A Review of Criteria for the Evaluation of Pulpotomy Outcomes in Mature Permanent Teeth

Introduction: During the past decade, with a view to understanding pulp biology better and developing bioactive materials, pulpotomy has been reinvestigated as a definitive treatment in mature permanent teeth. Pulp chamber pulpotomy or coronal pulpotomy is widely used in deciduous and immature permanent teeth, and there is thus a need for trials to evaluate the outcome of pulpotomy as a therapeutic procedure on mature permanent teeth in accordance with Good Clinical Practice guidelines. This study aimed to review publications reporting the outcomes of pulpotomy when indicated as a definitive treatment in mature permanent teeth and to discuss the relevance of the criteria that could be used in clinical practice or research. Methods: A review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was conducted on publications found by both PubMed and backward research. Results: Seven clinical trials, 9 cohort studies, and 15 cases reports have been included. Overall, goals, criteria for inclusion, and criteria for outcomes of pulpotomy varied among studies. The relevance and the reliability of the success or failure criteria of pulpotomy were discussed regarding the possible evolution of the radicular pulpal status that could be expected after pulpotomy. Finally, criteria for the evaluation of the outcome of pulpotomy are proposed. Conclusions: The use of standardized outcome criteria would facilitate further meta analyses, aiming to assess whether pulpotomy should be considered as a true alternative therapy to root treatment.