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Órgano Oficial de la Asociación Dental Mexicana

2026, Number 1

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Rev ADM 2026; 83 (1)

Full pulpotomy in mature permanent teeth with irreversible pulpitis; breaking the paradigm in Mexico.

Sánchez LTR, Domínguez PRA

Language: Spanish
References: 30
Page: 45-50
PDF size: 377.14 Kb.


ABSTRACT

In the current dental landscape in Mexico, it is imperative that dentists break the paradigm of treatment for symptomatic or asymptomatic irreversible pulpitis in mature permanent teeth, where traditionally root canal treatment has been the first line of action. We must move forward with the reliable approach offered by evidence-based dentistry. To this day, there is sufficient scientific evidence supporting total pulpotomy with the application of calcium silicate cements as the first-choice treatment in mature permanent teeth, offering a more conservative and potentially more accessible alternative to root canal treatment. So much so that various prestigious scientific societies have issued their position statements for the management of irreversible pulpitis. However, the reality is that in Mexico this new approach is not yet being adopted, and therefore its benefits are not being utilized by our population, a population that largely lacks access to specialized dental care and in which the need to resort to tooth extraction to resolve pain from pulpitis would be avoided.


REFERENCES

  1. Zanini M, Meyer E, Simon S. Pulp inflammation diagnosis from clinical to inflammatory mediators: a systematic review. J Endod. 2017; 43 (7): 1033-1051.

  2. Lin LM, Ricucci D, Saoud TM, Sigurdsson A, Kahler B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. Aust Endod J. 2020; 46 (1): 154-166.

  3. Krastl G, Galler K, Dammaschke T, Schafer E. Is pulpotomy a valid treatment option for irreversible pulpitis? Dtsch Zahnarztl Z Int. 2021; 3: 80-87.

  4. Michaelson PL, Holland GR. Is pulpitis painful? Int Endod J. 2002; 35 (10): 829-832.

  5. American Association of Endodontist. AAE position statement on vital pulp therapy. J Endod. 2021; 47 (9): 1340-1344.

  6. Eleazer PD, Glickman GN, McClanahan SB, Webb TD, Justman BC et al. Glossary of endodontic terms. 10th ed. Chicago (IL): American Association of Endodontists; 2020. pp. 1-48.

  7. Duncan HF, Galler KM, Tomson PL, Simon S, El-Karim I, Kundzina R et al. European Society of Endodontology position statement: management of deep caries and the exposed pulp. Int Endod J. 2019; 52 (7): 923-934.

  8. Sweet CA. Procedure for treatment of exposed and pulpless deciduous teeth. J Am Dent Assoc. 1930; 17 (6): 1150-1153.

  9. Sweet CA. Treatment of vital primary teeth with pulpal involvement: therapeutic pulpotomy. J Colo Dent Assoc. 1955; 33 (1): 10-14.

  10. Bakland LK. Endodontic considerations in dental trauma. In: Ingle JI, Bakland LK, editors. Endodontics. 5th ed. Hamilton-London: BC Decker Inc.; 2002. pp. 795-844.

  11. Ricucci D, Siqueira JF Jr, Li Y, Tay FR. Vital pulp therapy: histopathology and histobacteriology-based guidelines to treat teeth with deep caries and pulp exposure. J Dent. 2019; 86: 41-52.

  12. Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M et al. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J. 2017; 50 (9): 825-829.

  13. Ricucci D, Loghin S, Siqueira JF. Correlation between clinical and histologic pulp diagnoses. J Endod. 2014; 40 (12): 1932-1939.

  14. Ford TR, Torabinejad M, Abedi HR, Bakland LK, Kariyawasam SP. Using mineral trioxide aggregate as a pulp-capping material. J Am Dent Assoc. 1996; 127 (10): 1491-1494.

  15. Asgary S, Eghbal MJ. Treatment outcomes of pulpotomy in permanent molars with irreversible pulpitis using biomaterials: A multi-center randomized controlled trial. Acta Odontol Scand. 2013; 71 (1): 130-136.

  16. Asgary S, Eghbal MJ, Ghoddusi J. Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter randomized clinical trial. Clin Oral Investig. 2014; 18 (2): 635-641.

  17. Asgary S, Eghbal MJ, Fazlyab M, Baghban AA, Ghoddusi J. Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis: a non-inferiority multicenter randomized clinical trial. Clin Oral Investig. 2015; 19 (2): 335-341.

  18. Taha NA, Abdulkhader SZ. Full pulpotomy with biodentine in symptomatic young permanent teeth with carious exposure. J Endod. 2018; 44 (6): 932-937.

  19. Alqaderi H, Lee CT, Borzangy S, Pagonis TC. Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: A systematic review and meta-analysis. J Dent. 2016; 44: 1-7.

  20. Santos JM, Pereira JF, Marques A, Sequeira DB, Friedman S. Vital pulp therapy in permanent mature posterior teeth with symptomatic irreversible pulpitis: a systematic review of treatment outcomes. Medicina (Kaunas). 2021; 57 (6): 573.

  21. Moretto C, Kopper PMP, Münchow EA, Scarparo RK. Association between patient age and vital pulp therapy outcomes: A systematic review and meta-analysis of prognostic studies. Int Endod J. 2025; 58 (6): 809-832.

  22. Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod. 2011; 37 (5): 581-587.

  23. Li Y, Wang W, Zeng Q, Tang M, Massey J, Bergeron BE et al. Efficacy of pulpotomy in managing irreversible pulpitis in mature permanent teeth: A systematic review and meta-analysis. J Dent. 2024; 144: 104923.

  24. Li Y, Sui B, Dahl C, Bergeron B, Shipman P, Niu L et al. Pulpotomy for carious pulp exposures in permanent teeth: A systematic review and meta-analysis. J Dent. 2019; 84: 1-8.

  25. Silva EJNL, Pinto KP, Belladonna FG, Ferreira CMA, Versiani MA, De-Deus G. Success rate of permanent teeth pulpotomy using bioactive materials: A systematic review and meta-analysis of randomized clinical trials. Int Endod J. 2023; 56 (9): 1024-1041.

  26. Sánchez-Lara Y Tajonar RG, Vergara-Tinoco JV, Dammaschke T, Domínguez-Pérez RA. A pilot feasibility study to establish full pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis as a routine treatment in mexican public healthcare services. Healthcare (Basel). 2022; 10 (12): 2350.

  27. 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 (2): 225-230.

  28. Tan SY, Yu VSH, Lim KC, Tan BCK, Neo CLJ, Shen L et al. Long-term pulpal and restorative outcomes of pulpotomy in mature permanent teeth. J Endod. 2020; 46 (3): 383-390.

  29. Sonntag D. Éxito empírico frente a evidencia: ¿de qué evidencias se dispone en la endodoncia? Quintessence Publicación Int Odontol. 2010; 23 (3): 93-101.

  30. Rodríguez SLM, Salguero MU, Clavijo LR. Evidencia basada en la práctica: conocimientos, percepciones y comportamiento de los estudiantes de primer año de Odontología. Gac Médica Boliv. 2021; 44 (1): 57-63.




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