Preservation Of Pulp Vitality Research Articles

Effectiveness of pulpotomy in managing carious exposure in mature permanent teeth: A systematic review and meta-analysis

ObjectivesThis quantitative systematic review evaluated whether pulpotomy performed with hydraulic calcium silicate cements may be used as an alternative to root canal treatment (RCT) in mature permanent teeth with carious pulp exposure. Data sourcesA comprehensive search was conducted in PubMed, Web of Science, Scopus, and the Cochrane Library. No language restrictions were applied. The search included randomised controlled trials that compared pulpotomy to root canal treatment for managing carious exposure in mature permanent teeth. Study selectionStudies were selected based on predetermined inclusion criteria: randomised controlled trials involving mature permanent teeth with carious pulp exposure, using hydraulic calcium silicate cements for pulpotomy. Non-comparative studies, case reports, and trials involving primary or immature permanent teeth were excluded. DataData were extracted on success rates, clinical outcomes, follow-up periods, pain profiles, and potential complications. A meta-analysis was performed, revealing no statistically significant differences in success rates between pulpotomy and RCT. Both interventions demonstrated success rates exceeding 90 % at one-year and two-year follow-up periods. Pain profiles consistently showed lower post-operative pain intensity in the pulpotomy group compared to the RCT group during the first week. Potential complications, such as non-responsive pulp and difficulties in determining pulp vitality, were reported more frequently in the pulpotomy group. ConclusionsPulpotomy with bioactive hydraulic calcium silicate cements shows comparable success rates to RCT in managing carious pulp exposure in mature permanent teeth. The results suggest pulpotomy as a viable, less invasive alternative to RCT, particularly in cases where preservation of pulp vitality is paramount. Clinical significanceThis systematic review highlights pulpotomy as a less invasive and cost-effective alternative to root canal treatment in mature permanent teeth. With comparable success rates and lower post-operative pain, pulpotomy offers a promising approach to managing carious exposure and preserving tooth vitality.

COMPARATIVE EVALUATION OF 3MIXTATIN WITH MTA AND FORMOCRESOL FOR PULPOTOMY OF PRIMARY MOLARS: AN IN-VIVO STUDY

Background- Preservation of pulp vitality is of utmost importance to the normal physiological functioning of tooth in situ and physiological process of exfoliation in a tooth affected by disease or trauma. Pulpotomy serves such a purpose using various medicaments applied directly on vital pulp. Aim- To compare and evaluate the clinical and radiographic success of 3Mixtatin with MTA and formocresol for pulpotomy of primary molars. Materials & Methodology– Sixty primary molars were selected from 100 children aged between 5-9 years age who reported to Department of Pedodontics and Preventive Dentistry. All selected primary teeth were randomly divided in to three groups with 20 each depending on the type of pulpotomy medicament (Group I - Formocresol, Group II - MTA, Group III -3mixtatin) used. The children were then examined clinically and radiographically at 6 and 12 months. Results & Observation– Overall clinical and radiographic success rate of three groups at 6 months and 12 months were Group I showed success rate of 91.7 percent ,81.7 percent Group II showed 100percent, 91.7percent Group III showed 95 percent,85 percent respectively. Conclusion– 3mixtatin can be considered as additional pulpotomy medicament in primary teeth because of its bio-compatible and bioinductive properties.

Bioactive Biosilicate Cements in Pediatric Dentistry – A Review of the Latest Materials

