A systematic review of 23 randomised studies estimated 12-month success at 0.92 for full pulpotomy and 0.89 for partial pulpotomy in mature permanent posterior teeth with irreversible pulpitis. Intention-to-treat two-arm comparisons favoured full pulpotomy (OR 1.85), but GRADE certainty was low to very low and evidence beyond 12 months was less certain.
Key findings
- Across 23 studies, 12-month pooled success was 0.92 (95% CI 0.89-0.95) for full and 0.89 (0.81-0.95) for partial pulpotomy. Direct comparisons gave OR 1.85 (1.16-2.94) and fewer pain-related failures, OR 0.22 (0.07-0.64). Age and bleeding time were not clearly associated with full-pulpotomy success; later estimates were lower and less certain.
Why this matters globally
Vital pulp therapy may preserve living tissue and reduce treatment complexity in selected cases. The synthesis informs trials and guidance, but current certainty is insufficient for universal or long-term conclusions.
Thai researcher contribution
Multiple departments at Chulalongkorn University's Faculty of Dentistry collaborated with a Vietnamese researcher, supported by the Thailand Science Research and Innovation Fund at Chulalongkorn University.
Limitations to consider
Despite restricting inclusion to randomised trials, overall certainty was low to very low. Heterogeneity in success definitions, materials, techniques, diagnosis, and follow-up matters. Pooled single-arm proportions are not randomised head-to-head comparisons, and long-term and prognostic data are limited.