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WELCOME TO THE PIP STUDY

Pulpotomy or root canal treatment for the management of Irreversible Pulpitis in mature teeth (PIP Study)

What is PIP?

The PIP Study is looking at alternative ways to treat toothache and tooth decay.

Severe toothache and pain can be caused by tooth decay. Tooth decay is very common and treating decay costs the NHS over £3.4 billion each year. Where the tooth decay has spread deep into the nerve, this is usually treated by taking out the tooth or by Root Canal Treatment. Root canal treatment removes all the nerve from the tooth.

An alternative treatment for this kind of toothache is called a Pulpotomy. A Pulpotomy removes only the damaged part of the nerve, which can be a quicker and less invasive treatment.

Pulpotomy is already used on children’s teeth and on adult teeth when they are being treated in dental hospitals. However, it is not yet routinely used on adult teeth in NHS dental practices. We have recently conducted a PIP Feasibility Study where we took patients’ and dentists’ experiences of the new treatment (Full Pulpotomy) into account to assist us in planning the PIP Study. We successfully met the following criteria and in August 2022 NIHR advised that we can progress on to main study:

  • Recruited 21 GDPs in 13 practices ✔
  • Successfully trained all dentists ✔
  • 68% of treatments reached Clinical Fidelity. Once we introduced feedback forms, Clinical Fidelity was then 100% ✔
  • 100% satisfaction from responding participants ✔
  • 0.9 eligible patients were seen per practice per month ✔

Now we are moving onto planning and recruitment for the full PIP Study, where we will recruit 50 dental practices in England and Scotland. The dentists will recruit 530 NHS adult (16 years and older) dental patients who have Irreversible Pulpitis in permanent premolar and molar teeth and who agree to take part.

PIP Study primary objectives are:
  • To compare the clinical success of Full Pulpotomy (FP) with Root Canal Treatment (RCTx) (no re-intervention or symptoms of pulpitis or apical periodontitis) at 1 year.
  • To compare the costs and benefits of Full Pulpotomy (FP) with Root Canal Treatment (RCTx) over a modelled life-time horizon.

PIP Study Secondary objectives are:
  • To evaluate radiographic success (absence of radiolucency in participant’s initial intervention), patient health related quality of life, dental pain, dental anxiety, satisfaction with care/treatment and adverse events at 1 year. Patient health related quality of life and dental pain at 7 days.
  • To determine general population preferences for treatment and outcomes and predict uptake, NHS and patient perspective costs; incremental net benefit over the study follow up; and incremental cost per QALY over the 1-year follow-up and extrapolated over a modelled lifetime horizon.
  • To explore the implementation of technologies and the mechanisms of impact including acceptability of interventions to patient and clinicians.

The PIP Study is a £1.9m multicenter randomised controlled study.

Professors Clarkson and Ramsay are funded by a National Institute for Health Research (NIHR) HTA for this research project. Visit NIHR website
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Can I take part?

We are recruiting dental practices in England and Scotland. For more information about taking part in the PIP Study please contact PIP-Study@dundee.ac.uk or click on the following link / QR code to complete the Site Initiation Questionnaire (SIQ), this will take no more than 10-15 minutes.
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If you are interested in taking part, or have any questions

CONTACT US

Where can I take part?

The PIP Study are recruiting NHS dental practices and participants in England (London and Liverpool) and Scotland.

If you would like more information about what is involved, please get in touch.

Our study email address is PIP-Study@dundee.ac.uk

Complete Dental Care

Key people:

Investigator:

  • Mr Neil Marshall

Address:

253 Paisley Road West
Glasgow
G51 1NB
Main Street Dental Care

Key people:

Investigator:

  • Anita Belbin

Address:

45A Main Street
Thornliebank
Glasgow
G46 7SF
Montrose Dental Care

Key people:

Investigator:

  • Dr Lorraine Arnot

Address:

53 John Street
Montrose
DD10 8LZ
Rankin Dental

Key people:

Investigator:

  • Mr Mark Rankin

Address:

30 Ellon Road
Bridge of Don
Aberdeen
AB23 8BX
Hall & Smith Dental Practice

Key people:

Investigator:

  • Mr Jack Cottam

Address:

147 Stricklandgate
Kendal
Cumbria
LA9 4RF
The Dental House

Key people:

Investigator:

  • Mr Amaar Hassan

Address:

6-10 Derby Lane
Old Swan
Liverpool
L13 3DL
Neasden Dental Clinic

Key people:

Investigator:

  • Priya Arora

Address:

1 Dollis Hill Lane
Neasden
London
NW2 6JH
Surgery @102 Ltd

Key people:

Investigator:

  • Heba Ali

Address:

102 Ealing Road
Wembley
London
HA0 4TH
Broxden Dental Centre

Key people:

Investigator:

  • Ms Morag Curnow

Address:

Tweed Place
Perth
PH1 1TJ
Springfield Medical Centre

Key people:

Investigator:

  • Mr Thomas Richmond

Address:

30 Ponderlaw Street
Arbroath
DD11 1ES
Kings Cross Health & Community Care Centre

Key people:

Investigator:

  • Ms Heather Ballantyne

Address:

Hospital Street
Dundee
DD3 8EA

Study news

Recruitment

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Trial sites

Latest addition to sites:

Kings Cross Health & Community Care Centre
Springfield Medical Centre
Broxden Dental Centre
Surgery @102 Ltd

Key facts about the study and documents

I am a dentist – how do I join the study?

The PIP Study

The PIP study will compare the effectiveness of Full Pulpotomy and Root Canal Treatment for Irreversible Pulpitis in permanent premolar and molar teeth in adults. The study will take place in primary care dental practices across Scotland and England.

PIP Study

We will recruit 530 patient participants from 50 general dental practices in Scotland and England. We are looking for dental practices to recruit 11 adult patients (16 years and older) seeking treatment at NHS dental practices with symptoms indicative of Irreversible Pulpitis in a premolar/molar tooth with deep caries and or a deep restoration.


The patient must be willing to be randomly allocated (computer generated) to one of the two study groups – Full Pulpotomy or Root Canal Treatment.
The PIP Study will take place over 12 months and patient participants will be followed up by the PIP Study Team in Dundee at 7 days and then again by GDP at 1 year after treatment. Link to PIP Flyer

The NHS National Institute for Health Research Health Technology Assessment programme has commissioned a collaborative team from the Universities of Dundee, Aberdeen, Glasgow, King's College London, Liverpool, Sheffield, and NHS Education for Scotland to conduct this research.

If you are interested in being involved in this primary care research study, or would like further details, please contact us to arrange a short briefing to answer any questions you may have about involvement with PIP.

Contact the team: PIP-Study@dundee.ac.uk

PPI (Patient & Public Involvement) in Dental Clinical Research, We Need You!!!

Are you interested in joining a Patient & Public Involvement Group? Members of the public are being invited to help support the PIP & SCRiPT Dental Research Studies, you can find more information about joining the group here and here.

If you would like to express an interest in joining the PPI Group, please click the following link https://forms.office.com/r/jNmpuBRN00 / QR code to complete the PPI Group Expressions of Interest Form, this will take no more than 5 minutes to complete, thank you.

Key contacts

Click on cards to find out more

Organisation

Funding acknowledgement

Professors Clarkson and Ramsay are funded by the National Institute for Health Research (NIHR) HTA for this research project. Visit the NIHR website (NIHR HTA ref: NIHR129230).
Trial Sponsor: University of Dundee