Evaluating postoperative pain, cost-effectiveness, and patient acceptability of full pulpotomy compared to root canal treatment in teeth with symptomatic irreversible pulpitis: A preliminary clinical study / Foo Kent Room

Foo , Kent Room (2024) Evaluating postoperative pain, cost-effectiveness, and patient acceptability of full pulpotomy compared to root canal treatment in teeth with symptomatic irreversible pulpitis: A preliminary clinical study / Foo Kent Room. Masters thesis, Universiti Malaya.

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Abstract

Introduction: Full pulpotomy is suggested to be an alternative treatment option for root canal treatment (RCT) of permanent mature teeth with irreversible pulpitis. Aims: This study aimed to compare postoperative pain, cost-effectiveness and acceptability of the full pulpotomy procedure with conventional RCT in patients attending the dental clinics of the Faculty of Dentistry, Universiti Malaya diagnosed with symptomatic irreversible pulpitis (IRP) in the posterior permanent teeth with mature roots. Methodology: Twentyeight patients were included in this study and equally randomised into two groups, full pulpotomy (n=14) and RCT (n=14). The first group underwent full pulpotomy procedure and filled using Biodentine (Septodont, Saint Maur des Fosses, France), while the second group underwent conventional RCT procedures. Patients were given questionnaires to assess acceptability and cost effectiveness of the treatment on the day after first visit. Preoperative and postoperative pain scores on days 1, 3 and 7 were recorded using the universal pain assessment tool. Two sets of pain score data were collected (after the first visit and after treatment was completed). Data were collected and statistically analysed through the Mann-Whitney U test. Results: At day 1, pulpotomy recorded a significantly lower pain score postoperatively after the first visit when compared to RCT (p=0.022). The postoperative pain score on day 3 and day 7 after first visit was not significantly different between these two groups. Regarding the pain score after completing treatment, the difference in postoperative pain score for these two groups was not significant for day 1, day 3 and day 7. Both full pulpotomy and RCT achieved high satisfaction in terms of cost effectiveness, with full pulpotomy recording higher satisfaction in terms of treating dental pain with a significant difference (p=0.022). Patients who underwent both treatment modalities reported similar, high levels of acceptability in this clinical trial (P>0.05). Conclusion: Given the study limitations, full pulpotomy may be a good substitute for RCT for treatment in cases of symptomatic IRP in permanent mature teeth in terms of postoperative pain, cost effectiveness and patient acceptability.

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