ABSTRACT Pediatric dentistry plays a critical role in ensuring the oral health and well-being of children and adolescents. The quest for effective dental materials that are safe, biocompatible, and capable of promoting natural remineralization has led to the emergence of biosilicate cements as a promising advancement in this field. Biosilicate cements are bioactive materials composed of amorphous silica, calcium oxide, phosphorus pentoxide, and other trace elements. The bioactivity of biosilicate cements allows them to interact with living tissues, promoting remineralization and stimulating the formation of hydroxyapatite, a vital component of teeth and bones. Their ability to release essential ions, such as calcium, phosphate, and fluoride, supports the natural healing processes, aiding in the preservation of pulp vitality and reducing the risk of secondary caries. Biosilicate cements offer versatility in pediatric dentistry, finding application indirect pulp capping, indirect pulp capping, and small-sized restorations. Their rapid setting time proves advantageous when treating young patients with limited cooperation. Furthermore, the continuous release of fluoride contributes to caries prevention and enhances the long-term oral health of children. While the advantages of biosilicate cements in pediatric dentistry are promising, this manuscript also discusses the limitations and challenges associated with their use. Some biosilicate cements may have different handling characteristics compared to traditional materials, necessitating adaptations in clinical techniques. In addition, long-term clinical data on the performance of these materials in pediatric patients are still limited, requiring further research to establish their efficacy and longevity. This manuscript explores the potential of biosilicate cements in pediatric dentistry.

The effect of marsupialization of large cystic lesions of the jaws on pulp vitality

AbstractIntroductionThere is a paucity of studies evaluating the preservation and recovery vitality of teeth associated with cystic lesions in the jaws.The purpose of the present study was to evaluate whether the use of the marsupialization treatment method in the large cystic lesions of the jaws associated within involved teeth would save the pulp vitality.Materials and methodsIt was a cohort study of patients treated at the Department of Oral and Maxillofacial Surgery from April 2019 to April 2023. Patients with primary cystic lesions associated teeth, with a cyst diameter of >3.4 cm, along with dental root resorption of less than half the root length, and treated by marsupialization were included. Patient age, gender, location, associated teeth, size, management, dental pulp vitality before and after marsupialization, and the duration of treatment were evaluated. Pulp vitality of involved teeth was assessed with electrical pulp tester.Predictor VariableIt was the treatment method.Main Outcome Variable(s)The primary outcome variable was the recovery or preservation of pulp vitality.CovariatesThe study variables were demographic, clinical features of the cysts, clinical features of associated teeth, and treatment method.AnalysesCategorical data were presented in mean with standard deviation, and set the level of statistical significance at p < 0.05.ResultsThe sample included 73 patients with large cystic lesions; 47 (64.4%) were male and 26 (35.6%) were female. The age range was 9 to 68 years (mean ± standard deviation, 22.4 ± 4). The 73 patients had 305 teeth associated with large cystic lesions. Of these dentitions, 85.9% of teeth had normal pulp vitality and 14.1% were negative before marsupialization. Following marsupialization, preservation of pulp vitality was noted in 61.3% and 18.0% of teeth lost their vitality. Of those without normal dental pulp vitality, 70.9% of teeth recovered their vitality of which 46.5% had recovered their vitality 9 to 12 months following marsupialization.ConclusionMarsupialization followed by second surgery maybe a treatment option for preserving and recovering the pulp vitality of teeth associated with large cystic jaw lesions.

Cone beam computed tomographic assessment of radiographic changes after indirect pulp capping using diode lasers and silver diamine fluoride in permanent molars with deep carious lesions

Aim: To compare the preservation of pulp vitality by indirect pulp capping using Diode laser and Silver Diamine Flouride in management of deep carious lesions. Methods: Thirty patients with an age range of 18-46 years were selected and randomly divided into 3 equal groups: Group 1 (Control group): indirect pulp capping was performed using Biodentine, Group 2: Diode laser with an output power of 0.5 watt was applied before Biodentine placement, and Group 3: Application of Silver Diamine Flouride followed by Biodentine. Pre-operative clinical assessment and radiographs were performed before intervention and then the patients received their treatment and final restorations. Follow-up with clinical assessments was performed after 3 and 6 months. Cone beam computed tomography was performed at the day of intervention and after 6 months. Clinical and Radiographic data were collected, tabulated and statistically analyzed to compare between the success rates of indirect pulp capping using diode laser, Silver Diamine Flouride and Biodentine in management of deep carious lesions. Results: The results of clinical assessment for all groups have shown success rate of 100%. The remaining dentin thickness was significantly increased in all study groups after application of intervention. Also, the remaining dentin density showed significant increase in all groups, where Diode laser application with an output power of 0.5 watt group was significantly higher than the control group, with no significant difference between other groups. Conclusions: Within the limitations of the current study, the following can be concluded: 1. Using Biodentine in indirect pulp capping is the treatment of choice in management of deep carious lesions. 2. Silver Diamine Flouride can be used as an alternative indirect pulp capping material. 3. Diode laser can show promising results in terms of Cavity Disinfection & can have better biomodulating outcomes on the pulpal tissue healing and repair.

