Turmeric Gel as Alternative Non-vital Pulpotomy Medicament in Primary Teeth

Study Overview
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Brief Summary
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The purpose of this randomized controlled clinical trial is to use Turmeric gel as non-vital Pulpotomy medicament compared to Formocresol in primary teeth by evaluating its antibacterial effect against Streptococcus mutans and Lactobacillus acidophilus. It is hypothesized that there is no difference in the antibacterial effect of Turmeric gel compared with Formocresol, when used as non-vital Pulpotomy medicaments.

Detailed Description
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It is a multi-arm parallel Randomized Controlled Trial in which forty patients aged between 4 to 8 years, each containing at-least one non-vital primary molar, will be selected and randomly divided into Group A (Formocresol) and Group B (Turmeric gel). Non-vital Pulpotomy will be performed by removing the coronal necrotic pulp. Sterile paper point will be dipped in the root canals and taken to the laboratory. Cotton pellets soaked in the respective medicaments will be placed over the root canal orifices and filled temporarily. Patients will be recalled after one week. Samples will be again taken, and tooth restored. Comparison between bacterial count at baseline and after one week of treatment will be made and expressed as Colony-Forming Units/ml (CFU/ml).

Official Title
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Turmeric Gel as Alternative Non-Vital Pulpotomy Medicament in Primary Teeth-A Randomized Controlled Trial

Conditions
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Non-Vital Tooth

Intervention / Treatment
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* Drug: Turmeric Gel
* Drug: Formocresol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cooperation of patients and consent of parents. Patients with ASA classification I and II (mild to moderate systemic disease). Non-traumatic extensively carious hence restorable primary molars. No history of antibiotic use for 2 weeks. Presence of following clinical signs or symptoms suggestive of non-vital tooth such as tenderness on percussion, non-responsive to cold test, periapical/furcal radiolucency, localized gingival/mucosal soreness/ redness/ swelling, and/or slight mobility-grade I. Exclusion Criteria: History of allergy to anesthetics and latex. Radiographic evidence of pulpal floor opening into the furcation area. More than half of the roots resorbed.

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Turmeric gel= interventional drug Formocresol= Control drug (standard drug)
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Formocresol (Control-Gold standard-Group A)<br>Premade Formocresol (Tricresol & Formalin) was used composed of Tricresol 35%, Formaldehyde (40%) 19%, excipient additive 100% (PD, Switzerland, ISO9001/ISO9001_2000/ ISO13485/CE_MARK), (Universal Dental Pvt, Ltd). | Drug: Formocresol<br>* Formocresol will be used as non-vital pulpotomy medicament (which is gold standard)<br>* Other names: Medicaments for non-vital pulpotomy procedure;|
| Experimental: Turmeric gel (Experimental-Group B)<br>Turmeric gel will be self-prepared at the Institute of Microbiology and Molecular Genetics, Punjab University, Lahore. 2kgs of Turmeric rhizomes were purchased from a local market in Lahore and verified by a taxonomist, Botany Department, Government College University, Lahore (voucher number: GC.Herb.Bot.3693). Approximately 170g powder along with 550ml distilled water will be taken in a Soxhlet extractor for 96 hours and then filtered repeatedly through Whatman No.1 filter paper. The obtained filtrate will then be mixed with 6% Sodium Carboxy-Methyl Cellulose (NaCMC) (Genevex Chem, Hyderabad, India) to form gel. Four Vitamin C grounded tablets (Wilson's Vitamin C, Wilson's Healthcare, Islamabad, Pakistan) and twelve Vitamin E capsules (Evion, Martin Dow pharmaceuticals, Ltd. Karachi, Pak) will then be added in 100g of gel as antioxidants. | Drug: Turmeric Gel<br>* Turmeric gel will be used as non-vital pulpotomy medicament compared with Formocresol (which is gold standard)<br>* Other names: Medicaments for non-vital pulpotomy procedure;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Antibacterial effect | Bacterial count of S. mutans and L. acidophilus counted as Colony Forming Units/ml (CFU/ml) | 1 week |