Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis

Abstract

To assess the outcome of full pulpotomy using Biodentine in permanent teeth with carious exposures and symptoms indicative of irreversible pulpitis. Sixty-four permanent molar teeth with symptomatic vital pulps in 52 patients aged 19-69years were included. Preoperative pulpal and periapical diagnosis was established. After informed consent, the tooth was anaesthetized, isolated using rubber dam and disinfected with 5% NaOCl before caries excavation; subsequently, the pulp was amputated to the level of the canal orifices. Haemostasis was achieved, and a 3-mm layer of Biodentine (Septodont, Saint-Maur-des-Fosses, France) was placed as the pulpotomy agent. Resin-modified glass-ionomer liner was placed and the tooth restored with either resin composite or amalgam, and a postoperative periapical radiograph exposed. Clinical and radiographic evaluation was completed at 6months and 1year postoperatively. Pain levels were scored preoperatively and 2days post-treatment. Clinical signs and symptoms indicative of irreversible pulpitis were established in all teeth, and periapical rarefaction was present in nine teeth. After 2days, 93.8% reported complete relief of pain. At 6months, 63 of 64 attended recall with 98.4% clinical and radiographic success. At 1year, 59 of 63 attended recall, with 100% clinical and 98.4 radiographic success. Seven of eight cases with periapical rarefaction who attended recall had improvement in the periapical index (PAI) score. A hard tissue barrier was detected radiographically in four cases. Full pulpotomy using Biodentine was a successful treatment option for cariously exposed pulps in mature permanent molar teeth with clinical signs and symptoms indicative of irreversible pulpitis, up to 1year.