Management of Severe Pre-eruptive Caries in First Permanent Molar: A Case Report

Introduction: The study aimed to discuss the diagnosis and treatment of a six years old boy with severe pre-eruptive caries with preservation of pulp vitality after surgical exposure in the permanent mandibular molar. Pre-eruptive intra coronal caries are often an accidental lesion as a radiolucent finding in the coronal dentin of a tooth which did not erupted into the oral space. However, treatment modality is still not reported systematically. Case Presentation: The preventive approach effectively preserved the tooth vitality with no symptoms, while normal root development is processing during follow-up sessions. Conclusions: Accurate radiographic examination in visit and follow up sessions is fundamental for proper detection and intervention in pre-eruptive caries lesions.

Tissue engineering atthe dentin-pulp interface using human treated dentin scaffolds conditioned with DMP1 or BMP2 plasmid DNA-carrying calcium phosphate nanoparticles.

Hard dental tissue pathologies, such as caries, are conventionally managed through replacement by tooth-colored inert biomaterials. Tissue engineering provides novel treatment approaches to regenerate lost dental tissues based on bioactive materials and/or signaling molecules. While regeneration in the form of reparative dentin (osteo-dentin) is feasible, the recapitulation of the tubular microstructure of ortho-dentin and its special features is sidelined. This study characterized in vitro, and in vivo human EDTA-treated, freeze-dried dentin matrices (HTFD scaffolds) conditioned with calcium phosphate nanoparticles (NPs) bearing plasmids encoding dentinogenesis-inducing factors (pBMP2/NPs or pDMP1/NPs). The uptake and transfection efficiency of the synthesized NPs on dental pulp stem cells (DPSCs) increased in a concentration- and time-dependent manner, as evaluated qualitatively by confocal laser microscopy and transmission electron microscopy, and quantitatively by flow cytometry, while, in parallel, cell viability decreased. HTFD scaffolds conditioned with the optimal transfectability-to-viability concentration at 4µg Ca/mL of each of the pBMP2/NPs or pDMP1/NPs preserved high levels of cell viability, evidenced by live/dead staining in vitro and caused no adverse reactions after implantation on C57BL6 mice in vivo. HTFD/NPs constructs induced rapid and pronounced odontogenic shift of the DPSCs, as evidenced by relevant gene expression patterns of RunX2, ALP, BGLAP, BMP-2, DMP-1, DSPP by real-time PCR, and acquirement of polarized meta-mitotic phenotype with cellular protrusions entering the dentinal tubules as visualized by scanning electron microscopy. Taken together, HTFD/NPs constitute a promising tool for customized reconstruction of the ortho-dentin/odontoblastic layer barrier and preservation of pulp vitality. STATEMENT OF SIGNIFICANCE: In clinical dentistry, the most common therapeutic approach for the reconstruction of hard dental tissue defects is the replacement by resin-based restorative materials. Even modern bioactive materials focus on reparative dentinogenesis, leading to amorphous dentin-bridge formation in proximity to the pulp. Therefore, the natural microarchitecture of tubular ortho-dentin is not recapitulated, and the sensory and defensive role of odontoblasts is sidelined. This study approaches the reconstruction at the dentin-pulp interface using a construct of human treated dentin (HTFD) scaffold and plasmid-carrying nanoparticles (NPs) encoding dentinogenic factors (DMP-1 or BMP-2) with excellent in vitro and in vivo properties. As a future perspective, the HTFD/NPs constructs could act as bio-fillings for personalized reconstruction of the dentin-pulp interface.

