Full pulpotomy versus root canal treatment in mature permanent teeth with irreversible pulpitis: a systematic review and meta-analysis

Ana Rodríguez Yanes and Anarodriguez@infomed.sld.cu

SAP Dentistry, 2026

Abstract: Introduction: Irreversible pulpitis in mature permanent teeth has traditionally been managed with root canal treatment, yet full pulpotomy with calcium silicate cements is increasingly proposed as a less invasive alternative that preserves the radicular pulp. Methods: This systematic review followed PRISMA 2020. PubMed, OpenAlex, Crossref and Semantic Scholar were searched from 2019 to 2026 for randomized controlled trials and prospective comparative studies comparing full pulpotomy with calcium silicate cements versus root canal treatment in mature permanent teeth with symptomatic irreversible pulpitis. Risk of bias was assessed with RoB 2 and ROBINS-I, and 12-month clinical success was pooled with a random-effects meta-analysis. Results: Ten studies were included. Clinical success at 12 months was 94.8% for full pulpotomy and 96.5% for root canal treatment, with a pooled risk ratio of 0.99 (95% CI 0.94 to 1.03; I2 = 0%). Radiographic success was similar, and postoperative pain was comparable or lower after pulpotomy. Conclusions: Full pulpotomy with calcium silicate cements achieves success rates comparable to root canal treatment at 12 months in mature permanent teeth with irreversible pulpitis and may offer shorter and less costly treatment, although the certainty of the evidence remains limited by the small number of trials and short follow-up.

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:cwf:dentar:dent2026258

DOI: 10.62486/dent2026258

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