Concept

# Pulpotomy vs Pulpectomy

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

| 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

 01

Is a pulpotomy the same as a root canal?

Answer

No.

- 01 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.
- 02 The two have different goals, and which one applies depends on the condition of the pulp.

 02

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.

- 01 Whether 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.

 03

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.

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

## References

1. [AAE Position Statement: Vital Pulp Therapy (2021)](https://www.aae.org/wp-content/uploads/2021/05/VitalPulpTherapy_PositionStatement_v2.pdf)
2. [Duncan HF et al. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline — Int Endod J (2023);56 Suppl 3:238-295. DOI 10.1111/iej.13974](https://doi.org/10.1111/iej.13974)
3. [Li Y et al. "Efficacy of pulpotomy for managing irreversible pulpitis in mature permanent teeth: a systematic review and meta-analysis" — J Dent (2024);144:104923](https://doi.org/10.1016/j.jdent.2024.104923)

## Related

[Vital Pulp Therapy→](https://endo-guide.app/vital-pulp-therapy)[Diagnosis & Pulp Classification→](https://endo-guide.app/diagnosis)[Vital Pulp Therapy (glossary)→](https://endo-guide.app/glossary/vital-pulp-therapy)

## Other Concepts

[Reversible vs Irreversible Pulpitis→](https://endo-guide.app/concepts/reversible-vs-irreversible-pulpitis)[Pulpal vs Periapical Pain→](https://endo-guide.app/concepts/pulpal-vs-periapical-pain)[Acute vs Chronic Apical Periodontitis→](https://endo-guide.app/concepts/acute-vs-chronic-apical-periodontitis)[Pulpitis vs Periodontitis→](https://endo-guide.app/concepts/pulpitis-vs-periodontitis)[Cold Test vs Electric Pulp Test→](https://endo-guide.app/concepts/cold-test-vs-electric-pulp-test)

![Uzm. Dt. Levent Yüksel](https://endo-guide.app/images/levent-yuksel.jpg)

Reviewed by

Uzm. Dt. Levent Yüksel

DDS · Endodontist

Endodontist — DDS, Hacettepe University; endodontics specialty training, Ankara University. 10+ years of clinical experience. Sole author and reviewer of EndoGuide content.

[About the author](https://endo-guide.app/about)[Editorial policy](https://endo-guide.app/editorial-policy)[Clinical profile](https://drleventyuksel.com/)

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