Alternative Management of Acute Irreversible Pulpitis of an Adult HIV-Positive Patient: A Case Report

Abstract

Background: Root canal treatment is the usual management of acute irreversible pulpitis of mature permanent teeth. MTA Pulpotomy can be used to treat acute irreversible pulpitis of an adult HIV-Positive patient alternative to root canal treatment as it is less invasive and one-step endodontic therapy. Objective: The aim was to evaluate the outcome of MTA Pulpotomy alternative to root canal treatment to manage acute irreversible pulpitis of an adult HIV-positive patient. Methods: Based on history, clinical and radiological examination the case was diagnosed as acute irreversible pulpitis on the mandibular left 2nd molar tooth in a patient who was HIV-positive and under treatment for 16 years. After anaesthetising and isolation with rubber dam coronal pulp was completely removed and MTA (Angelus, Brazil) was placed over the pulp chamber floor covering the canal orifices, and the rest of the cavity was sealed with glass-ionomer filling over the set MTA. The severity of postoperative pain was assessed by a visual analog scale after 24 hours, 48 hours, 72 hours, and 7 days. The incidence of any clinical symptoms or periapical pathology was determined using clinical and radiographic evaluation after 3-month, 6 months, and 1-year intervals. Results: Throughout the follow-up period, the patient was asymptomatic and there was no periapical pathology at the radiograph even at the end of one year. Conclusion: As a less invasive and single sitting short procedure, MTA pulpotomy can be done to treat acute irreversible pulpitis in the HIV-positive patient as an alternative to root canal treatment. Bangladesh Med Res Counc Bull 2021; 47(2): 230-234