Comparison of Two Dental Techniques Used to Treat Teeth Which Have Become Infected or Painful Following Trauma

Participants will be randomly allocated in to one of the above treatment groups. This means that neither the participants, nor the researchers, will be able to choose which group a participant will be allocated to.

In both techniques, in order to learn about the bacteria involved in non-vital teeth, the investigators will take samples of the bacteria within the root canal.

The outcomes of the study will provide us with further information about root growth, the bacteria involved in infection of non-vital teeth and the success of the different treatment methods that are available. This information will enable us to increase our understanding of the treatment of non-vital teeth with an open end and help us to explain our treatments to future patients.

All children presenting to Liverpool University Dental Hospital aged between 7 and 25 years of age and who are medically well and cooperative to receive prolonged treatment in the dental chair are eligible to take part in the study if they have a damaged upper front adult tooth in which the nerve has died and the root is open ended. Unfortunately, if there is dental decay in the tooth or a fracture of the root then these teeth are not suitable for this study. In some cases following damage to a tooth, the root of the tooth starts to dissolve and unfortunately these teeth are also not suitable for this study.

Suitable patients attend with their parent or carer for a consultation to the Paediatric Dentistry Clinic at Liverpool University Dental Hospital. Following this visit, if a suitable patient wishes to join our study the investigators will arrange two further visits during which the dental treatment will take place. Following completion of treatment, patients will be asked to return for four check ups over the next year so that the investigators can check that they are happy and that treatment has been successful.

There are no risks or disadvantages to taking part in this study. However, if the tooth does not respond to treatment, or if symptoms of infection arise, then alternative treatment methods may be initiated as necessary.

The study is being funded by the Royal Liverpool and Broadgreen University Hospitals NHS Trust and by the University of Liverpool.

Inclusion criteria

for participants:

• Between 7 and 25 years of age
• Have no significant medical history
• Cooperative in the dental chair
• Able to commit to the recall schedules prescribed by the study
• Have one or more traumatised non-vital permanent maxillary central incisors with incomplete root development

Exclusion criteria

for participants:

• Have a medical history that may complicate treatment
• Have a medical history for which the study procedures may place the patient at increased risk
• Have a diagnosis of avulsion or severe intrusion following dental trauma

Exclusion criteria

for Permanent maxillary central incisors:

• Less than half formed
• Have anatomical complexity (such as dens invaginatus)
• Have horizontal or vertical root fractures present
• Have evidence of root resorption