Biological Approach in the Management of Permanent Molars with Irreversible Pulpitis Using Platelet-Rich Fibrin as a Pulpotomy Medicament: Case Reports with 2-Year Follow Up

Abstract

The aim of vital pulp therapy is to maintain the health of pulp tissue by eliminating bacteria from the dentin pulp complex. Two patients diagnosed with symptomatic irreversible pulpitis in permanent mandibular molars with closed apices were managed using conservative treatment modalities such as vital pulpotomies with regenerative approaches. After caries excavation and pulpotomy, platelet-rich fibrin was used as a pulpotomy medicament followed by Biodentine placement. Final restorations were done with composite resins. At 6, 12, and 24 months recall, both the teeth responded positively to pulp sensibility tests, and radiographic examination revealed a normal periodontal ligament space. Positive results of this case imply the need for more studies with larger sample sizes. Further, a longer recall period is also required to justify the use of this approach for the treatment of pulpitis in human permanent molar teeth.