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Trial registered on ANZCTR
Registration number
ACTRN12624000769583
Ethics application status
Approved
Date submitted
14/05/2024
Date registered
24/06/2024
Date last updated
24/06/2024
Date data sharing statement initially provided
24/06/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Novel white crowns for drill-free treatment of dental caries in New Zealand children
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Scientific title
Novel white plastic crowns for drill-free treatment of dental caries in NZ children using the Hall Technique
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Secondary ID [1]
312094
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
dental caries
333728
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Condition category
Condition code
Oral and Gastrointestinal
330411
330411
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Developed novel white shell preformed crowns specially designed by the research team will be used.
The clinical procedure for the white shell crowns will follow the current protocol for the Hall Technique.
1) Children will be seated upright or lying down on a dental chair. O-rings will be placed in between teeth if space is inadequate; 2) Obvious food or debris will be washed from the cavity but no decay will be removed. 3) The correct size of white shell crown/metal PFC will be selected and tried on the tooth.; 4) The tooth and stainless-steel crown (SSC) will be rinsed and dried.; 5) The SSC will be filled with glass ionomer luting cement.; 6) The SSC will be placed firmly on the tooth and the child will be instructed to bite down until the crown is pushed over the tooth; 7) Extruded cement is then removed.
These clinical procedures will be carried out by trained dental therapists and/or oral health therapists at dental hubs within Southern Te Whatu Ora DHB. Multiple training sessions will be given to DTs/OHTs and the research team to ensure data accuracy and protocol compliance. The anticipated duration of the clinical procedures is 15 minutes per participant.
The feasibility clinical trial will end as soon as the target number of participants is reached.
Then the follow-up will take in place. In addition to 3-,6-, and 12-monthly phone calls, parents of participants will be encouraged to contact the research team or DT/OHT at any time for any concerns about the adverse effects of the treatment.
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Intervention code [1]
328534
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Treatment: Devices
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Comparator / control treatment
New Zealand registered Dental Therapists and/or Oral Health Therapists currently employed with Te Whatu Ora DHB will carry out full clinical performance/treatment for preformed metal crowns over 5 to 15mins within their treatment/procedure time. The clinicians will document clinical dental examinations recording clinical and radiographical findings prior to their clinical decision. The procedure (the size of preformed metal crown used, cotton roll to bite down, wet gauze and knotted floss to remove excess luting cement and its success occlusion) will be thoroughly documented. A research assistant will be monitoring and recording any unexpected adverse events and/or unanticipated problems involving risk to participants or others throughout the feasibility study and the main study
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Control group
Active
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Outcomes
Primary outcome [1]
338209
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Number of successful treatment deliveries completed using the white shell crown hall technique
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Assessment method [1]
338209
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The success of treatment is to be determined by clinical and radiographical assessments as:
1) Successful restoration – clinically satisfactory, crown adjustment or replacement not required (e.g. no intervention is required, no clinical signs or symptoms of abscess, pulp pathology, and no pathology evident on radiograph, or tooth has exfoliated without problems),
2) Minor failure – defined as secondary caries evident or new caries clinically or radiographically in the reversible pulpitis treated without requiring pulpotomy or tooth extraction, or 3) Major failure – irreversible pulpitis or dental abscess requiring tooth extraction, radiographic signs of pathology, restoration loss with the tooth no longer restorable, internal root resorption.
4) Quantitative scoring using the an index that scores the presence of severely decayed teeth with visible Pulpal involvement (P/p), Ulceration caused by dislocated tooth fragments (U/u), Fistula (F/f) and Abscess (A/a). Also known as PUFA index. Clinical and radiographic assessment will be repeated periodically at 6 and 12 months.
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Timepoint [1]
338209
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Radiographical and clinical assessment at 6-monthly and 12-monthly follow-up only from the date of participants’ procedure.
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Secondary outcome [1]
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Treatment experience (including acceptance) of the novel white shell crown system by children.
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Assessment method [1]
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The specifically study-designed questionnaire will include questions relating to treatment experience including the treatment acceptance.
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Timepoint [1]
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The questionnaire will be completed at the time of treatment and again at 6-monthly intervals for 2 years.
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Secondary outcome [2]
436508
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Treatment experience (including acceptance) of the novel white shell crown system by parents/caregivers.
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Assessment method [2]
436508
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The specifically study-designed questionnaire will include questions relating to treatment experience including the treatment acceptance.
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Timepoint [2]
436508
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The questionnaire will be completed at the time of treatment and again at 6-monthly intervals for 2 years.
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Secondary outcome [3]
436509
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Treatment experience (including acceptance) of the novel white shell crown system by dental practitioners
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Assessment method [3]
436509
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The specifically study-designed questionnaire will include questions relating to treatment experience including the treatment acceptance.
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Timepoint [3]
436509
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The questionnaire will be completed at the time of treatment and again at 6-monthly intervals for 2 years.
