Outcome of Mineral Trioxide Aggregate Pulpotomy for Mature Permanent Molars with Symptoms Indicative of Irreversible Pulpitis.

Root canal treatment (RCT) is preferred treatment for mature teeth with irreversible pulpitis. But sometimes it is very difficult to perform due to complex pulpal anatomy and the vitality of tooth is completely lost by this procedure. A new hope has been emerged to consider pulpotomy treatment as an effective treatment in mature permanent teeth with irreversible pulpitis as with the new understanding of pulp biology and recent innovation of bioactive material like MTA. The aim of the study was to evaluate the outcome of MTA pulpotomy for mature third molars with symptoms indicative of irreversible pulpitis. This quasi-experimental study was conducted at Department of Conservative Dentistry and Endodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from September 2019 to August 2020. Twenty permanent mandibular third molar teeth with fully developed roots and diagnosed as irreversible pulpitis in 20 patients aged 25-50 years were selected for this study. After informed consent, each tooth was anaesthetized, isolated with dental dam and disinfected with 5% NaOCl before caries excavation; caries was removed, and then, a full pulpotomy was performed. Haemostasis was achieved and MTA (Angelus, Brazil) was placed as the pulpotomy agent over the pulp chamber floor covering the canal orifices and rest of the cavity was sealed with glass-ionomer filling over the set MTA. Clinical and radiographic evaluation was completed at 3 months, 6 months, and 1 year postoperatively. Descriptive statistics were used to assess outcomes. The recall rate ranged from 90% at 3 months to 85% at 1 year, with an overall 100% clinical and radiographic success during the 3 month and 6 month, and 95% success at the end of 1 year. MTA pulpotomy sustained a good success rate over the 1 year follow-up in mature third molar teeth clinically diagnosed with irreversible pulpitis.