fibroblast, which can stimulate hard tissue formation. it has better structural integrity and forms a thicker, more localized dentinal bridge. mta results in a more predictable dentin bridge formation and pulpal health. mta has a high rate of success and has been shown to perform equal or better than formocresol or ferric sulfate. however, the cost, availability and difficulty in handling this material remains its current drawback. alternative pulpotomy techniques electro-surgery pulpotomy electro-surgical pulpotomy is a method of cutting and coagulating soft tissues by means of high frequency radio waves. it can control bleeding without chemical coagulation and is antibacterial. electrosurgical pulpotomy has a success rate of 70 to 94%. however, it is considered as a sensitive technique. laser pulpotomy the carbon dioxide laser emits an infrared beam that has an affinity for water, and is capable of producing well-localized cautery to soft tissue. tissue is removed by ablation through conversion of the laser beam to heat. the carbon dioxide laser appears to be a promising alternative for pulpotomy therapy. clinical significance conserving the vitality of pulp tissues appears to be a less painful alternative to root canal treatment (rct) for younger patients. the high success rate reported for pulpotomy suggests that this procedure offers hope as an alternative to root canal treatment in teeth with a diagnosis of irreversible pulpitis.