Regenerative Pulpotomy as a Novel Technique for Treatment of Permanent Mature Molars Diagnosed with Irreversible Pulpitis Using Platelet-Rich Fibrin: A Case Series Study

INTRODUCTION: Management of teeth with clinical signs/symptoms suggestive of irreversible pulpitis was conventionally invasive, but the emerging evidences suggested successful treatment outcome using the less invasive vital pulp procedures such as coronal pulpotomy, leading to preservation of the remaining pulp in a vital and functioning state. OBJECTIVES: Evaluation of the clinical/radiographic success of novel regenerative coronal pulpotomy technique using Platelet-Rich Fibrin(PRF) and Biodentine. METHODOLOGY: Three irreversibly inflamed permanent molars with mature roots in three patients were treated by regenerative pulpotomy technique. Access openings were done, and coronal pulps were removed to the level of root canal orifices. Hemostasis in all teeth were done by the compression with cotton pellets moistened with 2.5 % sodium hypochlorite(NaOCl). PRF membranes were prepared by drawing 10 ml of patients’ own blood, then they were immediately centrifuged using a table top centrifuge at 400 gforce for 12mins. The PRF membranes were placed over the remaining radicular pulps followed by Biodentine preparation and placement over the PRF. The cavities were then immediately restored. Patients were scheduled for clinical/radiographic evaluations after three-, six- and 12-months. RESULTS: Throughout the follow-up periods, the three teeth demonstrated clinical/radiographic success with complete resolution of clinical signs/symptoms. CONCLUSIONS: All presented cases showed a favorable clinical/radiographic outcomes of “Regenerative pulpotomy” procedure in treating irreversibly inflamed permanent molars using PRF and Biodentine combination.