Clinical trial NCT07002138: The Acceptability of Digital Impression Compared to Conventional Technique in Children
Official title: The Acceptability of Digital Impression Compared to Conventional Technique in Children - A Randomized Controlled Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dental Anxiety
Gagging
Dental Impression Techniques
Pediatric Dentistry
Keywords: intraoral scanners
pediatric dentistry
gag reflex
alginate impressions
children preference
parents preference
Lead sponsor: Beirut Arab University
Sponsor class: OTHER
First posted: 2025-06-03
Enrollment: 40
Sex: ALL
Minimum age (years): 6
Maximum age (years): 11
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: OTHER

Brief summary: This randomized crossover clinical trial aims to evaluate the acceptability of digital intraoral impressions compared to conventional alginate impressions in children aged 6 to 11 years. The study will assess patient comfort, anxiety, time efficiency, and preference using validated tools. A total of 40 children who require dental impressions for orthodontic or prosthetic treatment will be enrolled and randomly assigned to receive both impression techniques in alternating order, with a washout period of 14-21 days between sessions. Data collection includes Visual Analog Scale (VAS) scores for comfort and gag reflex, Venham's Clinical Anxiety Scale for anxiety assessment, and comparative questionnaires for both patients and parents. The study aims to determine whether digital impressions offer a more acceptable and less distressing alternative for pediatric patients in clinical dental settings.

Detailed description: This randomized crossover clinical trial aims to evaluate and compare the acceptability, comfort, time efficiency, and anxiety levels associated with digital intraoral impressions versus conventional alginate impressions in children aged 6 to 11 years. Dental impressions are essential in pediatric treatment planning, yet conventional alginate techniques are often poorly tolerated by children due to discomfort, taste, gagging, and procedural anxiety. Advances in digital dentistry, particularly intraoral scanners (IOS), provide a less invasive alternative with potential to enhance patient cooperation and improve the overall experience. Despite their growing use in adult patients, evidence regarding children's acceptance of intraoral scanning remains limited, particularly in the Middle East.

This study will be conducted at the Pediatric Dentistry Department of Beirut Arab University over a four-month period and will involve 40 pediatric patients who require dental impressions for fixed or removable appliances. A 1:1 randomization process will assign participants to one of two sequences: Group 1 will receive a digital impression first, followed by a conventional impression after a 14-21 day washout period; Group 2 will receive the procedures in reverse order. All procedures will be performed by a single calibrated operator.

Digital impressions will be made using the Medit i700 intraoral scanner, which allows 3D image acquisition without physical materials or trays. The scanning process includes drying the teeth and capturing occlusal, lingual, and buccal surfaces. Conventional impressions will be obtained using Hydrogum 5 alginate, involving tray selection, alginate mixing, and taking maxillary and mandibular impressions, followed by disinfection.

To assess acceptability and experience, several outcome measures will be recorded. Patient comfort and specific sensory responses will be measured using a Visual Analog Scale (VAS), where children will rate domains such as general feeling, breathing difficulty, taste or smell discomfort, thermal discomfort (heat/cold), gag reflex, and pain. Operator-assessed anxiety levels will be scored using the Venham's Clinical Anxiety Scale (VCAS), ranging from 0 (no anxiety) to 5 (severe anxiety). Total procedure time will be recorded using a digital stopwatch, beginning at tray or scanner insertion and ending at procedure completion. After both procedures, a structured comparative questionnaire will be administered to children, their parents, and the operator to assess perceived comfort, ease, duration, and preference.

Additionally, the operator's subjective perception of difficulty, applicability, and preference for each method will be documented. Intra-examiner reliability for digital scanning will be evaluated using repeated scans of 10 cases at a 48-hour interval, with agreement assessed via Cohen's Kappa statistic.

Statistical analysis will be conducted using SPSS version 26. Normality testing will guide the use of parametric or non-parametric tests (e.g., paired t-test or Wilcoxon signed-rank test), with a significance level set at α = 0.05. Descriptive statistics will be presented for baseline demographic data.

The study has been approved by the Ethics Committee of Beirut Arab University (Protocol ID: 2023-H-0139-D-M-0578). Informed consent will be obtained from parents or legal guardians before participation, and confidentiality will be strictly maintained. Participants will not incur costs or receive compensation.

By comparing these two impression methods in terms of comfort, anxiety, and feasibility, this study aims to generate original data relevant to pediatric dentistry and digital workflows. The findings may inform best practices and encourage the adoption of child-friendly technologies in clinical dental care.

Eligibility criteria: Inclusion Criteria:

* Children aged 6-11 years
* In need for the fabrication of fixed or removable appliance
* Having gagging problem based on the Classification of Gagging Problem scale starting from G1 to G5. (Saita et al., 2013) Where G1 is Normal Gagging: Normal gagging but not desensitized (controlled by the patient). The patient can withstand a full mouth examination with a dental mirror and a basic periodontal examination G2 is Mild gagging : Gagging when probe was used in a basic periodontal examination G3 is Moderate gagging: Gagging when examining molar teeth with a mirror G4 is Severe gagging: Gagging when examination of anterior teeth with a mirror G5 is Very severe gagging: Gagging at the moment when the dental mirror is inserted

Exclusion Criteria:

* Having a previous experience with any type of dental impressions.
* Having any systemic diseases or mental disorders.

Primary outcomes:
measure: Comparison of patient comfort during digital and conventional methods
timeFrame: Assessed immediately following each impression procedure during the same clinical visit
measure: Duration of digital versus conventional dental impressions
timeFrame: Assessed immediately following each impression procedure during the same clinical visit
Secondary outcomes:
measure: Comparison of child anxiety levels during digital and conventional impressions
timeFrame: Assessed immediately following each impression procedure during the same clinical visit.
measure: Comparison of patient and caregiver preferences for digital versus conventional impressions
timeFrame: Assessed immediately after digital procedure during the same clinical visit.
measure: Comparison of operator perception of difficulty and applicability of digital versus conventional impressions
timeFrame: Assessed immediately after both impressions were completed for each participant during the same clinical session.
Other outcomes:
Locations:
city: Beirut
country: Lebanon
facility: The Pediatric Dental clinics of the Faculty of Dentistry at Beirut Arab University
Study officials:
affiliation: Beirut Arab University
name: Associate Professor Ahmad Tarabaih, Associate Professor Ahmad
role: STUDY_DIRECTOR
References: