Three Dimensional Evaluation of Apexogenesis of Immature Young Permanent Teeth With Different Endodontic Material

Study Overview
=================
Brief Summary
-----------------
Randomized Clinical Trial using Three Dimensional Evaluation of Apexogensis of immature young permanent teeth with Different Endodontic Tri-calcium Silicate-Based Putties

Detailed Description
-----------------
Treatment of immature permanent teeth has always been challenging in endodontics, not only because of their wide-open root apices but also because of the thin underdeveloped dentinal walls.Apexogenesis falls under the category of vital pulp therapy (VPT) procedure to maintain pulp vitality, induce dentin bridge formation and encourage continued root maturation. To overcome the drawbacks of tricalcium silicate-based cements, a range of bioactive endodontic cements have been developed. EndoSequence BC RRM-Fast Set Putty and NeoPutty (NuSmile, Houston, TX, USA) are the two materials evaluated in this study.

Official Title
-----------------
Three Dimensional Evaluation of Apexogenesis of Immature Young Permanent Teeth With Different Endodontic Tri-calcium Silicate-Based Putties: Randomized Clinical Trial

Conditions
-----------------
Deep Carious Young 1st Permanent Molar With Open Apex

Intervention / Treatment
-----------------
* Procedure: endo-sequence putty
* Procedure: neo-MTA putty


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: First permanent molar with pulpitis. Sufficient tooth structure for placing rubber dam. Presence of open apex. Short root length. Exclusion Criteria: Insufficient tooth structure that need post and core. Presence of swelling. Presence of sinus tract. Presence of root fracture. Presence of root crack. Presence of external or internal root resorption. Presence of periapical pathosis. Presence of root calcification.

Ages Eligible for Study
-----------------
Minimum Age: 6 Years
Maximum Age: 9 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group (I) control<br>young permanent pulpy exposed carious tooth of the selected participants will be treated with specific technique called apexogenesis using bio-compatible material (endo-sequence putty ). This material is administrated to the tooth by placing about 2-4 mm bulk of material in the pulp champers at the cervical line then sealing the capping material with glass ionomer and stainless steel crown. | Procedure: endo-sequence putty<br>* pupal medicament which is materials used in case of vital pulp therapy (VPT) procedure after opening access in the inflamed pulp to maintain it is vitality, inducing dentin bridge formation and encourage continued root maturation.<br>* Other names: Endodontic Tri-calcium Silicate-Based Puty;|
| Experimental: Group (II)<br>young permanent pulpy exposed carious tooth of the selected participants will be treated with specific technique called apexogenesis using bio-compatible material (neo-MTA putty). This material is administrated to the tooth by placing about 2-4 mm bulk of material in the pulp champers at the cervical line then sealing the capping material with glass ionomer and stainless steel crown. | Procedure: neo-MTA putty<br>* pupal medicament which is materials used in case of vital pulp therapy (VPT) procedure after opening access in the inflamed pulp to maintain it is vitality, inducing dentin bridge formation and encourage continued root maturation.<br>* Other names: Endodontic Tri-calcium Silicate-Based Puty;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| asymptomatic | pain relief after procedure by Numeric rating scales on follow up visits.Most pain scales use numbers from 0 to 10. A score of 0 means no pain, and 10 means the worst pain you have ever felt. | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| complete root maturation | increasing the length the root till the apex closure which is determined by cone beam analysis | one year |