention, durability, overall satisfaction, and child's satisfaction. | 12 months |
| child satisfaction assessment | • The patient's perception of the treatment will be assessed by using the Facial Image Scale (FIS) modified from the Maunuksela et al scale
| immediately after treatment |