Full Pulpotomy in Permanent Teeth With Irreversible Pulpitis and Apical Periodontitis

This study will evaluate whether full pulpotomy can successfully treat mature permanent teeth with irreversible pulp inflammation and a periapical lesion. Full pulpotomy involves removing the inflamed pulp tissue from the crown of the tooth while preserving the healthy tissue inside the roots. The study will assess pain relief, patient satisfaction, and clinical and radiographic healing over time, including healing of the periapical lesion using dental X-rays and limited-field CBCT imaging. The findings may help determine whether full pulpotomy can provide a less invasive alternative to root canal treatment for selected teeth with periapical lesions.

Inclusion Criteria: * • Non -contributory medical history (SAI, II). * Posterior permanent tooth (premolar, molar). * Age range 8-30 years * Deep caries extending into the inner quarter of dentin or exposing the pulp on the periapical radiograph * The tooth should give positive response to cold sensibility testing * Clinical diagnosis of symptomatic/asymptomatic irreversible pulpitis based on the symptoms, radiographic findings and results of cold testing * The tooth is restorable, probing pocket depth and mobility are within normal limits * Periapical radiograph demonstrates the presence of periapical lesion. Exclusion Criteria: * Non-restorable tooth. * Signs of pulpal necrosis including sinus tract or swelling. * Evidence of necrotic tissue in one or all canals. * Profuse pulpal bleeding and inability to achieve hemostasis.