Pulp sensibility assessment following permanent tooth pulpotomy: a scoping review of clinical studies

Vital pulp therapy (VPT), particularly pulpotomy, has emerged as a predictable treatment option for permanent teeth with deep caries and even in the presence of symptomatic irreversible pulpitis. Although numerous clinical studies have reported favorable outcomes, considerable variation exists in the methods used to assess postoperative pulp sensibility. This scoping review aimed to systematically map the pulp sensibility assessment methods, diagnostic methods, and follow-up schedules employed in clinical studies evaluating permanent tooth pulpotomy. This scoping review was conducted according to the PRISMA-ScR guidelines and prospectively registered in the Open Science Framework. Electronic searches were performed in PubMed (MEDLINE), Web of Science, and Scopus without date restrictions. Clinical studies involving partial or full pulpotomy in permanent teeth that reported postoperative pulp sensibility assessment were included. Data regarding study characteristics, pulpotomy procedures, sensibility assessment methods, follow-up intervals, and key findings were extracted and synthesized descriptively. The search identified 4,287 records, of which 35 studies fulfilled the eligibility criteria. The included studies comprised randomized controlled trials, prospective and retrospective clinical studies, and one quasi-experimental study. EPT combined with cold testing was the most frequently used assessment methods, followed by cold testing alone and EPT alone. Follow-up intervals varied substantially, ranging from 2 days to 8 years, although most studies evaluated sensibility at 6, 12, and 24 months. A consistent finding across studies was the markedly higher positive response rate obtained with EPT compared with cold testing after full pulpotomy. Teeth treated with partial pulpotomy generally maintained more favorable responses to both EPT and thermal tests. Several studies also reported transient postoperative thermal hypersensitivity during the early healing period, particularly following partial pulpotomy. Considerable heterogeneity exists in postoperative pulp sensibility assessment methods following permanent tooth pulpotomy. According to the included studies, EPT demonstrated higher response rates than cold testing after full pulpotomy. Standardized assessment methods and the incorporation of objective assessment methods are needed to improve the consistency of outcome reporting and facilitate comparisons among future VPT studies.