Primary-Tooth Pulpotomy for Children in Apex
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A pulpotomy can help preserve a deeply decayed primary tooth when the pulp inside the tooth has been exposed but the tissue in the roots remains healthy enough to maintain. Green Level Pediatric Dentistry & Orthodontics uses biocompatible materials such as mineral trioxide aggregate, or MTA, and Biodentine® when clinically appropriate.
What Is a Primary-Tooth Pulpotomy?
A pulpotomy is a vital pulp treatment performed on a primary tooth. The dentist removes the affected pulp tissue from the tooth’s crown while leaving the healthy pulp tissue inside the roots intact.
After bleeding is controlled, MTA or Biodentine® is placed over the remaining pulp tissue. The tooth is then sealed and restored to help protect it from bacteria and withstand normal chewing.
A pulpotomy is different from a pulpectomy. A pulpotomy preserves healthy pulp inside the roots, while a pulpectomy removes pulp tissue from both the crown and root canals.
Benefits of a Primary-Tooth Pulpotomy
Preserves the Primary Tooth
Successful treatment can allow the primary tooth to remain functional until it is naturally ready to fall out.
Protects Developing Teeth
Maintaining a primary tooth can help preserve space and guide the developing permanent tooth beneath it.
Uses Bioactive Materials
MTA and Biodentine® are calcium silicate materials that create a protective seal and support healing around the remaining vital pulp tissue.
Did You Know…
Primary teeth play an important role in chewing, speech development, and maintaining space for permanent teeth. Treating a restorable primary tooth may help avoid premature tooth loss and the spacing problems that can follow.
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The Pulpotomy Process
1
Examination and Diagnosis
The dentist reviews the child’s symptoms, examines the tooth, and uses dental imaging when needed. The tooth must have enough healthy remaining structure and show findings consistent with vital pulp treatment.
2
Pulp Treatment
After the tooth is numbed and isolated, the affected pulp tissue inside the crown is removed. Bleeding is controlled, and MTA or Biodentine® is placed over the remaining pulp.
3
Tooth Restoration
The tooth is sealed and restored. A pediatric crown is commonly recommended for a primary molar because it provides full coverage and protects the treated tooth during chewing.
“A primary-tooth pulpotomy is designed to preserve the healthy pulp remaining in the roots while protecting the tooth from further bacterial exposure. Careful diagnosis and a well-sealed final restoration are important parts of determining whether the tooth can remain functional.”
Dr. Michael Kim
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“My kids have been going to this practice since they were toddlers, and having one doctor who understands their complete dental history and growth patterns has made such a difference. Dr. Kim treats them like they’re his own children and recommends only what’s truly necessary. The convenience of having both their regular checkups and orthodontics in one place has been a game-changer for our family.”
“What impressed me most was how honest the doctor is about treatment recommendations. He explained exactly why each step was needed and never pushed unnecessary procedures. Having someone I trust completely managing both my kids’ dental and orthodontic care gives me peace of mind. The staff is incredibly kind and patient with nervous children.”
“We switched practices specifically because we wanted someone who could handle both pediatric dentistry and orthodontics under one roof. The continuity of care is amazing, and our kids actually look forward to their appointments. The whole team treats every patient like family, and the clinical expertise is evident in every interaction.”
