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Falhas:
ID
6255
Descrição
PRL1013: Enrollment Form (ENR) Postoperative Hypersensitivity Randomized Comparative Effectiveness Research Trial (POH RCERT) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A63D65F7-CD34-5822-E040-BB89AD4372DF
Link
Palavras-chave
Versões (2)
- 18/12/2014 18/12/2014 - Martin Dugas
- 09/01/2015 09/01/2015 - Martin Dugas
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18 de dezembro de 2014
DOI
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Licença
Creative Commons BY-NC 3.0 Legacy
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Dental Caries NCT01268605 Eligibility - PRL1013: Enrollment Form (ENR) - 3246000v1.0
No Instruction available.
- StudyEvent: PRL1013: Enrollment Form (ENR)
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No Instruction available.
- StudyEvent: PRL1013: Enrollment Form (ENR)
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
PractitionersEngagedinAppliedResearchandLearningNetworkClinicalStudySiteIdentifierNumber
Item
Site Code
text
C15206 (NCI Thesaurus ObjectClass)
C0008972 (UMLS 2011AA ObjectClass)
C37901 (NCI Thesaurus ObjectClass)
C0205145 (UMLS 2011AA ObjectClass)
C52664 (NCI Thesaurus ObjectClass)
C1709628 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0008972 (UMLS 2011AA ObjectClass)
C37901 (NCI Thesaurus ObjectClass)
C0205145 (UMLS 2011AA ObjectClass)
C52664 (NCI Thesaurus ObjectClass)
C1709628 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
PatientDentistVisitDate
Item
Date of visit
date
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C52654 (NCI Thesaurus Property)
C0011441 (UMLS 2011AA Property)
C25716 (NCI Thesaurus Property)
C0545082 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C52654 (NCI Thesaurus Property)
C0011441 (UMLS 2011AA Property)
C25716 (NCI Thesaurus Property)
C0545082 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
PatientCoordinatingIdentifierNumber
Item
Subject ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Subject Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
PersonReportedAgeValue
Item
Subject's age
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25375 (NCI Thesaurus Property)
C0684224 (UMLS 2011AA Property)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0027361 (UMLS 2011AA ObjectClass)
C25375 (NCI Thesaurus Property)
C0684224 (UMLS 2011AA Property)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Item
How many teeth are being enrolled on this protocol
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C15207 (NCI Thesaurus Property)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C37948 (NCI Thesaurus Property)
C1516879 (UMLS 2011AA Property)
C0237753 (UMLS 2011AA ValueDomain)
C15207 (NCI Thesaurus Property)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C37948 (NCI Thesaurus Property)
C1516879 (UMLS 2011AA Property)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
CL Item
4 (4)
Item
Tooth number with occlusal caries
text
C52593 (NCI Thesaurus ObjectClass)
C0011334 (UMLS 2011AA ObjectClass)
C52591 (NCI Thesaurus ObjectClass)
C0447303 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C13072 (NCI Thesaurus ValueDomain)
C0011443 (UMLS 2011AA ValueDomain)
C0011334 (UMLS 2011AA ObjectClass)
C52591 (NCI Thesaurus ObjectClass)
C0447303 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C13072 (NCI Thesaurus ValueDomain)
C0011443 (UMLS 2011AA ValueDomain)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Upper Left (12)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Upper Left (13)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Upper Left (14)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Upper Left (15)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Lower Left (18)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Lower Left (19)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Upper Right (2)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Lower Left (20)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Lower Left (21)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Lower Right (28)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Lower Right (29)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Upper Right (3)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Lower Right (30)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Lower Right (31)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Upper Right (4)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Upper Right (5)
