Traditional or minimal intervention endodontics for managing carious teeth with symptomatic pulpitis in general dental practice

Finally, the views of patients and the dental team were sought regarding the acceptability and wider implementation of pulpotomy as a definitive treatment for painful teeth. Clinical and radiographic outcomes of pulpotomy and root canal treatment were equivalent, although less than those reported when treatment is carried out by specialist practitioners. There were significant differences in gene expression between healthy pulp and that with a clinical diagnosis of irreversible pulpitis, however, in a targeted proteomic analysis, there was no correlation between the expression of TNF-α, MMP-9, IL-8, IL-1β, S100A-9 and CXCL-1 and treatment outcome.

Most stakeholders viewed pulpotomy favourably, but several service provider, patient and health system level factors exist which may influence its wider application within the Northern Ireland health service system. Pulpotomy may be an acceptable and effective treatment for managing irreversible pulpitis, but clinicians require contract reform to be able to apply this treatment within the General Dental Practice setting.

The search for a biomarker of pulpitis which could reliably support clinical decision-making, however, continues.<br><br><i>Thesis is embargoed until 31st July 2030</i>.<br><br>