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Contact Information:

Dr Ikhlas El Karim
+44 (0)2890976026
i.elkarim@qub.ac.uk


Ms Siobhan Cushley
+44 (0)7860707782
s.cushley@qub.ac.uk


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Be Part of Research - Trial Details - Traditional root canal or minimally invasive pulpotomy treatment for managing painful carious teeth in general dental practice
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Traditional root canal or minimally invasive pulpotomy treatment for managing painful carious teeth in general dental practice

Not Recruiting

Open to: All Genders

Age: Adult

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Medical Conditions

Conservative treatment of irreversible pulpitis in adult patients in pre/molar teeth

This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


When a tooth is decayed and has a deep cavity, the nerve of the tooth (the dental pulp) can become infected and inflamed. This can be very painful and the pulp needs to be treated to ease the pain. Teeth with infected pulps are traditionally treated by conventional root canal treatment (RCTx). This involves removing the damaged area of the tooth including the entire dental pulp, cleaning, disinfecting and sealing the root canal before placing a filling in the crown of the tooth. Root canal treatment is a technically difficult procedure to carry out particularly in teeth at the back of the mouth. It often requires several visits to the dentist to be completed, is destructive to the tooth and is expensive for patients. One of the alternatives is called pulpotomy, which is a simpler, less expensive procedure performed in a single visit. Pulpotomy aims to remove only a portion of the infected nerve tissue, thereby keeping the tooth alive. Complete pulpotomy (Cp) involves the removal of all of the infected nerve tissue in the crown of the tooth leaving the pulp in the root intact. The pulp is then sealed with a material that aids healing before the placement of the final filling. Whether or not pulpotomy is successful depends in part on the dentist knowing that the tooth is suitable for the procedure. Currently dentists use pain symptoms as a guide to diagnosis and if the patient reports continuous pain then the dentist assumes that the whole pulp is inflamed and carries out RCTx. Pain is subjective as people differ in the way they report pain. The presence of pain alone would not inform the dentist whether the whole or part of the pulp is inflamed. When the pulp becomes inflamed, it produces proteins, which suggest the presence of inflammation, so testing for these proteins may help dentists know the degree of inflammation in the pulp and subsequently decide whether to offer complete pulpotomy or root canal treatment. This study will investigate if pulpotomy is as clinically and cost-effective as root canal treatment for treating infected tooth pulps in general dental practices in Northern Ireland (NI). The researchers will also measure inflammatory proteins found in infected dental pulp tissue to determine if their concentration can be used to make a diagnosis and decide on the best treatment for a patient.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

23 Sep 2021 31 May 2024

Participants will be randomly allocated to receive one of two treatments to relieve their dental pain - the current standard of care, root canal treatment or complete pulpotomy. The patient will complete a pain diary recording their experience of pain on days 3 and 7 after the procedure and will be assessed clinically and radiographically 12 months after completion of the procedure. Patients will also complete a short questionnaire about their experience of receiving care and will be invited to put a monetary value on the treatment. A laboratory analysis will be conducted on pulp tissue samples collected at the time of the procedure. Any relationship between the amount of inflammatory proteins present in the tissue sample and the outcome of the treatment will be investigated.


When a tooth is decayed and has a deep cavity, the nerve of the tooth (the dental pulp) can become infected and inflamed. This can be very painful and the pulp needs to be treated to ease the pain. Teeth with infected pulps are traditionally treated by conventional root canal treatment (RCTx). This involves removing the damaged area of the tooth including the entire dental pulp, cleaning, disinfecting and sealing the root canal before placing a filling in the crown of the tooth. Root canal treatment is a technically difficult procedure to carry out particularly in teeth at the back of the mouth. It often requires several visits to the dentist to be completed, is destructive to the tooth and is expensive for patients. One of the alternatives is called pulpotomy, which is a simpler, less expensive procedure performed in a single visit. Pulpotomy aims to remove only a portion of the infected nerve tissue, thereby keeping the tooth alive. Complete pulpotomy (Cp) involves the removal of all of the infected nerve tissue in the crown of the tooth leaving the pulp in the root intact. The pulp is then sealed with a material that aids healing before the placement of the final filling. Whether or not pulpotomy is successful depends in part on the dentist knowing that the tooth is suitable for the procedure. Currently dentists use pain symptoms as a guide to diagnosis and if the patient reports continuous pain then the dentist assumes that the whole pulp is inflamed and carries out RCTx. Pain is subjective as people differ in the way they report pain. The presence of pain alone would not inform the dentist whether the whole or part of the pulp is inflamed. When the pulp becomes inflamed, it produces proteins, which suggest the presence of inflammation, so testing for these proteins may help dentists know the degree of inflammation in the pulp and subsequently decide whether to offer complete pulpotomy or root canal treatment. This study will investigate if pulpotomy is as clinically and cost-effective as root canal treatment for treating infected tooth pulps in general dental practices in Northern Ireland (NI). The researchers will also measure inflammatory proteins found in infected dental pulp tissue to determine if their concentration can be used to make a diagnosis and decide on the best treatment for a patient.

Who can participate?
General dental practice patients aged 18 years and older who have pain in a permanent back tooth from an infected nerve

You can take part if:



You may not be able to take part if:


1. Teeth with active periodontal disease (pocket depth >5 mm)2. Participants with complex medical histories that may affect their caries experience and healing ability3. Inability to provide consent4. History of trauma to tooth5. Presence of apical radiolucency or ligament enlargement on radiograph6. Pregnant or breast-feeding patient


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

This is is a low-risk study. Complete pulpotomy forms the first stage of traditional root canal treatment so it is not a new procedure to dentists. Patients will have the opportunity to have their dental pain managed in a more conservative way that is both simpler and quicker to complete than the current standard of care. There is a small risk that treatment may not fully resolve the patient's symptoms and more treatment may be required.

Ms Siobhan Cushley
+44 (0)7860707782
s.cushley@qub.ac.uk


Dr Ikhlas El Karim
+44 (0)2890976026
i.elkarim@qub.ac.uk



The study is sponsored by Queen's University Belfast and funded by Public Health Agency.



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Read full details for Trial ID: ISRCTN49302282
Last updated 22 November 2023

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