Item
Tooth quadrant
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12421 (NCI Thesaurus Property)
C0226896 (UMLS 2011AA Property)
C61106 (NCI Thesaurus Property)
C1631280 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12421 (NCI Thesaurus Property)
C0226896 (UMLS 2011AA Property)
C61106 (NCI Thesaurus Property)
C1631280 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL Item
Upper Right Quadrant (Upper Right)
CL Item
Upper Left Quadrant (Upper Left)
CL Item
Lower Right Quadrant (Lower Right)
CL Item
Lower Left Quadrant (Lower Left)
DentalInstrumentationAirSpeedDescriptionValue
Item
Air velocity
double
C41136 (NCI Thesaurus ObjectClass)
C0226984 (UMLS 2011AA ObjectClass)
C16742 (NCI Thesaurus ObjectClass)
C0348000 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C41146 (NCI Thesaurus Property)
C0678536 (UMLS 2011AA Property)
C0001861 (NCI Metathesaurus Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0226984 (UMLS 2011AA ObjectClass)
C16742 (NCI Thesaurus ObjectClass)
C0348000 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C41146 (NCI Thesaurus Property)
C0678536 (UMLS 2011AA Property)
C0001861 (NCI Metathesaurus Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Item
Air stimulation pain level
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25201 (NCI Thesaurus ObjectClass)
C1522640 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C61406 (NCI Thesaurus Property)
C1948023 (UMLS 2011AA Property)
C73434 (NCI Thesaurus Property)
C0001861 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25201 (NCI Thesaurus ObjectClass)
C1522640 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C61406 (NCI Thesaurus Property)
C1948023 (UMLS 2011AA Property)
C73434 (NCI Thesaurus Property)
C0001861 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
10 (10)
Item
Does the pain linger >4 seconds (after removal of air blast)
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25201 (NCI Thesaurus Property)
C1522640 (UMLS 2011AA Property)
C25649 (NCI Thesaurus Property)
C1527428 (UMLS 2011AA Property)
C62180 (NCI Thesaurus Property)
C0009264 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25201 (NCI Thesaurus Property)
C1522640 (UMLS 2011AA Property)
C25649 (NCI Thesaurus Property)
C1527428 (UMLS 2011AA Property)
C62180 (NCI Thesaurus Property)
C0009264 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Cold stimulation pain level
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25201 (NCI Thesaurus ObjectClass)
C1522640 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62180 (NCI Thesaurus Property)
C0009264 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25201 (NCI Thesaurus ObjectClass)
C1522640 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62180 (NCI Thesaurus Property)
C0009264 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
10 (10)
ToothColdSensitivityAssessmentDuration
Item
Time to cold sensation
double
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25201 (NCI Thesaurus Property)
C1522640 (UMLS 2011AA Property)
C62180 (NCI Thesaurus Property)
C0009264 (UMLS 2011AA Property)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25201 (NCI Thesaurus Property)
C1522640 (UMLS 2011AA Property)
C62180 (NCI Thesaurus Property)
C0009264 (UMLS 2011AA Property)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
Item
Does the pain linger > 4 seconds
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25201 (NCI Thesaurus Property)
C1522640 (UMLS 2011AA Property)
C25649 (NCI Thesaurus Property)
C1527428 (UMLS 2011AA Property)
C62181 (NCI Thesaurus Property)
C2350229 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25201 (NCI Thesaurus Property)
C1522640 (UMLS 2011AA Property)
C25649 (NCI Thesaurus Property)
C1527428 (UMLS 2011AA Property)
C62181 (NCI Thesaurus Property)
C2350229 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Gingival index
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C32677 (NCI Thesaurus ObjectClass)
C0017562 (UMLS 2011AA ObjectClass)
C0349674 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C32677 (NCI Thesaurus ObjectClass)
C0017562 (UMLS 2011AA ObjectClass)
CL Item
Normal Appearance, No Bleeding (Normal appearance, no bleeding)
CL Item
Mild Inflammation; Slight Change In Color And Mild Edema (Mild inflammation; slight change in color and mild edema)
CL Item
Moderate Inflammation; Redness, Edema And Glazing; Bleeding On Probing (Moderate inflammation; redness, edema and glazing; bleeding on probing)
CL Item
