{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:07:39Z","timestamp":1785434859925,"version":"3.56.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publication Fund of the University of Bonn"},{"id":[{"id":"https:\/\/ror.org\/041nas322","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background\/Objective: The present case demonstrates the successful preservation of a severely inflamed dental pulp despite uncontrolled bleeding occurring during pulpotomy. This novel therapeutic approach was developed when a 7-year-old boy presented for endodontic treatment one week after sustaining a crown-root fracture in an immature incisor. The tooth exhibited slight hypersensitivity to cold testing, with no tenderness to percussion or palpation. An exposed pulp was present; however, when he could avoid contact with the exposed pulp tissue, the patient reported no symptoms. Methods: The critical determinant of success when uncontrolled pulpal bleeding occurred following pulpotomy was the stepwise treatment in two visits and the bacteria-tight seal of the access cavity. The seal was achieved through the incremental application of the temporary filling material. A calcium hydroxide preparation was applied as interappointment topical pulp dressing. Four weeks after the initial visit the pulpotomy could be accomplished. Results: During 3.5 years of follow-up, the patient remained without symptoms and the tooth showed ongoing root growth in length and width combined with positive reaction to electric pulp testing. Conclusions: In summary, this case demonstrates that, despite persistent bleeding following pulpotomy, pulpal vitality can be preserved, thereby promoting continued root development.<\/jats:p>","DOI":"10.3390\/dj14050275","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T09:03:37Z","timestamp":1778144617000},"page":"275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Two-Visit Pulpotomy Approach for the Management of Uncontrolled Bleeding in a Crown-Root Fractured Immature Incisor: A Case Report"],"prefix":"10.3390","volume":"14","author":[{"given":"Holger","family":"Jungbluth","sequence":"first","affiliation":[{"name":"Department of Operative Dentistry and Periodontology, University Hospital, Faculty of Medicine, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Jepsen","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry and Periodontology, University Hospital, Faculty of Medicine, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Yvonne","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry and Periodontology, University Hospital, Faculty of Medicine, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1601-1546.2012.00286.x","article-title":"Pulp Preservation in Immature Permanent Teeth","volume":"23","author":"Bogen","year":"2010","journal-title":"Endod. Top."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/edt.12578","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations","volume":"36","author":"Bourguignon","year":"2020","journal-title":"Dent. Traumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/iej.13690","article-title":"Pulpotomy for Treatment of Complicated Crown Fractures in Permanent Teeth: A Systematic Review","volume":"55","author":"Donnelly","year":"2022","journal-title":"Int. Endod. J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"European Society of Endodontology (2006). Quality Guidelines for Endodontic Treatment: Consensus Report of the European Society of Endodontology. Int. Endod. J., 39, 921\u2013930.","DOI":"10.1111\/j.1365-2591.2006.01180.x"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/j.1600-9657.2009.00778.x","article-title":"Traumatic Injuries to Permanent Teeth in Turkish Children, Ankara","volume":"25","author":"Altun","year":"2009","journal-title":"Dent. Traumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/j.1600-9657.2010.00878.x","article-title":"Dental Injuries among Children and Adolescents Aged 1\u201315 Years Attending to Public Hospital in Temuco, Chile","volume":"26","author":"Bustos","year":"2010","journal-title":"Dent. Traumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1111\/j.1600-9657.2008.00689.x","article-title":"Dental Trauma in an Australian Rural Centre","volume":"24","author":"Lam","year":"2008","journal-title":"Dent. Traumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/j.1600-9657.2012.01133.x","article-title":"Pattern of Traumatic Dental Injuries in the Permanent Dentition among Children, Adolescents, and Adults","volume":"28","author":"Lauridsen","year":"2012","journal-title":"Dent. Traumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1034\/j.1600-9657.2003.00133.x","article-title":"Dental Injuries in Norwegians Aged 7\u201318 Years","volume":"19","author":"Skaare","year":"2003","journal-title":"Dent. Traumatol."},{"key":"ref_10","first-page":"329","article-title":"Etiology and Pathogenesis of Traumatic Dental Injuries. A Clinical Study of 1298 Cases","volume":"78","author":"Andreasen","year":"1970","journal-title":"Scand. J. Dent. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0300-9785(72)80042-5","article-title":"Epidemiology of Traumatic Dental Injuries to Primary and Permanent Teeth in a Danish Population Sample","volume":"1","author":"Andreasen","year":"1972","journal-title":"Int. J. Oral Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1600-9657.2006.00369.x","article-title":"Factors Affecting Treatment Outcomes Following Complicated Crown Fractures Managed in Primary and Secondary Care","volume":"22","author":"Jackson","year":"2006","journal-title":"Dent. Traumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0099-2399(78)80153-8","article-title":"A Clinical Report on Partial Pulpotomy and Capping with Calcium Hydroxide in Permanent Incisors with Complicated Crown Fracture","volume":"4","author":"Cvek","year":"1978","journal-title":"J. Endod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1111\/edt.12297","article-title":"Cvek Pulpotomy\u2014Revisited","volume":"32","author":"Bimstein","year":"2016","journal-title":"Dent. Traumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/iej.13866","article-title":"Factors That Influence the Outcome of Pulpotomy in Permanent Teeth","volume":"56","author":"Duncan","year":"2023","journal-title":"Int. Endod. