Vital pulp therapy of permanent teeth with symptom of irreversible pulpitis using Bioceramic Putty (One-Fil® PT): A randomized controlled trial

Abstract

Vital pulp therapy aims to preserve the vitality and normal function of the pulp and provides a biologically driven alternative to conventional root canal treatment. Its application in matfure permanent teeth with irreversible pulpitis is still under debate, although calcium silicate-based bioceramics have shown promising outcomes. Objective: To evaluate the clinical and radiographic outcomes of vital pulp therapy using the One-Fil® bioceramic putty (MEDICLUS, South Korea) in permanent teeth diagnosed with irreversible pulpitis and to analyze the preoperative factors affecting treatment prognosis.
Materials and methods.
A randomized controlled trial was conducted from September 2023 to September 2025 in Basra, Iraq. Thirty-nine patients (40 posterior teeth, aged 13–45 years) underwent partial pulpotomy or full pulpotomy using a One-Fil bioceramic putty. Clinical and radiographic follow-ups were performed at 6, 12, and 24 months. Success was defined as absence of symptoms or radiographic pathosis.
Results.
Thirty-nine teeth were evaluated (recall rate 82%). The overall success rates were 97.4% at 6 months, 92.1% at 12 months, and 89.5% at 24 months. Full pulpotomy showed a higher success rate (95%) than partial pulpotomy (84.2%). Premolars achieved 100% success, whereas molars showed slightly lower outcomes (86.2%). Failures (10.5%) were associated with the molar location, severe preoperative symptoms, and abnormal periapical status.
Conclusion.
Vital pulp therapy with bioceramic putty demonstrated excellent success in mature permanent teeth, including cases of irreversible pulpitis. FP provided superior long-term outcomes compared to PP.