Severe Inflammation; Marked Redness And Edema; Ulceration; Spontaneous Bleeding (Severe inflammation; marked redness and edema; ulceration; spontaneous bleeding)
Item
Does the subject have solely adult dentition
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C13072 (NCI Thesaurus ObjectClass)
C0011443 (UMLS 2011AA ObjectClass)
C33313 (NCI Thesaurus ObjectClass)
C0348070 (UMLS 2011AA ObjectClass)
C1512698 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus Property)
C13072 (NCI Thesaurus ObjectClass)
C0011443 (UMLS 2011AA ObjectClass)
C33313 (NCI Thesaurus ObjectClass)
C0348070 (UMLS 2011AA ObjectClass)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Are all protocol teeth permanent posterior teeth and present withthe clinical diagnosis of new Class I caries extending into dentinwith or without radiographic confirmation
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C0205355 (NCI Metathesaurus ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C52593 (NCI Thesaurus Property)
C0011334 (UMLS 2011AA Property)
CL356172 (NCI Metathesaurus ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C0205355 (NCI Metathesaurus ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C52593 (NCI Thesaurus Property)
C0011334 (UMLS 2011AA Property)
CL356172 (NCI Metathesaurus ValueDomain)
Code List
Are all protocol teeth permanent posterior teeth and present withthe clinical diagnosis of new Class I caries extending into dentinwith or without radiographic confirmation
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Are these the only teeth that meet the eligibility criteria
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C49487 (NCI Thesaurus ObjectClass)
C1298908 (UMLS 2011AA ObjectClass)
C15206 (NCI Thesaurus ObjectClass)
C0008972 (UMLS 2011AA ObjectClass)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0205394 (UMLS 2011AA ObjectClass)
C49487 (NCI Thesaurus ObjectClass)
C1298908 (UMLS 2011AA ObjectClass)
C15206 (NCI Thesaurus ObjectClass)
C0008972 (UMLS 2011AA ObjectClass)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Are these the only teeth that will be treated (will receive restoration) at this time
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C12506 (NCI Thesaurus Property)
C0040426 (UMLS 2011AA Property)
C16112 (NCI Thesaurus Property)
C1516637 (UMLS 2011AA Property)
C74521 (NCI Thesaurus Property)
C2700399 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0027361 (UMLS 2011AA ObjectClass)
C12506 (NCI Thesaurus Property)
C0040426 (UMLS 2011AA Property)
C16112 (NCI Thesaurus Property)
C1516637 (UMLS 2011AA Property)
C74521 (NCI Thesaurus Property)
C2700399 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Are these the only teeth that will be treated (will receive restoration) at this time
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is/Are the radiographic depth(s) of the lesion(s), when visible, less than or equal to half the Dento-Enamel Junction (DEJ) to the pulp
text
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property)
C0439849 (UMLS 2011AA Property)
C79874 (NCI Thesaurus Property)
C2699427 (UMLS 2011AA Property)
C32453 (NCI Thesaurus Property)
C0011429 (UMLS 2011AA Property)
C32505 (NCI Thesaurus Property)
C0011350 (UMLS 2011AA Property)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C0221198 (UMLS 2011AA ObjectClass)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property)
C0439849 (UMLS 2011AA Property)
C79874 (NCI Thesaurus Property)
C2699427 (UMLS 2011AA Property)
C32453 (NCI Thesaurus Property)
C0011429 (UMLS 2011AA Property)
C32505 (NCI Thesaurus Property)
C0011350 (UMLS 2011AA Property)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
Is/Are the radiographic depth(s) of the lesion(s), when visible, less than or equal to half the Dento-Enamel Junction (DEJ) to the pulp
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
CL Item
Not Visible, But Confirmed Clinically (Not visible, but confirmed clinically)
Item
Tooth Number
text
C13072 (NCI Thesaurus ObjectClass)
C0011443 (UMLS 2011AA ObjectClass)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25700 (NCI Thesaurus Property)
C0449913 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C13072 (NCI Thesaurus ValueDomain)
C0011443 (UMLS 2011AA ValueDomain)
C0011443 (UMLS 2011AA ObjectClass)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25700 (NCI Thesaurus Property)
C0449913 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C13072 (NCI Thesaurus ValueDomain)
C0011443 (UMLS 2011AA ValueDomain)
