Therapeutic pulpotomy an alternative to root canal

Dental Tribune International

Mon. 16 February 2026

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DUNDEE, Scotland: Management of irreversible pulpitis in permanent teeth is undergoing a gradual but meaningful shift. Advances in diagnostic understanding and biomaterials have renewed interest in vital pulp therapies. A new study canvassing the attitudes of both UK and US dentists has explored how contemporary clinical attitudes are evolving, particularly around therapeutic pulpotomy as a definitive treatment option.

The study reports findings from a practice-based survey comparing the perspectives of 750 dental practitioners in the UK and the US on the management of irreversible pulpitis. Most respondents were general dental practitioners working in primary care, reflecting a broader perspective beyond a specialist-only sample. Root canal treatment was the dominant intervention in both countries, yet the survey highlights a clear and growing openness to therapeutic pulpotomy.

Although the survey found that pulpotomy was under-used in routine practice, a substantial proportion of the practitioners reported that they would be willing to consider it as a definitive option under appropriate conditions. This discrepancy between theoretical acceptance and actual clinical adoption points to ongoing barriers such as limited training, uncertainty about long-term outcomes and ingrained treatment paradigms favouring pulpectomy.

Differences between the two countries were notable. UK practitioners demonstrated higher theoretical acceptance of pulpotomy as a definitive treatment, potentially reflecting differences in undergraduate education, exposure to minimally invasive dentistry, and healthcare delivery models. Material choice also varied, UK respondents reporting greater use of calcium silicate cements. These findings suggest that education, guideline dissemination and system-level factors strongly influence uptake of vital pulp therapies.

From a clinical perspective, the study reinforces the importance of accurate diagnosis and case selection when managing teeth with signs of irreversible pulpitis. When clinical and radiographic signs suggest inflammation confined to the coronal pulp and the apical tissue is normal and haemostasis can be achieved, therapeutic pulpotomy may offer a less invasive, biologically driven alternative to root canal treatment. The authors conclude that further high-quality clinical trials, enhanced professional education and practical implementation support are essential to bridge the gap between emerging evidence and everyday practice, ultimately improving patient-centred care in primary dentistry.

The study, titled “Therapeutic pulpotomy for permanent teeth with irreversible pulpitis: Comparative results from a practice-based quick poll in the USA and UK”, was published online on 2 February 2026 in BDJ Open.