Evaluation of one- versus two-step technique on the outcome of mineral trioxide aggregate pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis

Abstract

Context: This study compares one-step and two-step mineral trioxide aggregate (MTA) pulpotomy techniques in treating symptomatic irreversible pulpitis (SIP) in mature molars over 12 months. Aims: To compare the clinical efficacy of one-step versus two-step MTA pulpotomy in mature permanent teeth with SIP. Setting and Design: This clinical trial involved 30 patients with SIP in mandibular molars, comparing one-step and two-step MTA pulpotomy. Methodology: Thirty patients (aged 15-35) with SIP in mandibular molars were randomly assigned to two groups: one-step MTA pulpotomy (n = 15), with final restoration in the same visit, and two-step MTA pulpotomy (n = 15), with interim restoration followed by final restoration after 24 h. Pain levels were assessed using the Numerical Rating Scale at 24, 48, and 72 h postoperatively. Clinical and radiographic follow-ups were performed at 3, 6, and 12 months to assess pulpal vitality, restoration quality, and treatment success. Statistical Analysis: The results were analyzed statistically using the independent t-test, Fisher's exact test, and Pearson's Chi-square test. Results: Both groups showed significant pain reduction (P < 0.05) and 100% success at 12 months. Electric pulp tests were positive in all teeth, with 73.33% responding to cold testing. Restoration quality showed no significant differences between groups. Conclusion: Both one-step and two-step MTA pulpotomy techniques showed high success rates in treating SIP in mature molars, with no significant difference. The one-step method is an effective alternative to the two-step approach.