Journal of Operative Dentistry & Endodontics

Register      Login

VOLUME 6 , ISSUE 1 ( January-June, 2021 ) > List of Articles


Outcome of Pulpotomy Using Bioceramic Material in Mature Permanent Anterior Teeth with Traumatic Pulp Exposure: A Case Report

Rugma Raj, Mali G Nair, Shiji Dinakaran, Anulekh Babu, Shabna Shajahan, Kanchana Devi, Swathi P Devadas, Parvathy D Kumar, Amitha Palliyali

Keywords : Biodentin, Complicated crown fracture, Dental trauma, Pulpotomy

Citation Information : Raj R, Nair MG, Dinakaran S, Babu A, Shajahan S, Devi K, Devadas SP, Kumar PD, Palliyali A. Outcome of Pulpotomy Using Bioceramic Material in Mature Permanent Anterior Teeth with Traumatic Pulp Exposure: A Case Report. J Oper Dent Endod 2021; 6 (1):24-27.

DOI: 10.5005/jp-journals-10047-0111

License: CC BY-NC 4.0

Published Online: 30-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim: To evaluate the outcome of pulpotomy in traumatized mature permanent teeth using bioceramic material. Rationale: To preserve the vitality of the tooth Background and objectives: Traumatic injuries to anterior permanent teeth are more common in which complicated crown fracture needs special attention. Preservation of pulp vitality is important rather than replacing it with a root filling material following pulp exposure. This case report evaluates the treatment outcome following pulpotomy using bioceramic materials in traumatized mature permanent anterior teeth based on clinical evaluation at 3, 6, 12 months follow-up and radiographic evaluation at 12 months or any time during the follow-up period if symptomatic. Clinically visible coronal discoloration and diffuse calcification were also assessed. Case description: A 14-year-old male patient was reported at the department following road traffic accident (RTA). On examination, a complicated crown fracture of teeth #9 was noted. Partial pulpotomy was performed. Pulpotomy medicament used was Biodentin. Nearly, 2.5% sodium hypochlorite used for hemostasis. The permanent restoration given was composite. Follow-up intervals were 3, 6, and 12 months. Conclusion: Pulpotomy is a suitable alternative to root canal treatment in traumatized anterior teeth with pulp exposure. Biodentin is a suitable bioceramic material for pulpotomy which promotes dentin bridge formation and protects the vitality of the remaining portions of the pulp. Further research and clinical trials are also needed to develop a treatment protocol. Clinical significance: Preservation of vitality of teeth has paramount importance as the vital pulp nourishes dentin and also forms reparative dentin in response to stimuli.

  1. Levin L, Day PF, Hicks L, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: general introduction. Dent Traumatol 2020;36(4):309–313. DOI: 10.1111/edt.12574.
  2. Crona-Larsson G, Norén JG. Luxation injuries to permanent teeth — a retrospective study of etiological factors. Dent Traumatol 1989;5(4):176–179. DOI: 10.1111/j.1600-9657.1989.tb00355.x.
  3. Ward J. Vital pulp therapy in cariously exposed permanent teeth and its limitations. Aust Endod J 2002;28(1):29–37. DOI: 10.1111/j.1747-4477.2002.tb00364.x.
  4. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod 1978;4(8):232–237. DOI: 10.1016/S0099-2399(78)80153-8.
  5. Seltzer S, Bender IB, Ziontz M. The dynamics of pulp inflammation: correlations between diagnostic data and actual histologic findings in the pulp. Oral Surg Oral Med Oral Pathol 1963;16:969–977. DOI: 10.1016/0030-4220(63)90201-9.
  6. Bourguignon C, Cohenca N, Lauridsen E, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol 2020;36(4):314–330. DOI: 10.1111/edt.12578.
  7. Padawe D, Takate V, Dighe K, et al. Prevalence of traumatic injuries to anterior teeth in 9–14 year school-going children in Mumbai, India. J Contemp Dent Pract 2019;20(5):622–630. PMID: 31316029.
  8. Aggarwal V, Logani A, Shah N. Complicated crown fractures – management and treatment options. Int Endod J 2009;42(8):740–753. DOI: 10.1111/j.1365-2591.2009.01588.x.
  9. Nagarajappa R, Ramesh G, Uthappa R, et al. Risk factors and patterns of traumatic dental injuries among Indian adolescents. J Dent Sci 2020;15(1):96–103. DOI: 10.1016/j.jds.2019.07.003.
  10. Ramachandran A, Khan SIR, Baskaradoss J. Epidemiology of traumatic dental injuries among adults in an Indian sub-population. 2019 [In review].
  11. Simon S, Perard M, Zanini M, et al. Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts. Int Endod J 2013;46(1):79–87. DOI: 10.1111/j.1365-2591.2012.02113.x.
  12. Abuelniel GM, Duggal MS, Kabel N. A comparison of MTA and Biodentin as medicaments for pulpotomy in traumatized anterior immature permanent teeth: a randomized clinical trial. Dent Traumatol 2020;36(4):400–410. DOI: 10.1111/edt.12553.
  13. Borkar S, Ataide I. Biodentin pulpotomy several days after pulp exposure: four case reports. J Conserv Dent 2015;18(1):73. DOI: 10.4103/0972-0707.148901.
  14. Haikal L, Ferraz dos Santos B, Vu D-D, et al. Biodentin pulpotomies on permanent traumatized teeth with complicated crown fractures. J Endod 2020;46(9):1204–1209. DOI: 10.1016/j.joen.2020.06.003.
  15. Bhat S, Hegde S, Adhikari F, et al. Direct pulp capping in an immature incisor using a new bioactive material. Contemp Clin Dent 2014;5(3):393. DOI: 10.4103/0976-237X.137967.
  16. Laurent P, Camps J, About I. Biodentin™ induces TGF-β1 release from human pulp cells and early dental pulp mineralization: biodentin induces mineralisation and TGF-β1 release. Int Endod J 2012;45(5):439–448. DOI: 10.1111/j.1365-2591.2011.01995.x.
  17. Kazemipoor M, Mahmoodi S. Evaluation of the response to electric pulp testing before and after pulp chamber pulpotomy. Int J Clin Dent 2018;11(2):109–115.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.