- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03956199
Pulpotomy vs.Root Canal Treatment in Managing Irreversible Pulpitis
November 9, 2020 updated by: King's College London
Managing Irreversible Pulpitis - The Effectiveness of Pulpotomy Compared to Root Canal Treatment as a Replacement for Conventional Root Canal Treatment: A Multicentre Randomized Controlled Trial
The study aims to compare two methods of repairing and saving a badly damaged or infected tooth.
One method is called root canal treatment (RoCT) and the other (new method) is called pulpotomy.
RoCT involves removing the damaged area of the tooth including the tooth nerve (called the pulp), cleaning, disinfecting and sealing it.
Pulpotomy however attempts to preserve as much of the tooth nerve as possible (keeping the tooth alive).
RoCT is more expensive and painful.
Therefore, some patients delay or avoid getting treated, resulting in later complications treated in an emergency setting.
This research will aim to show that pulpotomy is less painful, less involved (i.e. less invasive), less time consuming and consequently more cost effective.
Long term costs of dental treatment as well as the improved quality of life will therefore offer benefits for patients, public and the NHS who use dental services.
Caries (tooth decay) is the most common diseases in the world.
The NHS spends at least £3.4 billion per year on dental visits or at dental hospitals.
This does not include private (societal) costs to individuals who do not qualify for NHS dental treatment.
Consequently, those who end up avoiding or delaying treatment result in complications often treated through the NHS.
We have therefore chosen a randomized controlled trial design, a gold standard method to compare the effectiveness of the two treatment options.
The participants will be 168 dental patients (male or female) from different parts (London and Liverpool) of the UK so that results can be generalized.
This design was considered in consultation with a member of the public (a co-applicant) who will be involved in the trial from the start to completion.
The results will be published and discussed at conferences as well as through our patient and public network.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
168
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Liverpool, United Kingdom, L78XP
- Active, not recruiting
- Royal Liverpool University Hospital
-
London, United Kingdom, SE5 9RS
- Recruiting
- King's College Hospital
-
Contact:
- Francesco Mannocci
- Phone Number: 02011881573
- Email: francesco.mannocci@kcl.ac.uk
-
Sub-Investigator:
- Tiago Pimentel
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London, United Kingdom, SE19RT
- Recruiting
- Guy's Hospital
-
Contact:
- Francesco Mannocci, Prof
- Phone Number: 02011881573
- Email: francesco.mannocci@kcl.ac.uk
-
Principal Investigator:
- Tiago Pimentel
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years to 73 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
• Dental patients from an acute (secondary care) setting from at least three UK centres (including King's College London Dental Institute, Denmark Hill and Liverpool).
- Male or female (aged >16) able to provide informed consent in otherwise good general health with at least one molar tooth with clinical symptoms of irreversible pulpitis caused by caries, requiring RoCT (endodontic treatment).
- Patients enrolled will have clinical symptoms of irreversible pulpitis who need treatment.
Exclusion Criteria: Exclusion Criteria:
- The presence of fistulas or swelling
- Anterior teeth or premolars
- External or internal root resorption
- Multiple teeth with carious lesions in the same quadrant,
- Pregnant women, in view of requirements for radiographs.
- Patients younger than 16.
- Patients unable to give consent.
- Patients who have been administered antibiotics in the previous month.
- Immunocompromised patients
- Teeth with hopeless prognosis with caries extended into root dentine and with tooth margin at crestal bone level
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: experimental pulpotomy
|
removal of the pulp from pulp chamber
|
Active Comparator: Root canal treatment
|
Removal of at the entire content of the root canal system and root canal obturation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Short term pain following pulpotomy versus root canal treatment
Time Frame: 7 days
|
Pain, tenderness or swelling assessment at baseline and over the first 7 days post completion of treatment using a daily diary of pain (based on a 10 point visual analogue (VAS Scale), measured using the area under the curve (AUC) approach).
|
7 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cost-effectiveness of pulpotomy
Time Frame: 2 years
|
• Health care resource use between randomization and 12 months post randomization for assessing the cost-effectiveness of pulpotomy in comparison to RCT as measured by the incremental cost-effectiveness ratio (ICER) in terms of the INMB
|
2 years
|
sensitivity and specificity of CBCT versus periodical radiographs to detect periapical radiolucencies
Time Frame: 2 years
|
the sensitivity and specificity of periapical radiograph (clinical standard) to CBCT (experimental) in terms of detection of periapical disease.
|
2 years
|
success rates of pulpotomy compared to root canal treatment
Time Frame: 2 years
|
The vitality or absence of apical pathology of the tooth at 24 months: that is, an absence of either pain, swelling or tenderness to biting of the tooth and no evi-dence of inflammation in the tissues around the tip of the root detected by con-ventional radiographs and CBCT (independent assessors) after 24 months from randomisation.
Both assessors must agree to conclude an overall absence of apical pathology.
Treatment outcome will be assessed objectively using scans taken pre-treatment and and follow-up (6,12,24 months) appointments.
|
2 years
|
Quality of life difference between patients that receive pulpotomy versus root canal treatment
Time Frame: 12 months
|
• The EQ-5D-3L and EQ-5D-5L measured at baseline, over the first 7 days, 6 and 12 months post randomisation.
One major feature of the EQ-5D tool is that the health states obtained from the questionnaire may be con-verted into a single index value with country specific value sets.
This will facilitate the calculation and comparison of quality-adjusted life years (QALYs) between pulpotomy vs. primary root canal treatment.
The QALY is a measure of disease burden including the quality and quantity of life lived, with one QALY equating to one year in perfect health
|
12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
September 1, 2019
Primary Completion (Anticipated)
April 1, 2023
Study Completion (Anticipated)
April 1, 2023
Study Registration Dates
First Submitted
May 14, 2019
First Submitted That Met QC Criteria
May 17, 2019
First Posted (Actual)
May 20, 2019
Study Record Updates
Last Update Posted (Actual)
November 12, 2020
Last Update Submitted That Met QC Criteria
November 9, 2020
Last Verified
November 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PB-PG-0817-20040
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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