Coronal pulpotomy in mature permanent mandibular molars with irreversible pulpitis using fast setting calcium silicate cement: a case series with 1-year follow-up

Abstract

Context: Ultrafast Protooth is a calcium silicate cement with a rapid initial setting time of 2 minutes. Its fluoride release, apatite-forming capability and favourable biocompatibility make it a potential candidate for vital pulp therapy. Aim: This case series evaluates the coronal pulpotomy outcomes using Ultrafast Protooth in permanent molars having closed apices diagnosed with symptomatic irreversible pulpitis. Materials and methods: After anaesthetisation, the tooth was isolated and disinfected, and caries were excavated. Vitality was re-assessed intra-operatively based on the bleeding response. Coronal pulpotomy was performed using Ultrafast Protooth if haemostasis was achieved within the clinically accepted time. After confirming that the material had set, based on the manufacturer’s guidelines and clinical judgement, a permanent composite restoration was placed, followed by postoperative radiographs. Results: All teeth remained asymptomatic, showing no clinical signs of pain, inflammation, or infection and responded positively to pulp sensibility tests. Radiographs confirmed no periapical disease during the 1-year follow-up. Conclusion: Ultrafast Protooth showed favourable 1-year clinical and radiographic outcomes. Continued follow-up and further controlled trials are warranted to validate these findings.