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Eligibility
Key inclusion criteria
- all ethnicities, ages between 5-7 years
- willing to be examined by an oral health clinician
- any primary teeth requiring conventional Hall crowns (i.e. stainless-steel crowns) as a conservative treatment for dental caries
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Minimum age
5
Years
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Maximum age
7
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Multiple metal PFCs already placed
- have teeth-grinding habits or bruxism.
- medically-compromised
- unable to complete questionnaire
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation involved contacting the holder of the allocation schedule who was "off-site" or at central administration site.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Dynamic (adaptive) random allocation methods such as Minimisation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2024
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Actual
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Date of last participant enrolment
Anticipated
23/12/2024
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Actual
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Date of last data collection
Anticipated
28/02/2025
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Actual
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Sample size
Target
65
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
26299
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New Zealand
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State/province [1]
26299
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South Island
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Funding & Sponsors
Funding source category [1]
316452
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Government body
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Name [1]
316452
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Health Research Council (HRC) feasibility study fund
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Address [1]
316452
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Country [1]
316452
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New Zealand
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Funding source category [2]
316489
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Government body
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Name [2]
316489
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Ministry of Health Oral Health Research Grant
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Address [2]
316489
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Country [2]
316489
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New Zealand
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Funding source category [3]
316490
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Government body
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Name [3]
316490
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SfTi (Science for Technology and Innovation) Seed fund
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Address [3]
316490
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Country [3]
316490
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New Zealand
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Funding source category [4]
316503
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Other
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Name [4]
316503
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MedTech Core RAP Stage II Fund
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Address [4]
316503
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Country [4]
316503
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
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Country
New Zealand
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Secondary sponsor category [1]
318682
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None
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Name [1]
318682
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Address [1]
318682
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Country [1]
318682
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Other collaborator category [1]
283034
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Hospital
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Name [1]
283034
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Te Whatu Ora Southern
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Address [1]
283034
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Country [1]
283034
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315243
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University of Otago Human Ethics Committee (Health)
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Ethics committee address [1]
315243
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https://www.otago.ac.nz/council/committees/committees/humanethicscommittees
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Ethics committee country [1]
315243
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New Zealand
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Date submitted for ethics approval [1]
315243
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27/02/2023
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Approval date [1]
315243
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21/06/2023
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Ethics approval number [1]
315243
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2023 FULL 13593
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Summary
Brief summary
Dental caries is the most common chronic childhood disease in New Zealand. Traditional treatment involves surgical removal of the infected dental tissues and restoration using a filling material. The Hall Technique (HT) is known as a ‘no drill, no pain’ restorative procedure using metal preformed crowns (PFCs). Although effective clinically, this technique has an aesthetic limitation—the crown is silver rather than tooth-coloured. The metal PFCs also have other disadvantages: cost to healthcare providers is high and placement can be difficult. Our research team has successfully developed a novel white shell crown system for the Hall Technique, improving both aesthetics and crown placement, while reducing treatment costs. Tooth-coloured prototype crowns have been validated; however, its clinical feasibility needs to be tested.
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Trial website
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Trial related presentations / publications
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Public notes
The Ministry of Health has reported that Maori and Pasifika children are at a greater risk of developing dental caries. Although 95% of children are treated through the Community Oral Health Service in NZ, there is significant inequality in access to oral health care and oral health outcomes. Our proposed investigation of the effectiveness of the novel white shell crown system for drill-free caries management feasibility work centres on healthcare obligations under Te Tiriti o Waitangi for culturally-appropriate dental services that can aim for equity in best practice of dental caries treatment, especially for our Maori tamariki who experience higher rates of dental caries compared to non-Maori. Written and/or verbal consent will be obtained from the parents (caregivers) and, where appropriate, assent from the children who have been recruited. A randomised clinical trial will be used for the feasibility study; child participants will receive at least a white PFC (Intervention group) or a metal PFC (Control group).
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Contacts
Principal investigator
Name
134110
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Dr Joanne Choi
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Address
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310 Great King Street, Faculty of Dentistry, University of Otago, Dunedin 9016
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Country
134110
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New Zealand
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Phone
134110
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+64 0212139923
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Fax
134110
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Email
134110
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[email protected]
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Contact person for public queries
Name
134111
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Joanne Choi
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Address
134111
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310 Great King Street, Faculty of Dentistry, University of Otago, Dunedin 9016
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Country
134111
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New Zealand
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Phone
134111
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+64 0212139923
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Fax
134111
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Email
134111
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[email protected]
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Contact person for scientific queries
Name
134112
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Joanne Choi
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Address
134112
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310 Great King Street, Faculty of Dentistry, University of Otago, Dunedin 9016
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Country
134112
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New Zealand
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Phone
134112
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+64 0212139923
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Fax
134112
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Email
134112
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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