الفهرس 
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Abstract
Background: Clinically, the treatment of pulpal involved teeth in a young patient is a major challenge faced by most pediatric dentists and endodontists. During the past decade, with a view to understanding pulp biology and developing bioactive materials, pulpotomy has been reinvestigated as an alternative treatment in mature permanent teeth instead of root canal treatment.
Aim: To assess the postoperative pain after pulpotomy in comparison to root canal treatment in cariously exposed permanent mature molars and to evaluate the clinical and the radiographic
success of both treatments after 9 month follow up.
VII
Methodology: 52 patients having cariously exposed mature first permanent molar were randomly
assigned to either pulpotomy using Biodentine in the test group or root canal treatment in the control group. Postoperative pain was recorded using visual analog scale (VAS) scale starting from the same day of the treatment at night then every 24 hours until the fourth day. All the treated teeth were evaluated clinically and radiographically at 3, 6, 9 months of time interval using predetermined criteria.
Results: The test group (pulpotomy) recorded VAS scores which were significantly lower than control group at each day (day 0, 1, 2, 3 and 4). In test group (pulpotomy), VAS score significantly decreased by time from median value 3 (range 1; 5) at day 0, to a median =1 (range 0; 3) at day1; then significantly decrease to a median =0 at Day 2, Day 3 and Day4. In the control group (root canal treatment), VAS score showed a gradual statistically significant decrease by time from median value 6
(range 3; 9) at day 0, to a median =1 (range 0; 3) at Day 4. A significant difference between each two
observations was revealed. Regarding the clinical outcomes, no statistical significant difference was found between both groups at 9 month follow up with a clinical success rate 95.8% in the pulpotomy group in comparison to 100% in the root canal treatment group. Regarding the radiographic outcome,
no statistical significant difference was found between both groups at 9 month follow up with a clinical success rate 87.5% in the pulpotomy group in comparison to 100% in the root canal treatment group. Conclusions: Pulpotomy can serve as an alternative treatment option to root canal treatment in
management of mature permanent teeth with carious exposure. Pulpotomy and root canal treatment demonstrated effective and comparable postoperative reduction of pain. Irreversible pulpitis is no longer a contraindication to pulpotomy treatment.