Pulpotomy for an Immature Permanent Tooth With Symptomatic Irreversible Pulpitis Using Cold Ceramic

With recent advances in biomaterials, there has been growing interest in using pulpotomy to treat irreversible pulpitis instead of root canal therapy. In this report, we describe a case of pulpotomy with 9-month follow-up in an immature permanent tooth exhibiting signs and symptoms of symptomatic irreversible pulpitis.

A 9-year-old female presented with a chief complaint of a severe toothache in the lower left molar. Radiologic examination revealed a deep carious lesion and Nolla Stage 9. Based on the findings, a symptomatic irreversible pulpitis was diagnosed. Pulpotomy was preferred over root canal therapy in order to preserve the pulp and allow the roots to continue developing. Cold ceramic was used as a biomaterial barrier during pulpotomy. Evidence of dentin bridge formation, root development, and normal responses to cold and electric pulp tests were observed during the follow-up sessions at 3, 6, and 9 months.

Pulpotomy can be a good treatment option for irreversible pulpitis in immature permanent teeth. Irreversible pulpitis in these teeth does not necessarily mean that the entire pulp has been affected. By removing only the affected part of the pulp with pulpotomy, the healthy pulp could still be preserved.