COMPARATIVE CLINICAL, RADIOGRAPHICAL AND HISTOLOGICAL EVALUATION OF CORONAL PULPOTOMY TECHNIQUE WITH PRF AND A NOVEL CROSSLINKED PRF AS AN ALTERNATIVE TO PULPECTOMY FOR PRESERVING THE TOOTH VITALITY IN CONTEXT OF TISSUE ENGINEERING.

Background: Removal of infected pulp tissue from the coronal portion leads to preservation of a remaining vital and functioning pulp. Preservation of pulp vitality by pulpotomy is one of the universally accepted treatment procedure with the aid of latest bioactive materials leading to a more conservative approach in the management of teeth involving the pulp based on clinical conditions To comparatively evaluate the . Aim: clinical and radiological and histological outcome of platelet-rich brin (PRF) and the novel crosslinked PRF (C-PRF) developed by us as pulpotomy agent in context of tissue engineering in permanent teeth. 20 permanent mol Materials and Methods: ar teeth from 20 healthy patient aged 18-40 years with permanent molar teeth cariously exposed pulps and diagnosed clinically as irreversible pulpitis were selected for the study. Written consent from the patients was taken. The patients were then randomly divided into 2 groups (n=10) . One group received PRF pulpotomy anther group received our novel crosslinked PRF (C-PRF) pulpotomy. In all patients coronal pulp was removed after preparation of the access cavity with rubber dam under Lignocaine 2 % local anaesthesia. After hemostasis, exposed pulps were covered using PRF membrane with Biodentine or C-PRF with Biodentine, and then all teeth were restored with glass-ionomer cement. Clinical and radiographic evaluation was undertaken at 1 day, 3month and 6 months intervals. The results were analyzed using appropriate statistical tests. After around six months one case of each group third molar teeth was extracted due to positional problem and causation of cheek ulceration. Histological examination of the extracted teeth was done. Statistical Analysis was performed with he Results: lp of Epi Info (TM) 7.2.2.2 EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). Test of proportion was used to nd the Standard Normal Deviate (Z) to compare the difference proportions. p<0.05 was taken to be statistically signicant. C-PRF could improve the prognosis Conclusion: of pulpotomy procedures of mature permanent

Carboxymethyl cellulose hydroxyapatite hybrid hydrogel used to evaluate the osteogenic and odontogenic differentiation potential of dental pulp and periodontal ligament stem cells

In order to maintain optimal function, the aim of pulp treatment is to maintain the tooth structure intact. Retaining the vitality of teeth damaged due to caries or trauma is also one of the purpose of pulp treatment. In particular, the preservation of pulp vitality is essential for continuous root development and apical closure in the case of immature permanent teeth. In recent years, regenerative endodontic treatment procedures have been suggested in order to replace the damaged pulp tissue with viable tissue. The idea of regeneration of the dentin-pulp complex was introduced into endodontics to restore the vitality of young permanent teeth that have been non-vitalized due to trauma/dental caries. The concept of success in regenerative endodontic procedures is relied on three basic elements that are; stem cells, growth factors, and scaffolds. Each of these play their own important role in the regeneration of pulp-dentin complex. This invitro comparative study had intended to deal with the new experimental custom prepared semi-synthetic hybrid scaffold (CMC-HA), its acceptance for the cells (DPSCs and PDLSCs) seeded on it and osteogenic and odontogenic differentiation of both the dental pulp and periodontal ligament stem cells.

A critical analysis of research methods and experimental models to study pulpitis

