Partial Pulpotomy Succeeded in 91% of Mature Molars With Deep Caries at Two Years

Edited by Dentaltown staff

Partial pulpotomy preserved pulp vitality in more than nine of every 10 mature permanent molars with deep caries two years after treatment, and the calcium silicate material used made no significant difference to the outcome, according to a randomized clinical trial published Sept. 18 in the International Endodontic Journal.

The trial enrolled 139 mature permanent mandibular molars in adult patients with a median age of 36. All had deep carious lesions within 1.5 mm of the pulp and were diagnosed with initial, mild, moderate, or severe pulpitis under the Wolters classification. Teeth were randomly assigned to partial pulpotomy with White MTA Angelus, 64 teeth, or with the premixed calcium silicate putty NeoPutty, 75 teeth.

Every treated tooth completed the 24-month follow-up. Clinical and radiographic success was 90.6% in the MTA group and 92.0% in the putty group, a difference that was not statistically significant at P = .774. Overall success was 91.4%.

The variable that did predict outcome was hemostasis time. Longer bleeding before hemostasis was achieved carried lower odds of success, at an odds ratio of 0.623, with a 95% confidence interval of 0.429 to 0.905 and P = .013.

Preoperative pulpal diagnosis was not associated with outcome. Teeth that presented with severe pulpitis under the Wolters classification fared no worse than those with milder inflammation.

Researchers in the postgraduate endodontics program at Universidad Europea de Madrid led the trial, with collaborators at Fluminense Federal University in Brazil, the Dublin Dental University Hospital at Trinity College Dublin, and Universidad de los Andes in Chile. The trial is registered at ClinicalTrials.gov as NCT06881615.

The findings describe mandibular molars followed for 24 months, and the analysis of factors associated with outcome was exploratory. Performance beyond two years, and in maxillary teeth, was not assessed.

Sources:
International Endodontic Journal, “Two-Year Outcome of Partial Pulpotomy Using Mineral Trioxide Aggregate or a Premixed Calcium Silicate Cement: A Randomized Clinical Trial,” published online Sept. 18, 2026: doi.org/10.1111/iej.70274
PubMed record, PMID 42755412: pubmed.ncbi.nlm.nih.gov/42755412
ClinicalTrials.gov, trial registration NCT06881615: clinicaltrials.gov/study/NCT06881615