Successful Tampon Pulpotomy in a Molar With an Endodontic Lesion: A Case Report

Vital pulp therapy (VPT) has emerged as an alternative approach to root canal treatment (RCT) for managing cases with irreversible pulpitis/apical periodontitis, aiming to preserve pulp vitality and promote healing and regeneration of pulpal tissues. The tampon approach, which entails the placement of endodontic biomaterials over the pulpal wound to mechanically tamponade uncontrollable bleeding, shows promise as a technique within VPT. A 32-year-old female patient presented with severe/lingering pain in the lower left quadrant. Clinical/radiographic examinations confirmed symptomatic irreversible pulpitis and symptomatic apical periodontitis in the first right lower molar; radiographic examination exhibited an endodontic lesion for the mesial root and periodontal ligament (PDL) widening for the distal root. The patient opted for VPT; however, despite several attempts to achieve hemostasis using various solutions, including NaOCl, hemorrhage persisted. Therefore, a layer of freshly mixed calcium-enriched mixture cement was applied using a dry cotton pellet, resulting in bleeding control. Then, a permanent restoration was placed. Follow-up examinations revealed the resolution of symptoms and the one-year radiographic examination showed complete healing of the endodontic lesion. The successful outcomes highlight the effectiveness of tampon pulpotomy in managing irreversible pulpitis and associated apical lesions. Tampon pulpotomy offers several advantages, including preserving healthy pulp tissue, reduced invasiveness, and immediate hemorrhage control. This technique presents an alternative to more invasive procedures, such as RCT, and promotes patient satisfaction through a simplified treatment approach. Further clinical trials are needed to validate the findings of this case report and establish the long-term success rates of tampon pulpotomy.