(PR058) A Systematic Review and Meta-Analysis on the Efficacy of Pulpotomy in Managing Irreversible Pulpitis in Mature Permanent Teeth

Objectives: This research evaluated the success rates of pulpotomy, compared its efficacy with non-surgical root canal treatment (NSRCT), analyzed various pulpotomy techniques, and assessed the effectiveness of contemporary bioactive materials for managing irreversible pulpitis in mature permanent teeth.

Methods: A comprehensive literature search was conducted across databases, including PubMed, Web of Science, Scopus, and the Cochrane Library, adhering to PRISMA 2020 guidelines. Studies were selected through a multi-step screening process, focusing on adult populations, randomized controlled trials, and single-arm trials.

Results: Fifteen randomized controlled trials and eight single-arm trials were included. The pooled clinical success rate of pulpotomy was 92.9% (95% CI; 82.1–99.0%) for follow-ups over 24 months, while the pooled radiographic success rate was 78.5% (95% CI; 66.7–88.4%). Meta-analyses showed no significant differences in success rates among pulpotomy and NSRCT, between full and partial pulpotomy techniques, or between Mineral Trioxide Aggregate and Calcium Enriched Mixture pulpotomy, indicating comparable efficacy across these variables.

Conclusion: The findings highlight the potential of less invasive treatments, suggesting pulpotomy as a viable alternative to NSRCT for managing irreversible pulpitis in mature teeth. Limitations, such as varying trial quality and bias in some studies, emphasize the need for further research to standardize methodologies and enhance the understanding of pulpotomy efficacy. Future studies should focus on standardized protocols to validate these findings and improve patient treatment outcomes.