Therapeutic Irrigation Procedures to Treat Apical Periodontitis-TIPTAP
Research type
Research Study
Full title
A randomised controlled pilot study to determine the effect of irrigation techniques used to enhance the release of endogenous signalling molecules from dentine matrix to treat apical periodontitis.
IRAS ID
253012
Contact name
Phillip Tomson
Contact email
Sponsor organisation
University of Birmingham
ISRCTN Number
ISRCTN93101288
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Apical periodontitis is a dental infection which develops around the root of a tooth and affects ~4-6% of the UK population. Current treatment strategies focus solely on removing bacteria from within the root canal space during Non-Surgical Root Canal Treatment (NSRCT). Despite radical improvements in techniques available to disinfect canals, over the last 2-3 decades there has been no proportionate improvement in success rates, with ~20% of cases failing to demonstrate complete healing following NSRCT. Over time this has placed significant burden on public resources as evidenced by increased referrals to dental hospitals, extensive waiting lists and increased use of anti-microbials.
It has long been known numerous bioactive molecules (dentine extracellular matrix components [dECM]) exist within the structure of the dentine. In a laboratory setting, they have demonstrated significant antibacterial properties and the ability to induce the functional processes of dental tissue repair. Through a different irrigation procedure, our group have optimised methods for releasing dECMs during NSRCT and hypothesise this intervention could potentially promote a reduction in inflammation, improve healing and lead to more favourable outcomes for patients suffering from apical periodontitis, a concept which has not yet been investigated. We propose to test this hypothesis at the Birmingham Dental Hospital by comparing clinical/radiographic signs of periradicular healing, and the molecular inflammatory response, in patients undergoing standard NSRCT (control arm) to those who having NSRCT with an irrigant regime that promotes release of dEMCs (intervention arm).Data generated from this randomised controlled pilot study will not only help us understand the process of healing following treatment of apical periodontitis at a molecular level, but also help us explore if there is therapeutic potential in enhancing dEMC release during NSRCT.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
19/WM/0149
Date of REC Opinion
10 Jun 2019
REC opinion
Favourable Opinion