CL Item
3rd Molar (wisdom Tooth) Permanent Arch Upper Right (1)
CL Item
Lateral Incisor Permanent Arch Upper Left (10)
CL Item
Cuspid (canine/eye Tooth) Permanent Arch Upper Left (11)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Upper Left (12)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Upper Left (13)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Upper Left (14)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Upper Left (15)
CL Item
3rd Molar (wisdom Tooth) Permanent Arch Upper Left (16)
CL Item
3rd Molar (wisdom Tooth) Permanent Arch Lower Left (17)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Lower Left (18)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Lower Left (19)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Upper Right (2)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Lower Left (20)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Lower Left (21)
CL Item
Cuspid (canine/eye Tooth) Permanent Arch Lower Left (22)
CL Item
Lateral Incisor Permanent Arch Lower Left (23)
CL Item
Central Incisor Permanent Arch Lower Left (24)
CL Item
Central Incisor Permanent Arch Lower Right (25)
CL Item
Lateral Incisor Permanent Arch Lower Right (26)
CL Item
Cuspid (canine/eye Tooth) Permanent Arch Lower Right (27)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Lower Right (28)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Lower Right (29)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Upper Right (3)
CL Item
1st Molar (6-yr. Molar) Permanent Arch Lower Right (30)
CL Item
2nd Molar (12-yr. Molar) Permanent Arch Lower Right (31)
CL Item
3rd Molar (wisdom Tooth) Permanent Arch Lower Right (32)
CL Item
2nd Bicuspid (2nd Premolar) Permanent Arch Upper Right (4)
CL Item
1st Bicuspid (1st Premolar) Permanent Arch Upper Right (5)
CL Item
Supernumerary 3rd Molar (wisdom Tooth) Permanent Arch Upper Right (51)
CL Item
Supernumerary 2nd Molar (12-yr. Molar) Permanent Arch Upper Right (52)
CL Item
Supernumerary 1st Molar (6-yr. Molar) Permanent Arch Upper Right (53)
CL Item
Supernumerary 2nd Bicuspid (2nd Premolar) Permanent Arch Upper Right (54)
CL Item
Supernumerary 1st Bicuspid (1st Premolar) Permanent Arch Upper Right (55)
CL Item
Supernumerary Cuspid (canine/eye Tooth) Permanent Arch Upper Right (56)
CL Item
Supernumerary Lateral Incisor Permanent Arch Upper Right (57)
CL Item
Supernumerary Central Incisor Permanent Arch Upper Right (58)
CL Item
Supernumerary Central Incisor Permanent Arch Upper Left (59)
CL Item
Cuspid (canine/eye Tooth) Permanent Arch Upper Right (6)
CL Item
Supernumerary Lateral Incisor Permanent Arch Upper Left (60)
CL Item
Supernumerary Cuspid (canine/eye Tooth) Permanent Arch Upper Left (61)
CL Item
Supernumerary 1st Bicuspid (1st Premolar) Permanent Arch Upper Left (62)
CL Item
Supernumerary 2nd Bicuspid (2nd Premolar) Permanent Arch Upper Left (63)
CL Item
Supernumerary 1st Molar (6-yr. Molar) Permanent Arch Upper Left (64)
CL Item
Supernumerary 2nd Molar (12-yr. Molar) Permanent Arch Upper Left (65)
CL Item
Supernumerary 3rd Molar (wisdom Tooth) Permanent Arch Upper Left (66)
CL Item
Supernumerary 3rd Molar (wisdom Tooth) Permanent Arch Lower Left (67)
CL Item
Supernumerary 2nd Molar (12-yr. Molar) Permanent Arch Lower Left (68)
CL Item
Supernumerary 1st Molar (6-yr. Molar) Permanent Arch Lower Left (69)
CL Item
Lateral Incisor Permanent Arch Upper Right (7)
CL Item
Supernumerary 2nd Bicuspid (2nd Premolar) Permanent Arch Lower Left (70)
CL Item
Supernumerary 1st Bicuspid (1st Premolar) Permanent Arch Lower Left (71)
CL Item
Supernumerary Cuspid (canine/eye Tooth) Permanent Arch Lower Left (72)
CL Item
Supernumerary Lateral Incisor Permanent Arch Lower Left (73)
CL Item
Supernumerary Central Incisor Permanent Arch Lower Left (74)
CL Item
Supernumerary Central Incisor Permanent Arch Lower Right (75)
CL Item
Supernumerary Lateral Incisor Permanent Arch Lower Right (76)
CL Item
Supernumerary Cuspid (canine/eye Tooth) Permanent Arch Lower Right (77)
CL Item
Supernumerary 1st Bicuspid (1st Premolar) Permanent Arch Lower Right (78)
CL Item
Supernumerary 2nd Bicuspid (2nd Premolar) Permanent Arch Lower Right (79)
CL Item
Central Incisor Permanent Arch Upper Right (8)
CL Item
Supernumerary 1st Molar (6-yr. Molar) Permanent Arch Lower Right (80)
CL Item
Supernumerary 2nd Molar (12-yr. Molar) Permanent Arch Lower Right (81)
CL Item
Supernumerary 3rd Molar (wisdom Tooth) Permanent Arch Lower Right (82)
CL Item
Central Incisor Permanent Arch Upper Left (9)
