Pulpotomy in mature permanent teeth: a new era of minimally invasive endodontics
The long-held belief that root canal treatment (RCTx) is the only therapeutic option for the preservation of vital mature permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure is being challenged by emerging clinical and histologic evidence. Crucial pulp therapy techniques like pulpotomy not only benefit patients more than traditional RCTx, but are also technically easier and more affordable.
A new era for minimally invasive VPT in mature permanent teeth has begun following recent position statements from the American Association of Endodontists and the European Society of Endodontology (ESE) that “pre-treatment diagnosis of irreversible pulpitis is not necessarily an indication for pulpectomy”.
Due to this paradigm shift, dentists may want to offer pulpotomy as the definitive treatment modality for treating mature permanent teeth with irreversible pulpitis or carious pulp exposures.
References
Philip, N., Suneja, B. Minimally invasive endodontics: a new era for pulpotomy in mature permanent teeth. Br Dent J 233, 1035–1041 (2022). https://doi.org/10.1038/s41415-022-5316-1
Lin L M, Ricucci D, Saoud T M, Sigurdsson A, Kahler B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. Aust Endod J 2020; 46: 154-166.
Anonymous. AAE Position Statement on Vital Pulp Therapy. J Endod 2021; 47: 1340-1344.
Duncan H F, Galler K M, Tomson P L et al. European Society of Endodontology position statement: Management of deep caries and the exposed pulp. Int Endod J 2019; 52: 923-934.
