Pulpotomy in Primary Molars with Deep Caries Using Biodentine: A Case Series with 1-Year Follow-Up

Background: Biodentine has emerged as a promising calcium silicate-based material for vital pulp therapy in primary teeth. This case series describes short-term clinical and radiographic outcomes of Biodentine pulpotomy followed by immediate stainless steel crown restoration for deeply carious primary molars treated under general anesthesia. Methods: Data were collected prospectively within an ongoing clinical project. Five pediatric patients, aged 3 to 6 years, presented with multiple carious primary teeth. A total of 15 deeply carious primary molars without clinical or radiographic signs of irreversible pulpitis, pulp necrosis, or periradicular pathology were included. Under general anesthesia, pulpotomies were performed. Pulp status was assessed intraoperatively based on bright-red pulp bleeding and hemostasis achieved within 5 min. Biodentine was applied to cover the pulp stumps and fill the cavities, followed immediately by stainless steel crown restoration. Results: During the 1-year follow-up, all treated teeth maintained normal chewing function without unfavorable symptoms. Radiographic examination revealed normal periodontal ligament spaces and no furcation or periapical radiolucency, pathological internal or external root resorption, or abnormality of the developing permanent tooth germs. Conclusions: For deeply carious primary molars, Biodentine pulpotomy followed by immediate stainless steel crown restoration showed favorable short-term clinical and radiographic outcomes. This single-session approach may represent a feasible option for deeply carious primary molars.