Vital pulp therapy or root canal treatment? A 12-month clinical evaluation following prosthetic pulp exposure: a retrospective cohort study

This study retrospectively evaluated and compared the clinical and radiographic outcomes of full pulpotomy (FP) and root canal treatment (RCT) in teeth with iatrogenic pulp exposure during prosthetic crown preparation. Seventy-seven anterior and premolar teeth from 62 patients treated between October 2022 and October 2023 were included. All cases involved vital teeth without deep caries, treated within 24 h of pulpal exposure. FP was performed using Biodentine, whereas RCT followed a standardized crown-down protocol. Data on pain scores (VAS), analgesic use, treatment duration, and patient satisfaction were retrospectively extracted from standardized clinical records. Outcomes included recorded patient- and clinician-reported measures and radiographic evaluation using the periapical index (PAI). Statistical analysis was performed using SPSS v22.0 (SPSS Inc., Chicago, IL, USA). Categorical data were analyzed using Chi-square or Fisher’s exact tests, and Mann–Whitney U and Spearman correlation tests for continuous variables ( p < 0.05). At the 12-month follow-up, clinical and radiographic success was 100% for FP and 93% for RCT ( p = 0.328). FP showed significantly lower postoperative pain at 6, 12, 24, and 48 h ( p < 0.05) and lower analgesic use ( p = 0.001). Treatment time was shorter ( p = 0.001), and satisfaction regarding intraoperative pain was higher ( p < 0.001). Both treatments demonstrated high short-term success rates. FP was associated with lower postoperative pain, shorter treatment duration, and higher patient satisfaction. However, these findings should be interpreted with caution due to the retrospective design and limited sample size.