Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP): a feasibility study

Clarkson, J. E. et al. (2022) Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP): a feasibility study. Pilot and Feasibility Studies, 8(1), 77. (doi: 10.1186/s40814-022-01029-9) (PMID:35366952) (PMCID:PMC8976106)

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Abstract

Background: Progression of dental caries can result in irreversible pulpal damage. Partial irreversible pulpitis is the initial stage of this damage, confined to the coronal pulp whilst the radicular pulp shows little or no sign of infection. Preserving the pulp with sustained vitality and developing minimally invasive biologically based therapies are key themes within contemporary clinical practice. However, root canal treatment involving complete removal of the pulp is often the only option (other than extraction) given to patients with irreversible pulpitis, with substantial NHS and patient incurred costs. The European Society of Endodontology’s (ESE 2019) recent consensus statement recommends full pulpotomy, where the inflamed coronal pulp is removed with the goal of keeping the radicular pulp vital, as a more minimally invasive technique, potentially avoiding complex root canal treatment. Although this technique may be provided in secondary care, it has not been routinely implemented or evaluated in UK General Dental Practice. Method: This feasibility study aims to identify and assess in a primary care setting the training needs of general dental practitioners and clinical fidelity of the full pulpotomy intervention, estimate likely eligible patient pool and develop recruitment materials ahead of the main randomised controlled trial comparing the clinical and cost-effectiveness of full pulpotomy compared to root canal treatment in pre/molar teeth of adults 16 years and older showing signs indicative of irreversible pulpitis. The feasibility study will recruit and train 10 primary care dentists in the full pulpotomy technique. Dentists will recruit and provide full pulpotomy to 40 participants (four per practice) with indications of partial irreversible pulpitis. Discussion: The Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP) study will address the lack of high-quality evidence in the treatment of irreversible pulpitis, to aid dental practitioners, patients and policymakers in their decision-making. The PIP feasibility study will inform the main study on the practicality of providing both training and provision of the full pulpotomy technique in general dental practice. Trial registration: ISRCTN Registry, ISRCTN17973604. Registered on 28 January 2021. Protocol version: Protocol version: 1; date: 03.02.2021

Item Type:Articles
Additional Information:This study is funded by the National Institute for Health Research (NIHR) Health Technology Assessment Program (project reference NIHR129230).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Robertson, Mr Douglas and Conway, Professor David
Authors: Clarkson, J. E., Ramsay, C. R., Mannocci, F., Jarad, F., Albadri, S., Ricketts, D., Tait, C., Banerjee, A., Deery, C., Boyers, D., Marshman, Z., Goulao, B., Hamilton, A. R., Banister, K., Bell, R., Brown, L., Conway, D. I., Donaldson, P., Duncan, A., Dunn, K., Fee, P., Forrest, M., Glenny, A.-M., Gouick, J., Gupta, E., Jacobsen, E., Kettle, J., MacLennan, G., Macpherson, L., McGuff, T., Mitchell, F., van der Pol, M., Moazzez, R., Robertson, D., Wojewodka, G., Young, L., and Lamont, T.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Journal Name:Pilot and Feasibility Studies
Publisher:BioMed Central
ISSN:2055-5784
ISSN (Online):2055-5784
Copyright Holders:Copyright © The Author(s) 2022
First Published:First published in Pilot and Feasibility Studies 8(1):77
Publisher Policy:Reproduced under a Creative Commons Licence
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