<b>Assessing Awareness, Decision-Making &amp; Practice Patterns for Pulpotomy Versus Pulpectomy in Pediatric Endodontic Emergencies Among Dental Practitioners Across Pakistan – A Cross-Sectional Study</b>

Background: Appropriate selection of pulpotomy or pulpectomy in pediatric endodontic emergencies depends on accurate assessment of pulp vitality, inflammation, radicular involvement, and systemic signs. Although contemporary pediatric dentistry increasingly supports conservative vital pulp therapy where biologically indicated, practice variation may persist because of differences in training, guideline awareness, diagnostic confidence, and availability of clinical resources. Objective: To assess knowledge, clinical decision-making, and self-reported practice patterns regarding pulpotomy versus pulpectomy in pediatric endodontic emergencies among dental practitioners in Pakistan. Methods: A cross-sectional online survey was conducted among 340 dental practitioners from multiple regions of Pakistan using a structured questionnaire. Data were analyzed using IBM SPSS Statistics version 26.0. Descriptive statistics were calculated, and associations between total knowledge score and decision-making score were assessed using Spearman’s rank correlation and Chi-square testing. Results: Most participants correctly identified indications for pulpotomy (84.4%) and pulpectomy (91.2%), while 60.6% selected MTA/bioceramics as the material with strongest current evidence for pulpotomy success. Only 19.1% had attended relevant CME/workshops in the previous three years, and 7.4% always used rubber dam isolation. Knowledge score showed a significant positive but weak correlation with decision-making score (ρ = 0.268, p < 0.001). Knowledge level was significantly associated with decision-making category (χ² = 13.087, p = 0.001). Conclusion: Dental practitioners demonstrated good basic awareness of pulp therapy indications, but important gaps remain in continuing education, rubber dam use, guideline familiarity, and emergency decision-making. Structured training and standardized protocols are needed to improve pediatric endodontic care