Anta S, Diouma N, Ousmane N S, Fatou L B, Florence F, Babacar T. Evaluation of complete pulpotomy with Biodentine on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis: 12 months follow up. J Endod 2022; 48: 312-329.

Faster procedure than full pulpectomy for relief of pain?

Conventional endodontic treatment for pulpitic teeth decreases the elasticity and defensive properties of the tooth. Histological studies show that pulpal inflammation is frequently located close to the carious lesion but normal histology is present in the root canals. There is evidence that pulpal tissue can heal itself after removal of the irritation.

In this observational study, 66 molars with symptoms of acute, irreversible pulpitis were treated by one operator with a standardised technique for pulpotomy and insertion of Biodentine and a coronal composite restoration. At 12-month review, of the 52 remaining cases, clinical success rate (no symptoms or signs) was 94% (n = 49) and radiographic success rate (no radiographic evidence of periapical disease) was 87% (n = 45). Success was significantly more likely in younger patients.

Whilst longer-term follow-up studies are needed, pulpotomy as described is easier and faster in emergency situations, and maintains the viability of the pulpal immune system within the roots of the tooth.