Clinical and Radiographic Success of Pulpotomy in Permanent Teeth With Irreversible Pulpitis: A Systematic Review.

Irreversible pulpitis in permanent teeth has traditionally been managed by root canal treatment. However, currently, vital pulp therapy, especially full and partial pulpotomy, is gaining popularity as a conservative technique to maintain pulp vitality and preserve tooth structure. This systematic review was carried out following the guidelines of the PRISMA 2020. A literature search was conducted using electronic databases PubMed, Cochrane library, and Google Scholar for studies published from 2010 to 2026. Following screening and eligibility assessment according to predefined inclusion criteria, 16 studies were included for qualitative synthesis. A total of 375 records were identified. Following removal of duplicates and screening, 16 studies were eligible and included in the review. Most included studies were randomized controlled trials, while a few were prospective or retrospective cohort studies. Overall, the included studies consistently reported favorable clinical and radiographic outcomes following pulpotomy in permanent teeth with irreversible pulpitis, particularly when calcium silicate-based materials such as mineral trioxide aggregate (MTA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), calcium-enriched mixture (CEM), TotalFill (FKG Dentaire, La Chaux-de-Fonds, Switzerland), and other bioceramics were used. Pulpotomy appears to be an effective and predictable conservative treatment option for permanent teeth with irreversible pulpitis, demonstrating favorable clinical and radiographic outcomes across both short- and long-term follow-up periods. However, additional high-quality multicenter studies with extended follow-up are required to further strengthen treatment recommendations.