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Status unknownNCT03956199Updated Nov 12, 2020

Pulpotomy vs.Root Canal Treatment in Managing Irreversible Pulpitis

An interventional study of pulpotomy and Root canal treatment in Pulpitis - Irreversible, sponsored by King's College London. Status unknown at 3 sites in United Kingdom. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-11-12.

Sponsored by King's College London · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Nov 2020), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
168
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

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.

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Conditions studied

  • Pulpitis - Irreversible

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03

In context

Pulpitis

302 studies on the registry are indexed under Pulpitis; 67 are open to participants now.

This study's planned enrollment of 168 is above the median of 62 across 275 interventional studies indexed under Pulpitis.

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Lead sponsor

King's College London is the lead sponsor of 506 studies on the registry; 125 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

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
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
168 participants (estimated)

Study arms

  • Experimental
    experimental pulpotomy

    Procedure: pulpotomy

  • Active comparator
    Root canal treatment

    Procedure: Root canal treatment

Interventions

  • Procedurepulpotomy

    removal of the pulp from pulp chamber

  • ProcedureRoot canal treatment

    Removal of at the entire content of the root canal system and root canal obturation

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What researchers measure

Primary outcomes

  1. Short term pain following pulpotomy versus root canal treatment

    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).

    Time frame: 7 days

Secondary outcomes

  1. Cost-effectiveness of pulpotomy

    • 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

    Time frame: 2 years

  2. sensitivity and specificity of CBCT versus periodical radiographs to detect periapical radiolucencies

    the sensitivity and specificity of periapical radiograph (clinical standard) to CBCT (experimental) in terms of detection of periapical disease.

    Time frame: 2 years

  3. success rates of pulpotomy compared to root canal treatment

    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.

    Time frame: 2 years

  4. Quality of life difference between patients that receive pulpotomy versus root canal treatment

    • 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

    Time frame: 12 months

07

Study locations

2 of 3 sites recruiting
  • Royal Liverpool University Hospital
    Liverpool, L78XP, United Kingdom
    Active, not recruiting
  • Guy's Hospital
    London, SE19RT, United Kingdom
    Recruiting
  • King's College Hospital
    London, SE5 9RS, United Kingdom
    Recruiting
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 12, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03956199
Lead sponsor
King's College London
Responsible party
Sponsor
First posted
May 20, 2019
Start date
Sep 1, 2019
Primary completion
Apr 1, 2023 (estimated)
Completion
Apr 1, 2023 (estimated)
Last update
Nov 12, 2020

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Nov 2020. You cannot join it, but the record below documents what was studied.

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