COMPARATIVE EVALUATION OF PULPOTOMY OUTCOMES USING MTA VS BIODENTINE IN DEEP CARIOUS LESIONS OF IMMATURE PERMANENT MOLARS REQUIRING SURGICAL EXPOSURE: A MULTIDISCIPLINARY APPROACH

Background: Pulpotomy in immature permanent molars with deep carious lesions presents a clinical challenge, particularly when access is hindered by partial eruption or soft tissue coverage such as an operculum. Successful vital pulp therapy in such cases depends not only on the choice of pulp-capping material but also on effective surgical access. Mineral Trioxide Aggregate (MTA) and Biodentine have emerged as bioactive materials with promising results in pulpotomy procedures. However, comparative outcomes in cases necessitating surgical exposure remain underexplored. Aim: This study aims to compare the clinical and radiographic outcomes of pulpotomy using MTA and Biodentine in deep carious immature permanent molars requiring minor surgical exposure, adopting a multidisciplinary approach that integrates operative, pediatric, and oral surgical protocols. Methods: A total of 60 children aged 7–11 years with deep carious lesions in immature mandibular first permanent molars were selected. All cases required surgical exposure due to limited eruption or operculum coverage. The participants were randomly assigned to two groups (n=30 each): Group A underwent pulpotomy using MTA, and Group B using Biodentine. Surgical access was achieved via operculectomy under local anesthesia. All cases were followed up at 3, 6, and 12 months for clinical symptoms (pain, tenderness, mobility, swelling) and radiographic signs (furcal radiolucency, periapical pathology, root development). Results: Both groups showed high clinical and radiographic success rates, with no statistically significant difference (p > 0.05) at 12 months. However, Biodentine demonstrated slightly faster handling and shorter setting time, improving clinical workflow. Conclusion: Both MTA and Biodentine are effective pulpotomy agents in immature permanent molars requiring surgical exposure. A multidisciplinary protocol combining precise surgical access and evidence-based material selection can enhance outcomes in complex pediatric restorative cases. Further longitudinal studies with larger sample sizes are recommended.