Traditional or minimal endodontics for carious teeth _V1
Research type
Research Study
Full title
Traditional or minimal intervention endodontics for managing carious teeth with symptomatic pulpitis (REFORM). A pragmatic randomised clinical trial in General Dental Practice in Northern Ireland.
IRAS ID
292497
Contact name
Ikhlas El Karim
Contact email
ISRCTN Number
ISRCTN49302282
Duration of Study in the UK
2 years, 7 months, 30 days
Research summary
When a tooth has a deep cavity, the nerve (dental pulp) becomes inflamed. This can be very painful and needs to be treated. Infected pulps are traditionally treated by root canal treatment (RCTx). RCTx is a technically difficult procedure involving removal of the entire pulp. It requires several visits to the dentist, is destructive to the tooth and expensive for patients. An alternative treatment is pulpotomy, a simple, inexpensive, less destructive procedure performed in a single visit. Complete pulpotomy (Cp) is a procedure in which all pulp tissue in the crown of the tooth is removed however the pulp in the roots is left intact prior to sealing with a material that promotes healing. Maintaining healthy living pulp tissue improves the long term survival of a tooth. Pulpotomy outcome depends in part on the dentist knowing that the tooth is suitable for the procedure. Currently dentists use pain symptoms as a guide and if the patient reports continuous pain then the dentist assumes that the whole pulp is inflamed and carries out RCTx. Pain however is subjective and the presence of pain alone would not inform the dentist whether the whole or part of the pulp was inflamed. When pulp becomes inflamed, it produces certain proteins, so testing for these proteins may help dentists predict the degree of inflammation and decide whether to offer pulpotomy or root canal treatment. This study will investigate if pulpotomy is an effective and cost-effective treatment for infected pulps in permanent teeth when carried out by General Dental Practitioners. We will also determine if the intervention is acceptable to both patients and practitioners and if markers of inflammation inform diagnosis and treatment suitability?
REC name
HSC REC A
REC reference
21/NI/0078
Date of REC Opinion
9 Jun 2021
REC opinion
Further Information Favourable Opinion