Fig. 1

Age : 15y

Tooth : Second maxillary right premolar

Dg : Irreversible pulpitis

Treatment plan : Pulpotomy

Fig. 2

Pre operative X-ray 

Fig. 3

Isolation, initial preparation which has resulted in pulp opening.

Fig. 4

Caries removal prior to pulpal access is required to reduce the bacterial load.

Hemostasis – cotton pellet within 3min.

video of the procedure

Fig. 5

MTA (mineral trioxide aggregate) was placed against the wound.

Fig. 6

Composite restoration

Fig. 7

X-ray after 1 treatment

Fig. 8

Intraoral picture after 1.5 year

Fig. 9

X-ray after 1.5 year

The patient has no complaints 

The vitality test is positive delayed


Pulpotomy is a prospective substitute for root canal treatment in managing permanent teeth with carious pulp exposures, even in permanent teeth with irreversible pulpitis. Large, well-designed trials comparing pulpotomy with other treatments in terms of cost-effectiveness should be informative.


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2. Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int Endod J. 2018;51:819–28.

3. Qudeimat MA, Alyahya A, Hasan AA. Mineral trioxide aggregate pulpotomy for permanent molars with clinical signs indicative of irreversible pulpitis: A preliminary study. Int Endod J. 2017;50:126–34.

4. McDonald RE, Avery DR, Dean JA. Treatment of deep caries, vital pulp exposure and pulpless teeth. In: Dentistry for the Child and Adolescent. 8th ed. St. Louis: Mosby: 2004. pp. 389–412.

5. Linsuwanont P, Wimonsutthikul K, Pothimoke U, Santiwong B. Treatment outcomes of mineral trioxide aggregate pulpotomy in vital permanent teeth with carious pulp exposure: The retrospective study. J Endod. 2017;43:225–30.

6. Yuanyuan Li 1, Bingdong Sui 2, Christian Dahl 3, Brian Bergeron 3, Peter Shipman 4, Lina Niu 5, Jihua Chen 6, Franklin R Tay 7  Pulpotomy for carious pulp exposures in permanent teeth: A systematic review and meta-analysis. In : J Dent, May 2019