Pulpitis is the inflammatory response of the dental pulp to a tooth insult, whether it is microbial, chemical, or physical in origin. It is traditionally referred to as reversible or irreversible, a classification for therapeutic purposes that determines the capability of the pulp to heal. Recently, new knowledge about dental pulp physiopathology led to orientate therapeutics towards more frequent preservation of pulp vitality. However, full adoption of these vital pulp therapies by dental practitioners will be achieved only following better understanding of cell and tissue mechanisms involved in pulpitis. The current narrative review aimed to discuss the contribution of the most significant experimental models developed to study pulpitis. Traditionally, in vitro two (2D)- or three (3D)-dimensional cell cultures or in vivo animal models were used to analyse the pulp response to pulpitis inducers at cell, tissue or organ level. In vitro, 2D cell cultures were mainly used to decipher the specific roles of key actors of pulp inflammation such as bacterial by-products, pro-inflammatory cytokines, odontoblasts or pulp stem cells. However, these simple models did not reproduce the 3D organisation of the pulp tissue and, with rare exceptions, did not consider interactions between resident cell types. In vitro, tissue/organ-based models were developed to better reflect the complexity of the pulp structure. Their major disadvantage is that they did not allow the analysis of blood supply and innervation participation. On the contrary, in vivo models have allowed researchers to identify key immune, vascular and nervous actors of pulpitis and to understand their function and interplay in the inflamed pulp. However, inflammation was mainly induced by iatrogenic dentine drilling associated with simple pulp exposure to the oral environment or stimulation by individual bacterial by-products for short periods. Clearly, these models did not reflect the long and progressive development of dental caries. Lastly, the substantial diversity of the existing models makes experimental data extrapolation to the clinical situation complicated. Therefore, improvement in the design and standardisation of future models, for example by using novel molecular biomarkers, databased models and artificial intelligence, will be an essential step in building an incremental knowledge of pulpitis in the future.

Selective Caries Removal- A New Improvised Technique for Caries Management

The strategies to manage deep caries are constantly evolving as evidence heaps for the use of minimalconservative techniques which would prevent pulpal exposure leading to preservation of pulp vitality,remineralisation of the carious dentin and arrest the progression of caries and offer a predictable success ofthe restoration. Changes in our understanding about the caries process, advent of new adhesive restorativematerials and the possibilities of remineralization of demineralized dental tissues helps us to exploredifferent techniques in caries management. Selective caries removal is now considered an efficient andevidence based approach in deep caries management and focuses on maximum retention of tooth materialthus avoiding the probability of pulp exposure to provide a sound peripheral bondable surface for restorationand creating excellent hermetic seal.

MTA Cvek Pulpotomy Followed by Fragment Re-Attachment in Traumatized Young Permanent Maxillary Left Central Incisor – A Case Report

Most common form of dental trauma in children are the fractures of crown mainly in anterior teeth. A case of complicated crown fracture treated with Cvek pulpotomy using MTA followed by fragment re-attachment with careful follow-up is presented here. Tooth fragment re-attachment provides feasible conservative alternative approach to restore esthetics and tooth function. Successful outcomes have been shown by the long term follow up of the treatment with the preservation of pulp vitality and continued development of root. Clinical results have also shown good esthetics and functional results of presented technique. KEYWORDS: Complicated crown fracture, Cvek pulpotomy, MTA, fragment re-attachment HOW TO CITE: Zalan AK, Zubairy KK, Zaman H, Maxood A, Gul A, Anser M. MTA cvek pulpotomy followed by fragment re-attachment in traumatized young permanent maxillary left central incisor – A case report. J Pak Dent Assoc 2021;30(1):70-73.

Management of Deep Carious Lesion with Single Visit Indirect Pulp Capping: A Case Report

Background: Preservation of pulp vitality is of utmost importance during management of deep caries cases.There remains a possibility of pulp tissue to repair upon excavation of caries with no pulpal exposure.However, in case of exposure of pulp, such type of minimally invasive management becomes doubtful& impulsive. Indirect pulp capping(IPC) treatment plays an essential role in these cases to prevent pulpalexposure.Case Presentation: This case report describes the single visit indirect pulp therapy in mandibular molar.Patient reported with a chief complaint of food lodgement and mild intermittent pain. There was no historyof night pain and/or spontaneous pain. The clinical and radiological evaluation revealed no peri-radicularpathosis and no pulpal involvement. The tooth was examined for vitality using electric pulp test and revealedvital pulp. The treatment was done with the protocol of Single Visit Indirect Pulp therapy using light curecalcium hydroxide and cavity was disinfected with 2% chlorhexidine. Cavity was lined with Glass IonomerCement and final restoration was done using Composite resin restoration. The patient was followed up till6 months and showed satisfactory outcome eliminating the need for more invasive approach as root canaltherapy.Conclusion: Indirect pulp therapy is a safe, economical and proven treatment option in the teeth that havenot involved pulp and with sound peri-radicular tissues. The success of Indirect Pulp Capping relies onproper case selection and diagnosis, complete isolation, caries removal and disinfection with selection ofsuitable pulp capping material

