Concept

Pulpotomy vs Pulpectomy

Q: Is a pulpotomy the same as a root canal?

No. A pulpotomy removes only the coronal pulp and aims to keep the root pulp alive, while a root canal (pulpectomy and obturation) removes the whole pulp. The two have different goals, and which one applies depends on the condition of the pulp.

How pulpotomy and pulpectomy differ in how much pulp is removed, when each is considered, and the goal of treatment, based on AAE/ESE guidance.

Pulpotomy and pulpectomy both manage an inflamed or exposed pulp, but they differ in how much of the pulp is removed. A pulpotomy removes only the coronal pulp and aims to keep the radicular pulp alive, while a pulpectomy removes the whole pulp from the crown and the canals. The practical difference usually comes down to how healthy the remaining pulp is judged to be and the goal of treatment. The contrast below summarizes the features clinicians typically weigh; the choice depends on the individual case and is made by the treating clinician.

Side-by-side

01How much pulp is removedOnly the coronal pulp; the radicular pulp is intended to stay vital.

Pulpotomy

Only the coronal pulp; the radicular pulp is intended to stay vital.

Pulpectomy

The entire pulp, from the pulp chamber through the root canals.

02Main goalPreserve a vital, functioning radicular pulp where it is judged healthy enough.

Pulpotomy

Preserve a vital, functioning radicular pulp where it is judged healthy enough.

Pulpectomy

Remove all pulp tissue and prepare the canals for filling.

03When it may be consideredCarious exposures and selected cases, including ongoing study of full pulpotomy in mature teeth with irreversible pulpitis.

Pulpotomy

Carious exposures and selected cases, including ongoing study of full pulpotomy in mature teeth with irreversible pulpitis.

Pulpectomy

When the pulp is judged unlikely to recover and a full root canal pathway is planned.

04Tooth type contextLong established in primary teeth and increasingly studied in mature permanent teeth.

Pulpotomy

Long established in primary teeth and increasingly studied in mature permanent teeth.

Pulpectomy

Used in primary teeth and as part of conventional root canal treatment in permanent teeth.

05General outcome aimRetain pulp vitality and continued root function where possible.

Pulpotomy

Retain pulp vitality and continued root function where possible.

Pulpectomy

Eliminate the diseased pulp and obturate the canal system.

Aspect	Pulpotomy	Pulpectomy
How much pulp is removed	Only the coronal pulp; the radicular pulp is intended to stay vital.	The entire pulp, from the pulp chamber through the root canals.
Main goal	Preserve a vital, functioning radicular pulp where it is judged healthy enough.	Remove all pulp tissue and prepare the canals for filling.
When it may be considered	Carious exposures and selected cases, including ongoing study of full pulpotomy in mature teeth with irreversible pulpitis.	When the pulp is judged unlikely to recover and a full root canal pathway is planned.
Tooth type context	Long established in primary teeth and increasingly studied in mature permanent teeth.	Used in primary teeth and as part of conventional root canal treatment in permanent teeth.
General outcome aim	Retain pulp vitality and continued root function where possible.	Eliminate the diseased pulp and obturate the canal system.

Frequently asked

Is a pulpotomy the same as a root canal?

Answer

No.

01A pulpotomy removes only the coronal pulp and aims to keep the root pulp alive, while a root canal (pulpectomy and obturation) removes the whole pulp.
02The two have different goals, and which one applies depends on the condition of the pulp.

Can a pulpotomy be used in adult teeth?

Answer

Full pulpotomy in mature permanent teeth with irreversible pulpitis is an area of active study, with some encouraging outcomes reported.

01Whether it is suitable depends on the case, and the decision is made by the treating clinician rather than as a routine substitute for root canal treatment.

How is it decided which one to do?

Answer

It generally depends on how healthy the remaining pulp is judged to be, the diagnosis, and the tooth.

01If the radicular pulp is considered able to heal, a pulpotomy may be considered; if not, a pulpectomy may be more appropriate.
02The clinician weighs the full picture.