NCT03215615

Brief Summary

Non-carious cervical lesion is frequently associated with gingival recession, resulting in a combined lesion that has a different treatment prognosis when the two lesions appear alone. The literature presents few studies that propose a multidisciplinary approach (restorative and root coverage surgery procedures) to optimize the treatment of this combined lesion. The previously proposed approaches and materials have limitations and an optimal clinical protocol has not been established yet. Thus the aim of this study is to evaluate a novel multidisciplinary protocol with two resin composites and two different adhesive systems through a randomized clinical trial and laboratory studies. 120 combined lesions will be randomly assigned to one of the following groups: NP + TE (n = 30) - Partial restoration of cervical lesions with nanofilled composite and total-etch adhesive system and periodontal surgery for root coverage, NP + UA (n = 30) - partial restoration of cervical lesions with nanofilled composite and self-etching adhesive system and periodontal surgery for root coverage, MH + TE (n = 30) - partial restoration of cervical lesions with microhybrid composite and total-etch adhesive system and periodontal surgery for root coverage, MH + UA (n = 30) - partial restoration of cervical lesions with microhybrid composite and self-etching adhesive system and periodontal surgery for root coverage. Restorations will be assessed using the USPHS criteria after one week, six months and twelve months.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
80

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Nov 2016

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 1, 2016

Completed
23 days until next milestone

First Submitted

Initial submission to the registry

November 24, 2016

Completed
8 months until next milestone

First Posted

Study publicly available on registry

July 12, 2017

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2019

Completed
Last Updated

June 13, 2019

Status Verified

June 1, 2019

Enrollment Period

2.6 years

First QC Date

November 24, 2016

Last Update Submit

June 12, 2019

Conditions

Outcome Measures

Primary Outcomes (1)

  • Modified United States Public Health Service (USPHS) criteria

    USPHS criteria is based on the following ratings: Color compatibility, retention, marginal adaptation, anatomic form, surface texture, marginal discoloration, sensibility pre-operative and postoperative and the presence of secondary caries

    1 year

Secondary Outcomes (2)

  • Aesthetics (Visual Analogue Acale - VAS)

    1 year

  • Dentin Hypersensitivity (Visual Analogue Acale - VAS)

    1 year

Study Arms (4)

Group NF + TE

ACTIVE COMPARATOR

Nanofilled Composite - Filtek Z350 XT® - 3M ESPE (NF) + Total Etch adhesive - Adper Single Bond 2® - 3M ESPE (TE) adhesive: combined lesions will be treated with partial restoration with nanofilled resin composite and total-etch adhesive system (two step). Subsequently, periodontal surgery will be performed for root coverage.

Procedure: Periodontal surgeryProcedure: Total Etch adhesiveProcedure: Nanofilled Composite

Group NF + UA

ACTIVE COMPARATOR

Nanofilled Composite - Filtek Z350 XT® - 3M ESPE (NF) + Universal Adhesive - Single Bond Universal® - 3M ESPE (UA): combined lesions will be treated with partial restoration with nanofilled resin composite and one-step self-etching adhesive system. Subsequently, periodontal surgery will be performed for root coverage.

Procedure: Periodontal surgeryProcedure: Universal AdhesiveProcedure: Nanofilled Composite

Group MH + TE

ACTIVE COMPARATOR

Micro-Hybrid Composite - Charisma Classic® - Heraeus Kulzer (MH) + Total Etch adhesive - Adper Single Bond 2® - 3M ESPE (TE) adhesive: combined lesions will be treated with partial restoration with micro-hybrid resin composite and total-etch adhesive system (two step). Subsequently, periodontal surgery will be performed for root coverage.

Procedure: Periodontal surgeryProcedure: Total Etch adhesiveProcedure: Micro-Hybrid Composite

Group MH + UA

ACTIVE COMPARATOR

Micro-Hybrid Composite - Charisma Classic® - Heraeus Kulzer (MH) + Universal Adhesive - Single Bond Universal® - 3M ESPE (UA): combined lesions will be treated with partial restoration with micro-hybrid resin composite and one-step self-etching adhesive system. Subsequently, periodontal surgery will be performed for root coverage.

Procedure: Periodontal surgeryProcedure: Universal AdhesiveProcedure: Micro-Hybrid Composite

Interventions

Coronally advanced flap for root coverage

Group MH + TEGroup MH + UAGroup NF + TEGroup NF + UA

Total-etch adhesive system (two step)

Group MH + TEGroup NF + TE

One-step self-etching adhesive system

Group MH + UAGroup NF + UA

Partial nanofilled-resin composite restoration

Group NF + TEGroup NF + UA

Partial micro-hybrid composite restoration

Group MH + TEGroup MH + UA

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Individuals presenting one or more combined defect, i.e. a NCCL classified as B+ (Pini-Prato et al., 2010): presenting more than 1mm in depth, affecting dental crown and root associated with Miller's class I or II gingival recession in canines or premolars with pulp vitality;
  • Healthy patients (systemically and periodontally), 18 years old, with at least 20 teeth in occlusion;
  • Plaque index ≤ 20% (Ainamo \& Bay, 1975);
  • NCCL cavo-surface margin without involvement of more than 50% of enamel;
  • In tooth included in the study and the adjacent elements of the following must be observed: probing depth less than 3 mm; do not show bleeding on probing (periodontal health) and no insertion loss in the proximal and palatal areas; Provide formal consent to participate in research, after the explanation of the risks and benefits by an individual not involved in it (Resolution #196 October 1996 and the Code of Dental Professional Ethics - C.F.O. - 179/93).

You may not qualify if:

  • NCCL previously restored;
  • Presence of caries;
  • Patients with periodontitis;
  • Patients with bruxism or teeth clenching;
  • Patients with orthodontic treatment in progress;
  • Pregnant patients or smokers;
  • Patients with systemic problems (cardiovascular, blood dyscrasias, immunodeficiency, diabetes and others), which contraindicate the surgical procedure; Previous periodontal surgery in the area of interest of the present study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

UEPJMF

São José dos Campos, São Paulo, 12245000, Brazil

Location

Related Publications (1)

  • Mathias-Santamaria IF, Santamaria MP, Silveira CA, Martinho FC, de Melo MAS, De Marco AC, Augusto MG, de Andrade GS, Roulet JF, Bresciani E. Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: a 2-year follow-up randomized clinical trial. Clin Oral Investig. 2023 Apr;27(4):1781-1792. doi: 10.1007/s00784-022-04806-1. Epub 2022 Dec 3.

MeSH Terms

Conditions

Tooth AbrasionGingival Recession

Condition Hierarchy (Ancestors)

Tooth WearTooth DiseasesStomatognathic DiseasesGingival DiseasesPeriodontal DiseasesMouth DiseasesPeriodontal Atrophy

Study Officials

  • Eduardo Bresciani, PhD

    Universidade Estadual Paulista Júlio de Mesquita Filho

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

November 24, 2016

First Posted

July 12, 2017

Study Start

November 1, 2016

Primary Completion

June 1, 2019

Study Completion

June 1, 2019

Last Updated

June 13, 2019

Record last verified: 2019-06

Locations