Delayed miniature pulpotomy in a symptomatic mature molar

Abstract

This case report describes miniature pulpotomy (MP) with calcium‑enriched mixture (CEM) cement,
1 week after carious pulpal exposure of a symptomatic mature molar. A 24‑year‑old woman was
referred with complaining of severe lingering pain on the second upper left molar; a dental history
revealed that the tooth had been prepared 1 week ago, but on pulp exposure, her dentist just
dressed the cavity. After anesthesia/isolation in the same session, the temporary restoration was
removed, the previously pulpal exposure was observed, and MP was carried out. Hemorrhage was
effectively controlled using 5.25% NaOCl, the clot free pulpal wound was completely covered
employing CEM cement, and the cavity was permanently restored by resin composite. The patient’s
pain gradually relieved within 24 h. The tooth was functional and able to respond to vitality tests
in regular clinical follow‑ups. At 15‑month follow‑up, a dentinal bridge was observed under the
capping biomaterial, radiographically; moreover, no calcification or apical pathosis was detected.
MP with CEM cement might be a treatment option for the management of exposed dental pulp
with a clinical diagnosis of irreversible pulpitis, although further trials with larger sample size and
longer follow‑ups are recommended.
Key Words: Calcium‑enriched mixture cement, dental pulp diseases, endodontics, pulpotomy