vital pulp therapy of a mature molar with concurrent hyperplastic pulpitis, internal root resorption and periradicular periodontitis: a case report

vital pulp therapy (vpt) of permanent mature teeth is continuously ascertaining to be a more reliable endodontic treatment. the purpose of this case report was to describe successful vpt of a mature mandibular left first molar with concurrent hyperplastic pulpitis, internal root resorption and periradicular periodontitis in a 35-year-old male patient. after complete caries removal and access cavity preparation, the dental pulp was removed from the coronal third of the roots. to protect the remaining pulp, calcium-enriched mixture (cem) cement was placed and adapted into the cavities; the tooth was then restored with amalgam. six months after vpt, radiographic examination showed evidence of periradicular healing. clinically, the tooth was functional without signs and symptoms of infection/inflammation. the successful outcome of this case suggests that diseased dental pulp ( i.e . irreversible pulpitis) has the potential to heal after pulp protection with cem biocement.