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Revitalization of Immature Permanent Teeth With Necrotic Pulps Using SHED Cells

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2013 by Fourth Military Medical University
Sponsor:
Information provided by (Responsible Party):
Jin yan, Prof, Fourth Military Medical University
ClinicalTrials.gov Identifier:
NCT01814436
First received: March 16, 2013
Last updated: NA
Last verified: March 2013
History: No changes posted
  Purpose

Revitalization of Young Immature Permanent Teeth With Necrotic Pulps Using Autologous Stem Cells from Human Exfoliated Deciduous Teeth


Condition Intervention
Dental Pulp Necrosis
Device: scaffold-free SHED-derived pellet

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Revitalization of Young Immature Permanent Teeth With Necrotic Pulps Using Autologous Stem Cells From Human Exfoliated Deciduous Teeth

Further study details as provided by Fourth Military Medical University:

Primary Outcome Measures:
  • Pulp and Apical regeneration [ Time Frame: 1 year following transplantation ] [ Designated as safety issue: Yes ]

    The main outcome measures in the study protocol were: pulp status evaluated by dental pulp vitality tester; pulp revascularization examined by laser dopler flow meter, and the index of clinical examination. In addition, we examined whether and to what extent adverse events, for which causal relationships with the use of SHED cell was not ruled out, emerged.

    The other main outcome measures in the study protocol were: the degree of apical closure; the rate of increase in root length and the change of root canal wall thickness. We examined and evaluate the anatomic morphology of teeth roots using dental computer tomography. We set rate of increase in root length as the most statistically important outcome (primary outcome).



Secondary Outcome Measures:
  • Clinical parameters [ Time Frame: 3~12 month following transplantation ] [ Designated as safety issue: No ]
    periapical lesion and tooth mobility


Estimated Enrollment: 80
Study Start Date: February 2013
Estimated Study Completion Date: October 2014
Estimated Primary Completion Date: July 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: scaffold-free SHED-derived pellet Device: scaffold-free SHED-derived pellet
The purpose of this clinical trial is to both clarify the efficiency of autologous SHED to regenerate pulp and apical tissue in the patients with immature permanent teeth and pulp necrosis to confirm the safety of using autologous stem cells in clinical endodontic regenerative medicine.
Other Name: SHED pellet

Detailed Description:

Irreversible damage to immature permanent teeth as a result of noxious infection or local trauma before normal physiological closure of the apical structure represents a real clinical challenge. The conventional therapeutic approach is to consider the use of synthetic biocompatible materials, such as calcium hydroxide [Ca(OH)2] and mineral trioxide aggregate (MTA), to induce apical closure, or apexification, by forming a hard tissue barrier across the root apex. However, neither MTA nor calcium hydroxide are currently able either to induce or stimulate pulp regeneration, or to ensure that conventional root development continues once damage has taken place, so that the inherent risk of root fracture remains. Along with the development of new regenerative protocols to resolve clinical deficiencies, continuing advances in the discovery and characterization of stem cells of dental origin—able to differentiate into multiple tissue types—have recently broadened possible therapeutic horizons towards pulp tissue regeneration and apexogenesis. Some studies have suggested that the recent discovery and characterization of stem cells from human exfoliated deciduous teeth (SHED) form the cell source of apexogenesis in immature teeth with periradicular periodontitis of endodontic origin. The purpose of this clinical trial is to both clarify the efficiency of autologous SHED to regenerate pulp and apical tissue in the patients with immature permanent teeth and pulp necrosis to confirm the safety of using autologous stem cells in clinical endodontic regenerative medicine. This is a single-centre, randomized, placebo-controlled study. This study has been approved by the ethical committees of School of Stomatology, Fourth Military Medical University. The study will be conducted according to the Declaration of Helsinki.

  Eligibility

Ages Eligible for Study:   7 Years to 12 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Those who has signed the informed consent.
  2. Those who are between 7-years-old to 12-years-old.
  3. Those with at least one young permanent teeth with pulp necrosis which caused by trauma.
  4. Those who can provide the health deciduous teeth.
  5. Those who have accomplished initial preparation and have been showing good compliance.
  6. Those whose guardians understand the purposes of the trial and are capable of making an independent decision to comply with trial requirements
  7. Those who are able to visit our hospital in accordance with the trial schedule

Exclusion Criteria:

  1. Those in an extremely poor nutritional condition (serum albumin concentration <2 g/dL)
  2. Those whose guardians would not cooperate with the treatment.
  3. Those who has uncontrollable oral disease.
  4. Those with severe dental fear.
  5. Those with coexisting mental or consciousness disorder.
  6. Those with teeth dysplasia and/or hereditary disease history.
  7. Those with systemic disease which may affect the postoperative healing.
  8. Those with bruxism and malocclusion.
  9. Those who are taking the medicine which would affect the postoperative healing.
  10. Those with the bad oral habits.
  11. Those who are undertaking other trail meanwhile or few weeks ago.
  12. Those coexisting disease of the blood or immune system.
  13. Those who are not capable to provide the deciduous dental pulp cells.
  14. Those with the severe tooth trauma (crown-root or root fracture, tooth displacement).
  15. Others who the investigators or sub-investigators determined as unsuitable for the trial.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01814436

Contacts
Contact: kun xuan 86-29-84776087 xuankun@fmmu.edu.cn
Contact: yan jin 86-29-84776147 yanjin@fmmu.edu.cn

Locations
China, Shaanxi
School of Stomatology, Fourth Military Medical University Recruiting
Xi'an, Shaanxi, China, 710032
Contact: Yan Jin, PhD    86-29-84776147    yanjinfmmu@gmail.com   
Principal Investigator: yan Jin, PhD         
Principal Investigator: Kun Xuan, PhD         
Sub-Investigator: yongjie zhang, PhD         
Sponsors and Collaborators
Fourth Military Medical University
Investigators
Principal Investigator: songtao shi, PhD chool of Stomatology, Fourth Military Medical Univeristy; Ostrow School of Dentistry, University of Southern California
  More Information

No publications provided

Responsible Party: Jin yan, Prof, Professor, Fourth Military Medical University
ClinicalTrials.gov Identifier: NCT01814436     History of Changes
Other Study ID Numbers: FourthMMU2013
Study First Received: March 16, 2013
Last Updated: March 16, 2013
Health Authority: China: Ministry of Health

Additional relevant MeSH terms:
Dental Pulp Necrosis
Dental Pulp Diseases
Necrosis
Pathologic Processes
Stomatognathic Diseases
Tooth Diseases

ClinicalTrials.gov processed this record on November 20, 2014