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11th Edition of International Conference on Dentistry
and Oral Health

September 18-20 | London, UK

September 18-20, 2025 | London, UK
ICDO 2025

Pulpotomy in mature teeth with symptomatic irreversible pulpitis

Fellahi Samir, Speaker at Oral Health Conferences
Fellahi Samir
University Alger, Algeria
Title: Pulpotomy in mature teeth with symptomatic irreversible pulpitis

Abstract:

Pulpotomy, traditionally reserved for immature teeth, is emerging as a viable treatment for irreversible pulpitis in mature permanent teeth. This shift challenges the conventional belief that irreversible pulpitis mandates root canal treatment (RCT). Recent studies (Taha & Abdulkader, 2018; Ricucci et al., 2014) suggest that inflammation is often confined to the coronal pulp, leaving the radicular pulp capable of healing.
Objective: To evaluate the outcomes of full pulpotomy using MTA and Biodentine in mature teeth with symptomatic irreversible pulpitis at the Central Military Hospital’s Endodontics Department.
Methods

  • Patients: Cases presenting with acute pulpitis (spontaneous pain, prolonged sensitivity to cold, no periapical lesions).
  • Technique:
    • Coronal pulp removal under rubber dam isolation.
    • Hemostasis with 1–5% NaOCl (achieved within 5 minutes).
    • MTA placement and sealed restoration.
    • Postoperative analgesia (ibuprofen 400 mg/48h).
  • Follow-up: Clinical/radiographic evaluation at 1, 3, and 6 months.

Results

  • Pain relief: 90% of patients reported complete resolution within 48h.
  • Success rates: 85% asymptomatic at 6 months; 70% showed dentinal bridge formation radiographically.
  • Failures: 5 cases required RCT due to persistent pain (attributed to incomplete hemostasis or undetected necrosis).

Discussion
Our findings align with modern evidence:

  • Histological reality: Inflammation is often localized (Ricucci, 2014), permitting pulp preservation.
  • Advantages over RCT: Simpler, faster, cost-effective, and preserves tooth vitality.
  • Limitations: Case selection is critical (strict exclusion of necrosis/periapical pathology).

Conclusion: Pulpotomy with MTA is a paradigm shift in managing irreversible pulpitis, offering a biologically grounded, minimally invasive alternative to RCT. While long-term data are needed, our clinical experience supports its adoption for select mature teeth, emphasizing the need to reassess the "irreversibility" dogma.
Keywords: Pulpotomy, MTA, irreversible pulpitis, vital pulp therapy, minimally invasive endodontics.

Biography:

Fellahi Samir Endodontist at the Algiers University, he graduated as a dentist in 1999, then he worked in many structures. From 2004 he began his speciality, after that, he obtained his assistant professor rank in 2011 .Actually; he is head of department and lecturer at the military hospital in Algeria since 2022.

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