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/iej.13080","article-title":"European Society of Endodontology Position Statement: Management of Deep Caries and the Exposed Pulp","volume":"52","author":"Duncan","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/edt.12079","article-title":"Management of Crown-Related Fractures in Children: An Update Review","volume":"30","year":"2014","journal-title":"Dent. Traumatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1111\/iej.13508","article-title":"Endodontic Management of Traumatized Permanent Teeth: A Comprehensive Review","volume":"54","author":"Krastl","year":"2021","journal-title":"Int. Endod. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1111\/iej.13955","article-title":"Treatment Outcome of Partial Pulpotomy Using Two Different Calcium Silicate Materials in Mature Permanent Teeth with Symptoms of Irreversible Pulpitis: A Randomized Clinical Trial","volume":"56","author":"Tzanetakis","year":"2023","journal-title":"Int. Endod. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1600-9657.1992.tb00228.x","article-title":"Prognosis of Luxated Non-Vital Maxillary Incisors Treated with Calcium Hydroxide and Filled with Gutta-Percha. A Retrospective Clinical Study","volume":"8","author":"Cvek","year":"1992","journal-title":"Dent. Traumatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.cden.2009.12.006","article-title":"Treatment of the Immature Tooth with a Non\u2013Vital Pulp and Apical Periodontitis","volume":"54","author":"Trope","year":"2010","journal-title":"Dent. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1111\/iej.13565","article-title":"PRILE 2021 Guidelines for Reporting Laboratory Studies in Endodontology: Explanation and Elaboration","volume":"54","author":"Nagendrababu","year":"2021","journal-title":"Int. Endod. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1016\/j.joen.2009.09.029","article-title":"AAE Consensus Conference Recommended Diagnostic Terminology","volume":"35","author":"Glickman","year":"2009","journal-title":"J. Endod."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/j.1600-0714.1982.tb00188.x","article-title":"Bacterial Leakage around Dental Restorations: Its Effect on the Dental Pulp","volume":"11","author":"Bergenholtz","year":"1982","journal-title":"J. Oral Pathol. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/iej.13128","article-title":"Management of Deep Caries and the Exposed Pulp","volume":"52","author":"Simon","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0022-3913(87)90104-1","article-title":"Biocompatibility of Surface-Sealed Dental Materials against Exposed Pulps","volume":"57","author":"Cox","year":"1987","journal-title":"J. Prosthet. Dent."},{"key":"ref_27","first-page":"54","article-title":"Current Recommendations for Vital Pulp Treatment","volume":"1","author":"Dammaschke","year":"2019","journal-title":"Dtsch. Zahn\u00e4rztl. Z."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1111\/iej.13508","article-title":"European Society of Endodontology Position Statement: Endodontic Management of Traumatized Permanent Teeth","volume":"54","author":"Krastl","year":"2021","journal-title":"Int. Endod. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1002\/ccr3.4017","article-title":"Management of Primary Molars with Irreversible Pulpitis Employing Tampon Pulpotomy: Report of Three Cases with 34-Month Mean Follow-Up","volume":"9","author":"Asgary","year":"2021","journal-title":"Clin. Case Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e72004","DOI":"10.1002\/ccr3.72004","article-title":"Management of Furcal Perforation\/Involvement in a Primary Molar With Irreversible Pulpitis Using Tampon Pulpotomy: A 18-Month Healing Case Report","volume":"14","author":"Asgary","year":"2026","journal-title":"Clin. Case Rep."},{"key":"ref_31","first-page":"299","article-title":"Guideline for Use of Vital Pulp Therapy in Permanent Teeth","volume":"47","author":"Coll","year":"2025","journal-title":"Pediatr. Dent."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00784-024-05661-y","article-title":"Novel Cryotherapy Technique for Pulpotomy in Mature Permanent Teeth with Symptomatic Irreversible Pulpitis-a Randomized Controlled Trial","volume":"28","author":"Akhil","year":"2024","journal-title":"Clin. Oral Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.joen.2025.01.020","article-title":"The Effect of Novel Cryotherapy Technique on Postoperative Pain for Pulpotomy in Permanent Molars with Symptomatic Irreversible Pulpitis: A Randomized Controlled Trial","volume":"51","author":"Yilmaz","year":"2025","journal-title":"J. Endod."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jones, R.S., Lee, H., Jia, J., and Sarvas, E.W. (2025). An Oxymetazoline-Based Hemostatic Solution Used with MTA for Pulpal Therapy: A Retrospective Study. Children, 13.","DOI":"10.3390\/children13010028"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/5\/275\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T09:55:38Z","timestamp":1778147738000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/5\/275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["dj14050275"],"URL":"https:\/\/doi.org\/10.3390\/dj14050275","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]}}}