CL Item
Second Molar Primary Arch Upper Right (A)
CL Item
Supernumerary Second Molar Primary Arch Upper Right (AS)
CL Item
First Molar Primary Arch Upper Right (B)
CL Item
Supernumerary First Molar Primary Arch Upper Right (BS)
CL Item
Canine(cuspid) Primary Arch Upper Right (C)
CL Item
Supernumerary Canine(cuspid) Primary Arch Upper Right (CS)
CL Item
Lateral Incisor Primary Arch Upper Right (D)
CL Item
Supernumerary Lateral Incisor Primary Arch Upper Right (DS)
CL Item
Central Incisor Primary Arch Upper Right (E)
CL Item
Supernumerary Central Incisor Primary Arch Upper Right (ES)
CL Item
Central Incisor Primary Arch Upper Left (F)
CL Item
Supernumerary Central Incisor Primary Arch Upper Left (FS)
CL Item
Lateral Incisor Primary Arch Upper Left (G)
CL Item
Supernumerary Lateral Incisor Primary Arch Upper Left (GS)
CL Item
Canine (cuspid) Primary Arch Upper Left (H)
CL Item
Supernumerary Canine (cuspid) Primary Arch Upper Left (HS)
CL Item
First Molar Primary Arch Upper Left (I)
CL Item
Supernumerary First Molar Primary Arch Upper Left (IS)
CL Item
Second Molar Primary Arch Upper Left (J)
CL Item
Supernumerary Second Molar Primary Arch Upper Left (JS)
CL Item
Second Molar Primary Arch Lower Left (K)
CL Item
Supernumerary Second Molar Primary Arch Lower Left (KS)
CL Item
First Molar Primary Arch Lower Left (L)
CL Item
Supernumerary First Molar Primary Arch Lower Left (LS)
CL Item
Canine (cuspid) Primary Arch Lower Left (M)
CL Item
Supernumerary Canine (cuspid) Primary Arch Lower Left (MS)
CL Item
Lateral Incisor Primary Arch Lower Left (N)
CL Item
Supernumerary Lateral Incisor Primary Arch Lower Left (NS)
CL Item
Central Incisor Primary Arch Lower Left (O)
CL Item
Supernumerary Central Incisor Primary Arch Lower Left (OS)
CL Item
Central Incisor Primary Arch Lower Right (P)
CL Item
Supernumerary Central Incisor Primary Arch Lower Right (PS)
CL Item
Lateral Incisor Primary Arch Lower Right (Q)
CL Item
Supernumerary Lateral Incisor Primary Arch Lower Right (QS)
CL Item
Canine (cuspid) Primary Arch Lower Right (R)
CL Item
Supernumerary Canine (cuspid) Primary Arch Lower Right (RS)
CL Item
First Molar Primary Arch Lower Right (S)
CL Item
Supernumerary First Molar Primary Arch Lower Right (SS)
CL Item
Second Molar Primary Arch Lower Right (T)
CL Item
Supernumerary Second Molar Primary Arch Lower Right (TS)
Item
Tooth quadrant
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12421 (NCI Thesaurus Property)
C0226896 (UMLS 2011AA Property)
C61106 (NCI Thesaurus Property)
C1631280 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12421 (NCI Thesaurus Property)
C0226896 (UMLS 2011AA Property)
C61106 (NCI Thesaurus Property)
C1631280 (UMLS 2011AA Property)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL Item
Upper Right Quadrant (Upper Right)
CL Item
Upper Left Quadrant (Upper Left)
CL Item
Lower Right Quadrant (Lower Right)
CL Item
Lower Left Quadrant (Lower Left)
BitewingRadiographDiagnosticImagingAssessmentDate
Item
What was the date of theradiograph (If yes, - Referring Question is in prior Module Is/Are the radiographic depths of the lesions, when visible, less than or equal to half the Dento-Enamel Junction DEJ to the pulp?)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C62057 (NCI Thesaurus ObjectClass)
C1879851 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C62057 (NCI Thesaurus ObjectClass)
C1879851 (UMLS 2011AA ObjectClass)
Item
Is/Are the protocol tooth/teeth in occlusion with a natural tooth
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C85060 (NCI Thesaurus Property)
C0205296 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C85060 (NCI Thesaurus Property)
C0205296 (UMLS 2011AA Property)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Would a resin-based composite restoration be the standard of care for the lesion(s)
text
C15368 (NCI Thesaurus ObjectClass)
C52586 (NCI Thesaurus ObjectClass)
C1711229 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C44275 (NCI Thesaurus Property)
C1442989 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C52586 (NCI Thesaurus ObjectClass)
C1711229 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C44275 (NCI Thesaurus Property)
C1442989 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is/Are the protocol tooth/teeth free of evidence of a pulpitis (no report of lingering pain associated with any stimulus)
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C49487 (NCI Thesaurus Property)
C1298908 (UMLS 2011AA Property)
