The CAP-1 Trial: Stepwise Excavation Versus One Completed Excavation in Deep Caries
A large proportion of dental practice involves the treatment of caries in the permanent dentition. In USA alone tooth related pain is annually responsible for 15 billions days lost through sickness. We do not know whether a stepwise excavation is better or worse compared with one final completed excavation in adults with deep caries with or without pain. A deep carious lesion is in the risk zone of being pulpal exposed during excavation.
The aim of the CAP-1-trial is to investigate the beneficial effects of stepwise excavation during two visits versus óne completed excavation of deep caries in permanent teeth with or without pain.
Consecutive patients contacting the units involved in the CAP trial for the treatment of deep caries. The trial will comprise 300 patients.
CAP-1-trial is a randomised patient- and observer-blinded multicenter trial, with two parallel intervention groups. Patients that fulfill the inclusions criteria and none of the exclusions criteria, will be centrally bloc-randomised in Copenhagen Trial Unit, Copenhagen DK, and stratified by age and pain. Allocation ratio is 1:1.
Interventions and products:
Patients are allocated for stepwise excavation in two visits or final excavation in one visit. The patients will not be informed about the result of the randomisation, i.e. the type of intervention. Therefore, all patients will be contacted for two visits. The second visit in the stepwise excavation group wil be used for the second and final excavation, and for the performance of a permanent restoration. The second visit in the one step excavation group will solely be used for the performance of a permanent restoration. The interventions in both groups are completed following 8-10 weeks after the randomisation.
A temporary calcium hydroxide based material is used in both groups (Dycal®). The temporary restoration material, glas-ionomer cement is used (Ketac Molar®) in between visits, and a resin material is used for the final restoration(Herculite®).
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Treatment
|Official Title:||The CAP-1 Trial: Effect of Stepwise Versus One Completed Excavation in Deep Caries in Permanent Teeth: A Randomised, Patient - and Observer-blinded Multicenter Trial|
- Primary outcome is whether the treatment can be made with a maintained sensible pulp and without root infection following a 1-year control. [ Time Frame: 1year control data for all treatments primo 2008 ] [ Designated as safety issue: No ]In this update we have also completed 5 yr control
- Secondary outcome constitutes pain intensity using a visual analogue scale measured before the first visit and 1 and 7 days after. [ Time Frame: ultimo 2007 ] [ Designated as safety issue: No ]
|Study Start Date:||February 2005|
|Study Completion Date:||June 2013|
|Primary Completion Date:||March 2007 (Final data collection date for primary outcome measure)|
Experimental: SW intervention
Stepwise removal of carious tissue in 2 stages
Other Name: Stepwise carious removal wos
Control intervention Direct complete excavation. The updated terminology for completed excavation is non-selective excavation to hard dentin
one complete excavation
Other Name: Non-selective carious removal to hard dentin
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00187837
|School of Dentistry, Faculty of Health Sciences|
|Copenhagen, Copenhagen N, Denmark, 2200|
|Study Director:||Lars Bjørndal||University of Copenhagen|