Regenerative Potentials of Mature Mandibular Molars With Symptomatic Irreversible Pulpitis Enhanced With Different Scaffolds

The study aims to assess different scaffolds used in regenerative pulpotomy of mature permanent mandibular first molars diagnosed with symptomatic irreversible pulpitis and their influence on postoperative pain and clinical and radiographic success rate of pulpotomy. It also aims to correlate the level of inflammatory mediators in pulpal blood to the success rate of pulpotomy.

Inclusion criteria

• ASA I patients who are free from any physical or mental handicapping condition with no underlying systemic disease.
• Age between 15-40 years.
• Males & Females.
• Patients' acceptance to participate in the trial.
• Patients who can understand pain scale and can sign the informed consent (Appendix I).
• Mature mandibular fist molars:

• Diagnosed clinically with symptomatic irreversible pulpitis and normal periapical tissue.
• Giving a positive response to pulp sensitivity testing.
• Having negative response to percussion.
• Having normal radiographic appearance of periapical tissues.
• Having bright red color of pulp tissue, with hemorrhage control within 10 mins, upon access cavity preparation.

Exclusion criteria

• Pregnant and lactating females.
• Patients with physical or mental handicapping conditions.
• Patients unwilling to participate in a 12-months follow up.
• Mandibular first molars with:

• Immature roots.
• Negative response to pulp sensitivity testing.
• Positive response to percussion.
• Radiographic evidence of periapical lesions, external or internal root resorption, vertical root fracture, or calcification.
• Intraoral swelling or fistula.
• Lack of pulpal bleeding, or inability to achieve hemostasis of the bleeding pulp within 10 mins, upon access cavity preparation.