Full Pulpotomy for Cariously Exposed Permanent Teeth as an Alternative to Conventional Root Canal Treatment: A Literature Review

Abstract

This review’s objective is to discuss the possibility of implementing the full pulpotomy procedure in cariously exposed permanent teeth as an alternative to conventional root canal treatment. The reader will be brought up to date by considering the indications, contraindications, rationale, advantages, disadvantages, clinical procedure, reported success rates, and prognosis of full pulpotomy. In addition, a discussion will be carried out regarding different materials used in full pulpotomy and a review of terminologies of different vital pulp therapy procedures. Four databases (PubMed, SCOPUS, Europe PMC, and Cochrane library) were systematically searched between August 2019 and December 2019. In addition, a manual search was carried out to find all related studies and articles relevant to full pulpotomy in permanent teeth. Full pulpotomy was historically indicated for treating primary and immature permanent teeth in young individuals. In addition, different vital pulp therapy procedures did not show promising results when they were prescribed for treating permanent dentition. However, recently, all vital pulp therapy procedures, including full pulpotomy, were revisited as definitive treatment modalities for permanent teeth due to the advancements in the fields of dental biomaterial and biology. There were many published clinical trial with inconsistent success rates in the literature. In these trials, different materials such as CH, MTA, CEM, Biodentine, and ZOE were used for the full pulpotomy procedure in cariously exposed permanent teeth. Only two randomized clinical trials compared between the full pulpotomy procedure in permanent teeth and conventional root canal treatment and reported comparable post-operative pain relief and success rates up to 5 years. According to the majority of the identified resources, it can be concluded that full pulpotomy can be a viable treatment option in cariously exposed mature and immature permanent teeth with reversible and reversible pulpitis. However, further well-designed clinical trials are needed.