Outcome of Direct Pulp Capping and Partial Pulpotomy in Reversible Pulpitis

TITLE: Outcome of Direct Pulp Capping and Partial Pulpotomy in Reversible Pulpitis It aims to answer does outcome of direct pulp capping and partial pulpotomy differ in mature permanent teeth with extremely deep caries with reversible pulpitis. P (Population) - Mature permanent mandibular molars with extremely deep caries and clinical signs of reversible pulpitis. I (Intervention) -Direct Pulp Capping in teeth with Reversible Pulpitis. C (Comparison) -Partial Pulpotomy in teeth with Reversible Pulpitis. O (Outcome) -Assessment of clinical & radiographic success at 6 and 12 months follow up -Assessment of pain experience at baseline, post-operatively every 24 hours for 1 week In extremely deep lesions, the dental pulp is often inflamed or at risk of microbial contamination, therefore requiring timely and precise intervention in order to preserve pulp vitality. In such cases, the removal of the superficial 2-3 mm of inflamed pulp tissue can help maintain the health of the remaining pulpal tissue. Duncan and other researchers have emphasized the importance of assessing both caries depth and pulpal status for deciding the effective treatment plan. Although numerous studies have investigated the outcomes of Direct Pulp Capping (DPC) and Partial Pulpotomy separately & have included cases based on caries depth & pulpal status, such as reversible pulpitis. However, there remains a notable lack of comparative clinical studies directly evaluating partial pulpotomy and direct pulp capping under standardized conditions involving extremely deep carious lesions with pulpal status as reversible pulpitis. Hence, this clinical trial aims to assess and compare the clinical and radiographic outcome of Direct Pulp Capping and Partial Pulpotomy in extremely deep caries with reversible pulpitis.

Inclusion criteria

• Patients aged 15-40 years.
• Mature permanent mandibular molars with extremely deep caries on radiograph, giving positive response to pulp sensibility test.
• Pulpal bleeding can be controlled within 10 minutes
• Patients having normal periapical status with periapical index (PAI) score ≤ 2
• Periodontally healthy teeth
• Positive response to pulp sensibility test

Exclusion criteria

• Non restorable teeth
• Negative response to vitality testing
• Presence of sinus tract or soft tissue swelling
• Absence of deep carious lesions radiographically
• Radiographic signs of internal or external root resorption
• Patient had moderate to severe pain, but preferred root canal treatment
• Presence of sound dentin over pulp and pulp not exposed intraoperatively
• Pulp haemorrhage could not be arrested within 10 minutes.
• Necrotic pulp evident upon exposure
• Pregnant women
• Absence of antagonist teeth
• Intake of antibiotics in last 30 days