Irreversible Pulpitis
Conditions
Keywords
pulpotomy, pulpitis, mature tooth, tricalcium silicate
Brief summary
The procedure currently recommended for the treatment of irreversible pulpitis is the endodontic treatment, i.e. the complete elimination of the pulp, disinfection and obturation of the whole root canal system. The emergency procedure consists of a pulpotomy, followed at an ulterior appointment by the root canal treatment. The purpose of the present pilot study is to evaluate the feasibility of performing the pulpotomy as a permanent treatment in mature molars. If hemostasis can be achieved after removing the coronal part of the pulp, a tricalcium silicate cement will be directly applied on the remaining pulp at the root canal entrances. A short-term follow-up will be performed at one week by evaluating the pain relief of the patient. Long-term success will then be evaluated every year by verifying the absence of periapical radiolucency on the x-ray as well as the absence of clinical symptoms and signs. A standard root canal procedure will serve as control. During the pulpotomy treatment, blood sample with microcapillary will be performed. We will analyze a ratio of pro-inflammatory and anti-inflammatory cytokines.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Good general health * Not pregnant women * At least one permanent molar in irreversible pulpitis * Adult patient * Mentally competent
Exclusion criteria
* Periapical radiolucency * Periodontical probing * Root fracture * Sinus tract * Swelling or mobility * External or/and internal resorption * Open apicies * A non restorable tooth
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the success rate (%) at 1 year | Follow up at 1 year for all patients included in the study | to evaluate the treatment success defined as the absence of clinical symptoms (pain, sinus tract..) and the absence of radiological symptoms (periapical radiolucency), in order to point the non-inferiority of the pulpotomy compared with the conventional treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the correlation between pro/anti-inflammatory cytokines and the success of pulpotomy | Follow up at 1 year for all patients included in the study | During the pulpotomy treatment, blood samples with microcapillaries will be performed. We will analyze a ratio of pro-inflammatory and anti-inflammatory cytokines. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the success rate (%) up to 4 years | Follow up at 4 years for all patients included in the test group | to evaluate the treatment success defined as the absence of clinical symptoms (pain, sinus tract..) and the absence of radiological symptoms (periapical radiolucency), in order to point the non-inferiority of the pulpotomy compared with the conventional treatment |