C52595 (NCI Thesaurus Property)
C0034103 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C49487 (NCI Thesaurus Property)
C1298908 (UMLS 2011AA Property)
C52595 (NCI Thesaurus Property)
C0034103 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Is/Are the protocol tooth/teeth free of evidence of a pulpitis (no report of lingering pain associated with any stimulus)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is the subject available for contact for at least four weeks post-treatment
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C67527 (NCI Thesaurus Property)
C0016884 (UMLS 2011AA Property)
C16033 (NCI Thesaurus Property)
C1522577 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C67527 (NCI Thesaurus Property)
C0016884 (UMLS 2011AA Property)
C16033 (NCI Thesaurus Property)
C1522577 (UMLS 2011AA Property)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Has the subject signed and dated the IRB-approved informed consent form or assent form for individuals under 18 years old
text
C16468 (NCI Thesaurus ObjectClass)
C0009797 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C25657 (NCI Thesaurus Property)
C1273518 (UMLS 2011AA Property)
C25679 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0009797 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C25657 (NCI Thesaurus Property)
C1273518 (UMLS 2011AA Property)
C25679 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Has the subject signed and dated the IRB-approved informed consent form or assent form for individuals under 18 years old
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
InformedConsentFormSignedDate
Item
Date of signed, witnessed, and dated informed consent/assent
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C16468 (NCI Thesaurus ObjectClass)
C0009797 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C16468 (NCI Thesaurus ObjectClass)
C0009797 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
Item Group
Exclusion Criteria (all Responses Must Be Checked "no" To Be Eligible)
Item
Is/Are the protocol tooth/teeth periodontally involved (mobility of 2 or greater or inflamed gingival tissues)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C63743 (NCI Thesaurus Property)
C0031090 (UMLS 2011AA Property)
C1512699 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C63743 (NCI Thesaurus Property)
C0031090 (UMLS 2011AA Property)
Code List
Is/Are the protocol tooth/teeth periodontally involved (mobility of 2 or greater or inflamed gingival tissues)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Does/Do the protocol tooth/teeth have existing restoration(s)
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C60718 (NCI Thesaurus ObjectClass)
C0399059 (UMLS 2011AA ObjectClass)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C60718 (NCI Thesaurus ObjectClass)
C0399059 (UMLS 2011AA ObjectClass)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Has/Have the protocol tooth/teeth been clinically assessed to be fractured
text
C12506 (NCI Thesaurus ObjectClass)
C0040426 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C52648 (NCI Thesaurus Property)
C1706353 (UMLS 2011AA Property)
C50777 (NCI Thesaurus Property)
C0040441 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0040426 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C52648 (NCI Thesaurus Property)
C1706353 (UMLS 2011AA Property)
C50777 (NCI Thesaurus Property)
C0040441 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is/Are the protocol tooth/teeth an abutment(s) for a removable partial denture
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66853 (NCI Thesaurus ObjectClass)
C0545406 (UMLS 2011AA ObjectClass)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66853 (NCI Thesaurus ObjectClass)
C0545406 (UMLS 2011AA ObjectClass)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Does/Do the protocol tooth/teeth have subgingival calculus(eligible if removed during the treatment visit)
text
C41136 (NCI Thesaurus ObjectClass)
C0226984 (UMLS 2011AA ObjectClass)
C52673 (NCI Thesaurus ObjectClass)
C0033284 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C60715 (NCI Thesaurus Property)
C0011330 (UMLS 2011AA Property)
C33304 (NCI Thesaurus Property)
C0031093 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0226984 (UMLS 2011AA ObjectClass)
C52673 (NCI Thesaurus ObjectClass)
C0033284 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C60715 (NCI Thesaurus Property)
C0011330 (UMLS 2011AA Property)
C33304 (NCI Thesaurus Property)
