Comparing Total Pulpotomy, Radicular Pulpotomy, and Root Canal Treatment for Deep Cavities and Painful Irreversible Pulpitis in Lower Premolars and Molars

What this Trial Is About

Researchers are evaluating the clinical effectiveness of total pulpotomy, radicular pulpotomy, and root canal treatment in mandibular premolar and molar teeth diagnosed with symptomatic irreversible pulpitis. The study aims to compare these treatments in terms of postoperative pain control and treatment success over time. A total of 99 teeth will be included and randomly assigned to one of the three treatment groups to assess outcomes using standardized protocols. The study involves three treatment groups total pulpotomy, radicular pulpotomy, and root canal treatment. Total pulpotomy consists of removing the coronal pulp and applying mineral trioxide aggregate MTA after achieving hemostasis. Radicular pulpotomy involves removing pulp tissue a few millimeters below the canal orifices, followed by MTA application. Root canal treatment includes cleaning and shaping of the root canals with irrigation and obturation using a calcium silicate-based sealer. All treated teeth will receive a final restoration with glass ionomer cement and composite resin. Participants will receive local anesthesia and undergo treatment according to their assigned group. Postoperative pain will be recorded using a visual analog scale at specified times up to 7 days after treatment. Clinical and radiographic evaluations to assess treatment success and periapical health will occur at 3, 6, and 12 months. Additional assessments include restorative integrity and pulp sensibility testing. Patients will be monitored for up to one year, with measures of pain and healing recorded as primary outcomes.

Outcomes of Pulpotomy and Root Canal Treatment in Teeth With Symptomatic Irreversible Pulpitis