Research-Reported Outcomes for Primary-Tooth Pulpotomy With MTA or Biodentine®
Biodentine® Pulpotomy Success After 24 Months
99.4%
MTA Pulpotomy Success After 24 Months
97.2%
Biodentine® Clinical Success After 24 Months
96.8%
MTA Clinical Success After 24 Months
96.8%
Biodentine® Radiographic Success After 24 Months
93.6%
MTA Radiographic Success After 24 Months
87.1%
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| Primary-Tooth Pulpotomy Outcome | Percentage | What the Research Shows |
|---|---|---|
| Biodentine® success after 24 months | 99.4% success | A randomized clinical trial involving primary molars reported a total 24-month success rate of 99.4% for pulpotomies performed with Biodentine®. |
| MTA success after 24 months | 97.2% success | The same long-term randomized trial reported a total 24-month success rate of 97.2% for primary-molar pulpotomies performed with MTA. |
| Biodentine® clinical success | 96.8% success | In a separate randomized trial involving children ages four to nine, 30 of 31 primary molars treated with Biodentine® were clinically successful after 24 months. |
| MTA clinical success | 96.8% success | The same study found that 30 of 31 primary molars treated with MTA met its clinical success criteria after 24 months. |
| Biodentine® radiographic success | 93.6% success | Twenty-nine of 31 Biodentine®-treated primary molars met the study’s radiographic success criteria at the 24-month evaluation. |
| MTA radiographic success | 87.1% success | Twenty-seven of 31 MTA-treated primary molars met the study’s radiographic success criteria after 24 months. The difference between the materials was not statistically significant. |
Sources: Vilella-Pastor S et al., “Long-Term Evaluation of Primary Teeth Molar Pulpotomies With Biodentine and MTA: A CONSORT Randomized Clinical Trial,” European Archives of Paediatric Dentistry, 2021; Bani M et al., “The Clinical and Radiographic Success of Primary Molar Pulpotomy Using Biodentine and Mineral Trioxide Aggregate: A 24-Month Randomized Clinical Trial,” Pediatric Dentistry, 2017; American Academy of Pediatric Dentistry, “Use of Vital Pulp Therapies in Primary Teeth With Deep Caries Lesions,” 2024
These percentages come from specific clinical trials with defined eligibility criteria, treatment techniques, restorations, and follow-up periods. Clinical success generally refers to the absence of symptoms or visible signs of infection, while radiographic success requires the absence of specified pathological findings on dental images. Results vary according to diagnosis, remaining tooth structure, treatment technique, final restoration, oral hygiene, and follow-up care.
Six Key Findings About Primary-Tooth Pulpotomy
The pulp inside the roots is preserved. A pulpotomy removes the affected tissue from the crown rather than removing all pulp tissue from the tooth.
Diagnosis determines whether treatment is appropriate. A tooth with uncontrolled bleeding, swelling, a draining bump, pathological root changes, or signs of nonvital pulp may require a different treatment.
MTA and Biodentine® are calcium silicate materials. Both are placed over the remaining pulp to create a protective barrier and support the treated tissue.
A strong final seal is essential. The restoration helps prevent bacteria from re-entering the tooth after pulp treatment.
A crown may protect the treated molar. Primary molars with extensive decay often require full coverage to withstand chewing forces and reduce the risk of restoration failure.
Follow-up remains important. The dental team monitors the tooth for pain, swelling, restoration damage, abnormal mobility, or radiographic changes until it falls out naturally.
Schedule a Pediatric Pulp Evaluation in Apex
Parents concerned about a child’s cavity, tooth sensitivity, or chewing discomfort can schedule an evaluation with Green Level Pediatric Dentistry & Orthodontics. The dentist can determine whether the tooth may benefit from a pulpotomy, filling, crown, pulpectomy, extraction, or another treatment.
Questions Apex Families Ask About Primary-Tooth Pulpotomy
Why would a primary tooth need a pulpotomy?
A pulpotomy may be recommended when deep decay reaches the pulp inside a restorable primary tooth, but the pulp tissue in the roots remains healthy enough to preserve. The procedure removes the affected coronal tissue and protects the remaining vital pulp.
Is a pulpotomy the same as a root canal?
No. A pulpotomy removes pulp only from the crown portion of the tooth. A pulpectomy removes pulp tissue from the crown and root canals. The appropriate procedure depends on the condition of the pulp and surrounding tissues.
What are MTA and Biodentine®?
MTA and Biodentine® are calcium silicate dental materials used to cover and protect the remaining pulp tissue. The dentist selects the material according to the tooth, clinical findings, treatment plan, and restorative needs.
Does a child need a crown after a pulpotomy?
A crown is commonly placed on a primary molar after pulpotomy treatment, particularly when substantial tooth structure has been lost. Full coverage helps seal and protect the tooth during chewing.
How does the dentist determine whether a pulpotomy will work?
The evaluation considers the child’s symptoms, the source and duration of pain, the tooth’s restorability, bleeding from the pulp, and dental imaging. Teeth with signs of advanced infection or nonvital pulp may not be candidates.
What symptoms require an appointment after treatment?
Parents should contact the practice if the child develops persistent pain, swelling, a gum bump, fever, increasing mobility, difficulty chewing, or damage to the crown or restoration. These findings should be evaluated promptly.