Effectiveness of Pulpotomy vs. Root Canal Treatment in Extremely Deep Caries

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age12+
SponsorNational University Hospital, Singapore

About this trial

Recent clinical trials comparing pulpotomy versus root canal treatment (RCT) have shown promising outcomes; however, the current evidence lacks generalisability to general practitioners. It remains to be elucidated whether these favourable results can be replicated in a primary care setting. This study aims to address that gap by involving senior dental students undergoing supervised university education and training, with the potential to inform future best practice guidelines and promote the adoption of vital pulp therapy (VPT) as a predictable treatment alternative in the general dental population.

The clinical procedure involves complete caries-free excavation carried out under rubber dam isolation. After confirming vital pulp status-demonstrated by bleeding upon entry, participants will be randomised to receive one of two treatments: RCT or full pulpotomy.

Outcomes will include clinical and radiographic success or failure of the intervention at 12 months. Additionally, patient-reported outcomes will be collected, specifically pain experienced and the use of analgesia during the immediate post-operative period (days 3 and 7).

Eligibility criteria

Qualifiers

Aged 12 years or older

Mature maxillary or mandibular permanent tooth with extremely deep restorations/caries penetrating the entire thickness of dentine on the radiograph without a radiopaque zone separating the lesion from the pulp (Bjorndal et al., 2019)

Tooth may or may not be symptomatic at the time of recruitment but must be responsive to cold and EPT sensibility testing

Tooth is restorable and can be adequately isolated during treatment

Disqualifiers

Teeth with difficult access and unpredictable isolation using a rubber dam

Teeth aberrant root canal morphology, extreme root curvatures (>30 degrees), calcified canals/sclerosed pulp

Teeth indicated for elective root canal treatment for restorative purposes

Teeth with apical periodontitis

Trial design

Treatments tested in this trial

  • Full Pulpotomy
  • root canal treatment and intracanal medicament

Treatment groups

93 Participants
are divided into 2 treatment groups