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.