In vivo Study of Use of Bioceramic Material in Open Crown-root Fractures

Treatment of crown root fracture is complex and requires an accurate diagnostic and treatment plan. The purpose of this article is to report a case of a maxillary central incisor with a crown-root fracture with pulp exposure treated and rehabilitated with the preservation of pulp vitality using a micro-pulpotomy and pre-mixed bioactive endodontic cements followed by zirconia restauration, a bioinert ceramic material, milled using CAD/CAM technology. The preservation of pulp vitality using premixed bioceramic materials, ensures the continuation of dentinogenesis with its benefits, higher resistance of radicular walls against fracture, smaller diameter of apical foramen as well as creating conditions over time for a post retained crown with better aesthetic results.

Comparative evaluation of clinical outcome of indirect pulp treatment with calcium hydroxide, calcium silicate and Er,Cr:YSGG laser in permanent molars.

The aim of the study was to compare preservation of pulp vitality by indirect pulp treatment with calcium hydroxide, calcium silicate based cement (Biodentine) and Er,Cr:YSGG laser in permanent molars. 30 patients were selected for this study as per the inclusion and exclusion criteria in the age group of 6-14 years and then randomly allocated to three groups A, B & C. In group A, after caries excavation, calcium hydroxide (Dycal) was placed at the floor. In group B, after caries excavation, calcium silicate based cement (Biodentine) was placed at the floor. In group C, after caries excavation, decontamination of the cavity was done with Er,Cr:YSGG laser. This was followed by placement of permanent restorative material in all the groups. Clinical and radiographic success was monitored at 3, 6 and months. Data analysis was performed using Statistical Package for the Social Science-21 (SPSS-21). At the end of 9 months, overall success rate of indirect pulp was 86.6%. There was no significant difference between the three groups. (p > 0.05). The study showed that the success of indirect pulp treatment is independent of the type of liner used for pulp capping. Moreover, the study also shows that Er,Cr;YSGG laser can be effectively used for indirect pulp capping procedures.

Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation

This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis.

Stepwise Excavation A conservative Community-Based Dental Treatment of Deep caries To Preserves the Tooth Vitality

Operative dentistry not only requires technical expertise and an in-depth understanding of materials science, but knowledge in cariologyand pulp biology is also essential. Treatment of deep caries lesions approaching a healthy pulp presents a significant challenge to the practitioner. The traditional management of carious lesions of any kind dictates the removal of all infected and affected dentin to prevent further cariogenic activity and provide a well–mineralized base of dentin for restoration. Pulp vitality is extremely important for the tooth viability, since it provides nutrition and acts as biosensor to detect pathogenic stimuli. In 1938, Bodeckerintroduced the Stepwise Excavation technique for treatment of teeth with deep caries for preservation of pulp vitality and conservative. Stepwise Excavation has gained a growing interest in the recent years from different researchers due to advances made in techniques and dental materials with good sealing ability and antibacterial properties. Clinical study on stepwise excavation of deep carious lesions in vital permanent teeth: a 12-month follow-up study shown this technique is a conservative community based treatment.

The four mechanisms of dental resorption initiation

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis. With this purpose, we suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests. 2) Root resorption by cementoblasts and Malassez epithelial rests death. 3) Dental resorption by odontoblasts cell death with preservation of pulp vitality. 4) Dental resorption by direct exposure of dentin to gingival connective tissue at the cementoenamel junction gaps.

The management of anterior tooth wear using gold palatal veneers in canine guidance

Localised anterior tooth wear can be managed using minimally invasive techniques with conservation of tooth structure and preservation of pulp vitality. This article describes and illustrates with two clinical cases, the management of localised tooth wear, with the restoration of canine guidance by a combination of gold palatal veneers and direct composite restorations.

Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.