Should I ask my dentist for a pulpotomy instead of normal root canal?

[JcMac]

should I ask my dentist for a pulpotomy instead of normal root canal?

I've had many teeth which started hurting after extensive fillings. Now I have two which are sensitive to cold, which started after bad (not extensive) fillings. Fillings have been re-done by a new dentist, who promised me the sensitivity to cold would pass, but it's been more than a month and no difference. I've also been using sensodyne for a month and no difference at all.

So I was wondering if I should start doing pulpotomy in these non-infectious, not so aggressive pulpitis cases, since it's a less invasive and cheaper treatment. Curiously no dentist ever mentioned to me the possibility, even though this meta-analysis says that the success rate of pulpotomy in mature molars is never inferior to normal root canal (pulpectomy).

I honestly suspect that my dentists never mentioned this possibility either because they don't usually do pulpotomies, or because they wanna make more money with the normal root canal treatment.

Efficacy of pulpotomy in managing irreversible pulpitis in mature permanent teeth: A systematic review and meta-analysis - PubMed

The study highlights the potential of less invasive treatments. Pulpotomy may be a viable alternative to NSRCT for managing irreversible pulpitis in mature permanent teeth. Limitations such as the low quality of some single-arm trials and the high risk of bias in some randomized controlled...

pubmed.ncbi.nlm.nih.gov

PS: and by the way, pulpotomy can be ended with either a crown or filling right, just like normal RCT? or only crown? because online sources only mention crown.

 

[Dr M]

Pulpotomies were traditionally done only in primary teeth with reversible pulpitis or a filling that was close to the nerve.
However, recent studies have shown that removing a coronal portion of the pulp, in mature molars, and then replacing it with a modern bio-compatible material such as MTA or even Biodentin, can still prove to be successful.
It is however very important that certain factors be considered before attempting this. The pulpitis should be reversible.
The correct material needs to be used. Caries should be excavated and then the procedure completed under strict moisture control protocols i.e rubberdam application.
Even if all of this is done correctly, there is still the risk that the tooth can be symptomatic at a later stage. Unfortunately I have seen cases where the canals sclerose after a pulpotomy was done. When the tooth then became symptomatic, a conventional root canal was no longer an option, and extraction was the only route to follow.