Complete Pulpotomy using Biodentine in Mature Permanent Teeth with Symptomatic Irreversible Pulpitis: A Quasi-Experimental Study

Abstract

Objective: This quasi-experimental study assessed the clinical and radiographic outcomes of complete pulpotomy using Biodentine in mature permanent molars with symptomatic irreversible pulpitis over a 12-month follow-up period. Methods: Thirty-three mature permanent molars in 30 patients (mean age 25.9 years) diagnosed with symptomatic irreversible pulpitis underwent complete pulpotomy. Hemostasis was achieved within ≤10 minutes using 2.5% sodium hypochlorite. Biodentine was placed over the radicular pulp stumps, followed by a permanent resin-composite restoration after one week. Clinical and radiographic evaluations were performed at 3, 6, and 12 months post-operatively. Success was defined as absence of pain, swelling, sinus tract, tenderness to percussion, pathological mobility, restoration failure, and radiographic evidence of periapical pathology, resorption, or periodontal ligament changes. Results: The overall success rate at 12 months was 94.0% (31/33 molars), with success rates of 100% at 3 months and 97.0% at 6 months. Treatment failure occurred in 6.0% of cases, primarily associated with persistent symptoms or restorative complications. Age, sex, and tooth location (maxillary vs. mandibular) were not significantly associated with treatment outcome (p>0.05). Pain resolved rapidly following the procedure, with only 3.0% of patients reporting persistent pain at 12 months. Conclusion: Complete pulpotomy using Biodentine is an effective and minimally invasive treatment option for mature permanent teeth with symptomatic irreversible pulpitis, demonstrating high clinical and radiographic success rates over a 12-month period.