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2026, Vol: 10, Issue: 7
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Review Article
Online Published: 22 May 2026
 


Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis

Reem Abdulrahman Sairafi, Farah Ziad Ramadan, Afrah Hamad Alharbi, Sary Marwan Aljuhani, Ebtehal Mohammed Aloudah, Razan Turki Alruwaili.


Abstract
Traditional management of irreversible pulpitis in mature permanent teeth has centered on root canal therapy. Full pulpotomy using bioactive cement has been proposed as a pulp-preserving alternative for pain control and tooth retention. In this systematic review and meta-analysis, parallel-group randomized controlled trials assessing full, total, or coronal pulpotomy compared to non-surgical root canal treatment (ROCT) in mature permanent molar teeth with irreversible pulpitis were included. Searches were performed in six databases and trial registries without restrictions. Pain outcomes within 7 days and clinical/radiographic success at ≥6 months were synthesized using random-effects models, RoB 2.0, and GRADE. Nine trials were considered for inclusion, out of which four trials contributed to combined clinical and radiographic success at 12-24 months; the pooled risk ratio for success was 0.99 (95% CI 0.96-1.03; I² = 0%), indicating no clinically important difference between treatments. Qualitative synthesis indicated that pulpotomy generally achieved rapid pain reduction, often comparable to or faster than root canal therapy, with frequent reports of reduced analgesic use and shorter procedure times. Based on the randomized evidence available, in mature permanent teeth presenting with irreversible pulpitis, full pulpotomy demonstrated clinical and radiographic success rates comparable to those of ROCT for up to medium-term observation. At least early pain relief was also comparable, making full pulpotomy a potential definitive treatment option in cases appropriately selected.

Key words: Irreversible pulpitis, vital pulp therapy, pulpotomy, root canal treatment, dental pain, randomized controlled trial, systematic review, meta-analysis


 
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How to Cite this Article
Pubmed Style

Sairafi RA, Ramadan FZ, Alharbi AH, Aljuhani SM, Aloudah EM, Alruwaili RT. Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. IJMDC. 2026; 10(7): 1926-1937. doi:10.24911/IJMDC.51-1769070038

Web Style

Sairafi RA, Ramadan FZ, Alharbi AH, Aljuhani SM, Aloudah EM, Alruwaili RT. Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. https://www.ijmdc.com/?mno=307688 [Access: July 08, 2026]. doi:10.24911/IJMDC.51-1769070038

AMA (American Medical Association) Style

Sairafi RA, Ramadan FZ, Alharbi AH, Aljuhani SM, Aloudah EM, Alruwaili RT. Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. IJMDC. 2026; 10(7): 1926-1937. doi:10.24911/IJMDC.51-1769070038


Vancouver/ICMJE Style

Sairafi RA, Ramadan FZ, Alharbi AH, Aljuhani SM, Aloudah EM, Alruwaili RT. Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. IJMDC. (2026), [cited July 08, 2026]; 10(7): 1926-1937. doi:10.24911/IJMDC.51-1769070038


Harvard Style

Sairafi, R. A., Ramadan, . F. Z., Alharbi, . A. H., Aljuhani, . S. M., Aloudah, . E. M. & Alruwaili, . R. T. (2026) Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. IJMDC, 10 (7), 1926-1937. doi:10.24911/IJMDC.51-1769070038


Turabian Style

Sairafi, Reem Abdulrahman, Farah Ziad Ramadan, Afrah Hamad Alharbi, Sary Marwan Aljuhani, Ebtehal Mohammed Aloudah, and Razan Turki Alruwaili. 2026. Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. International Journal of Medicine in Developing Countries, 10 (7), 1926-1937. doi:10.24911/IJMDC.51-1769070038


Chicago Style

Sairafi, Reem Abdulrahman, Farah Ziad Ramadan, Afrah Hamad Alharbi, Sary Marwan Aljuhani, Ebtehal Mohammed Aloudah, and Razan Turki Alruwaili. "Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis." International Journal of Medicine in Developing Countries 10 (2026), 1926-1937. doi:10.24911/IJMDC.51-1769070038


MLA (The Modern Language Association) Style

Sairafi, Reem Abdulrahman, Farah Ziad Ramadan, Afrah Hamad Alharbi, Sary Marwan Aljuhani, Ebtehal Mohammed Aloudah, and Razan Turki Alruwaili. "Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis." International Journal of Medicine in Developing Countries 10.7 (2026), 1926-1937. Print. doi:10.24911/IJMDC.51-1769070038


APA (American Psychological Association) Style

Sairafi, R. A., Ramadan, . F. Z., Alharbi, . A. H., Aljuhani, . S. M., Aloudah, . E. M. & Alruwaili, . R. T. (2026) Vital pulp therapy versus root canal treatment for irreversible pulpitis pain management - a systematic review and meta-analysis. International Journal of Medicine in Developing Countries, 10 (7), 1926-1937. doi:10.24911/IJMDC.51-1769070038




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