Researchers have found in a new study that partial radicular pulpotomy is emerging as a successful treatment option for managing symptomatic irreversible pulpitis in mature permanent molars. The findings, published in the Journal of Conservative Dentistry and Endodontics highlight that partial pulpotomy with Biodentine offers comparable clinical success to full pulpotomy while preserving more radicular pulp tissue. Irreversible pulpitis in mature teeth has long been treated with root canal therapy as the standard of care, but biologically based vital pulp therapies are gaining recognition for their potential to maintain pulp vitality, reduce invasiveness, and improve long-term prognosis.
The randomized controlled trial compared outcomes between full pulpotomy and partial radicular pulpotomy in adult patients diagnosed with symptomatic irreversible pulpitis. Biodentine was used as the capping material, and patients were monitored for clinical recovery, radiographic evidence of healing, and long-term success. Both groups showed favorable results, but partial pulpotomy achieved comparable efficacy while conserving a greater portion of the radicular pulp. This preservation of vital pulp tissue is important as it helps maintain dentinogenic capacity, immune defense, and natural reparative ability, providing patients with a biologically superior outcome compared to more extensive treatments.
The authors conclude that partial radicular pulpotomy should be considered a predictable and effective treatment choice for mature permanent molars with irreversible pulpitis. The study underscores the value of minimally invasive endodontics and aligns with global trends emphasizing tissue preservation and biological approaches. By demonstrating that partial pulpotomy is not inferior to full pulpotomy, the research encourages clinicians to adopt vital pulp therapy where feasible, potentially reducing the need for full root canal therapy in selected cases. This evidence adds momentum to the shift in contemporary endodontic practice toward approaches that balance clinical success with long-term tooth vitality.
Reference: Baranwal HC, Mittal N, Vijul, Swetha B, Raju G, Azeez MF. Outcome of full pulpotomy versus partial radicular pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis using Biodentine - A randomized controlled trial. J Conserv Dent Endod. 2025 Sep;28(9):937-942. doi: 10.4103/JCDE.JCDE_468_25. Epub 2025 Sep 5. PMID: 40964643; PMCID: PMC12440327..
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