C0031093 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Does/Do the protocol tooth/teeth have subgingival calculus(eligible if removed during the treatment visit)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is the subject undergoing active orthodontic treatment other than the use of a retainer
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C64248 (NCI Thesaurus ObjectClass)
C0204193 (UMLS 2011AA ObjectClass)
C62543 (NCI Thesaurus ObjectClass)
C0441330 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C64248 (NCI Thesaurus ObjectClass)
C0204193 (UMLS 2011AA ObjectClass)
C62543 (NCI Thesaurus ObjectClass)
C0441330 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Is the subject undergoing active orthodontic treatment other than the use of a retainer
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is the subject currently enrolled or have they completed in the past month a tooth bleaching program
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C94591 (NCI Thesaurus ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C94591 (NCI Thesaurus ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
Code List
Is the subject currently enrolled or have they completed in the past month a tooth bleaching program
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Has the subject had a prior reaction or have an inability to tolerate any of the dental products being used (such as severe topical or hypersensitivity reaction)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C3114 (NCI Thesaurus Property)
C0020517 (UMLS 2011AA Property)
C1708 (NCI Thesaurus Property)
C0450442 (UMLS 2011AA Property)
C15206 (NCI Thesaurus Property)
C0008972 (UMLS 2011AA Property)
C25370 (NCI Thesaurus Property)
C0680251 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0027361 (UMLS 2011AA ObjectClass)
C3114 (NCI Thesaurus Property)
C0020517 (UMLS 2011AA Property)
C1708 (NCI Thesaurus Property)
C0450442 (UMLS 2011AA Property)
C15206 (NCI Thesaurus Property)
C0008972 (UMLS 2011AA Property)
C25370 (NCI Thesaurus Property)
C0680251 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Has the subject had a prior reaction or have an inability to tolerate any of the dental products being used (such as severe topical or hypersensitivity reaction)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is the subject under treatment for medical disorders including dementia, Parkinson's disease, severe depression, severe anxiety, and any other medical condition that, in the opinion of the P-I, would affect the subject's judgment of post-operative hypersensitivity and/or ability to understand the informed consent process
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C54056 (NCI Thesaurus Property)
C0521987 (UMLS 2011AA Property)
C21055 (NCI Thesaurus Property)
C0684336 (UMLS 2011AA Property)
C25460 (NCI Thesaurus Property)
C1511481 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C54056 (NCI Thesaurus Property)
C0521987 (UMLS 2011AA Property)
C21055 (NCI Thesaurus Property)
C0684336 (UMLS 2011AA Property)
C25460 (NCI Thesaurus Property)
C1511481 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Is the subject under treatment for medical disorders including dementia, Parkinson's disease, severe depression, severe anxiety, and any other medical condition that, in the opinion of the P-I, would affect the subject's judgment of post-operative hypersensitivity and/or ability to understand the informed consent process
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Is the subject in another ongoing dental research study
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C41136 (NCI Thesaurus Property)
C0226984 (UMLS 2011AA Property)
C15206 (NCI Thesaurus Property)
C0008972 (UMLS 2011AA Property)
C37948 (NCI Thesaurus Property)
C1516879 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C41136 (NCI Thesaurus Property)
C0226984 (UMLS 2011AA Property)
C15206 (NCI Thesaurus Property)
C0008972 (UMLS 2011AA Property)
C37948 (NCI Thesaurus Property)
C1516879 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Preferred method of contact
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C42711 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C42711 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL Item
E-mail (E-mail)
C25170 (NCI Thesaurus)
C0013849 (UMLS 2011AA)
C0013849 (UMLS 2011AA)
CL Item
Telephone (Phone)
C25395 (NCI Thesaurus)
C0039457 (UMLS 2011AA)
C0039457 (UMLS 2011AA)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)