Pulpotomy for the management of Irreversible Pulpi/s in permanent posterior teeth (PIP): a feasibility study

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Introduction: Studies conducted in secondary care suggests symptomatic irreversible pulpitis in permanent posterior teeth could be managed with Full Pulpotomy (FP) rather than conventional root canal treatment (RCTx), preserving radicular vitality and promoting minimally invasive treatment. However, there is a lack of evidence in primary care settings, where the majority of dentistry is carried out. The NIHR-funded PIP study aims to address this evidence gap through a pragmatic multicentre randomised control trial in primary care in the UK, with the primary objective of comparing the clinical and cost effectiveness of FP compared with RCTx. A feasibility study was undertaken to determine progression to the randomised control trial.

Methods: For the feasibility study, general dental practitioners (GDPs) delivered FP to patients attending with irreversible pulpitis symptoms. Progression to the main study was dependant on meeting five feasibility criteria; the number of GDPs recruited, successful training in FP, clinical fidelity of FP, participant satisfaction, and number of potentially eligible patients per month per practice. A process evaluation with qualitative interviews was also conducted.
Results: A total of 11 GDPs recruited 23 participants. Successful training of GDPs and participant satisfaction reached 100%. Clinical fidelity was 68%, increasing to 100% following introduction of feedback forms, and the number of eligible patients per month was 0.9. Qualitative interviews showed a positive response from GDPs and participants.
Conclusion: The feasibility study showed FP can be delivered successfully in a primary care setting and allowed exploration of opportunities and challenges prior to progression to the randomised control trial.
Key learning points:
•A feasibility study is valuable in planning a multicentre randomised control trial
•A pragmatic approach allows for better reproducibility into primary care setting
•The feasibility study suggests that FP can be provided successfully in primary care
•Qualitative analysis showed patients and dentists were favourable towards FP
Original languageEnglish
Publication statusPublished - Sept 2023
EventEuropean Society of Endodontolgy - 21st Biennial Congress - Helsinki, Finland
Duration: 6 Sept 20239 Sept 2023


ConferenceEuropean Society of Endodontolgy - 21st Biennial Congress


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