Pulpotomy for Irreversible Pulpitis? Preliminary Qualitative Findings in the USA

Objectives: Symptomatic irreversible pulpitis is an acute dental emergency posing several challenges to dental professionals in primary care. Pulpotomy is a vital pulp therapy procedure consisting of the removal of the inflamed part of coronal pulp (partial or full) and the application of a biomaterial (Bi or Tricalcium silicate-based cements) directly onto the pulp tissue after haemostasis is achieved. This procedure can be a less complex alternative option to root canal treatment when irreversible pulpitis is treated at an early stage without signs of apical periodontitis or pulp necrosis. This study investigated dental practitioners’ current approaches and beliefs towards the clinical management and conservative treatment of irreversible pulpitis with normal apical tissues.
Methods: A brief 6-question questionnaire (“Quick Poll”) on the clinical management of irreversible pulpitis was conducted amongst dental practitioners who were members of the National Dental Practice-Based Research Network in the United States.
Results: One fifth of practitioners (n=83, 20%) included pulpotomy as one of the most common clinical management strategies for irreversible pulpitis with normal apical tissues in a permanent tooth. Pulpotomy with tricalcium silicate-based cements such as MTA, BiodentineTM and EndoSequence^® Root Repair MaterialTM is a treatment option being employed by 19.5% of the practitioners surveyed (n=81). 47% of practitioners (n=194) were in favor of pulpotomy as a definitive procedure and 69% (n=282) of practitioners felt that their patients would be in favor of this procedure.
Conclusions: This preliminary study highlights the interest and potential for the use of pulpotomy as a permanent treatment for the clinical management of irreversible pulpitis in permanent posterior teeth. Further research is needed to explore the potential for future implementation of such technique.