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©Operative Dentistry, 2010, 35-3, 370-374 SUMMARYStudies show that human permanent teeth with carious pulpal exposures can result in a high clinical success rate when treated with pulpotomy and direct pulp capping with mineral trioxide aggregate (MTA pulpotomy). In this case report, a 19-year-old female patient with a second premolar with irreversible pulpitis and symptomatic apical periodontitis was treated with MTA pulpotomy. Follow-up electric pulp tests showed viability of the tooth at three and 10 months. Ten months after the initial treatment, the tooth was extracted for orthodontic reasons and processed for histological examination. Microscopically, the pulpal wound treated with MTA was free from inflammation and covered with a thin layer of reparative dentin. The authors conclude that, when caries and bacterial contamination can be removed from the dentin-pulp complex, the inflamed but vital pulp of a permanent tooth may have a chance to return to a healthy, functional status after MTA pulpotomy. INTRODUCTIONMineral trioxide aggregate (MTA) is currently the best material for use in primary molar pulpotomy 1-2 and immature permanent tooth vital pulp therapy. Clinical RelevanceWhen caries and bacterial contamination can be mostly eliminated from the dentin-pulp complex, the inflamed pulp of a human permanent tooth with irreversible pulpitis may have a chance to return to a healthy and functional status after mineral trioxide aggregate pulpotomy.