Delayed miniature pulpotomy in a symptomatic mature molar

Area of Science:

• Dentistry
• Endodontics
• Dental Materials

Background:

• Carious pulpal exposure in mature molars presents a clinical challenge.
• Traditional treatments may involve root canal therapy, but vital pulp therapies aim to preserve pulp vitality.

Observation:

• A case report details a 24-year-old woman with severe pain in a second upper left molar, presenting with carious pulpal exposure one week after initial dental preparation.
• The exposed pulp exhibited hemorrhage, which was controlled using sodium hypochlorite (NaOCl).

Findings:

• Miniature pulpotomy (MP) was performed using calcium-enriched mixture (CEM) cement as a direct pulp capping agent.
• The patient experienced rapid pain relief within 24 hours and the tooth remained vital during follow-up.
• Radiographic evaluation at 15 months revealed a dentinal bridge formation beneath the CEM cement, with no signs of apical pathosis.

Implications:

• MP with CEM cement shows promise as a conservative treatment option for managing exposed dental pulp, even in cases diagnosed with irreversible pulpitis.
• Further clinical trials with larger sample sizes and extended follow-up periods are warranted to validate these findings and establish optimal treatment protocols.