Case Report: Pulpotomy in an Immature Cariously Exposed Second Permanent Molar

Abstract

Background: Exposure of the pulp by caries is often accompanied by chronic inflammation in the immediate area of the carious lesion and localized abscess formation. Direct pulp capping and vital pulpotomy are two accepted clinical modalities to preserve tooth vitality in cases of pulp exposure in carious young permanent teeth but the success rates are often less than 50%. Case report: A 13 year old boy presented with an immature and grossly carious 37. Having already lost 36 a decision was made to maintain 37. Treatment: A cervical pulpotomy was initiated using local analgesia. All the inflamed, contaminated pulp tissue in the pulp chamber to the level of the radicular pulp stumps was removed and a cervical pulpotomy was carried out. Following haemostasis the radicular pulp stumps were coveredwith non-setting calcium hydroxide then setting calcium hydroxide, and the tooth restored temporarily with zinc oxide and eugenol cement. Follow-up: At 26 months following the pulpotomy, the molar had been symptomless and there were no clinical signs of infection or inflammation. Radiographically root development of 37 was complete, the lamina dura was continuous apically and the root canals were partially sclerosed.