Clinical and radiographic evaluation of indirect pulp capping with three different materials: a 2-year follow-up study

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ABSTRACT

Aim

Indirect pulp capping (IPC) is a treatment that preserves pulp vitality. Several materials have been used for this procedure. The aim of this study is to evaluate the radiographic and clinical outcomes of TheraCal LC (Bisco Inc., Schaumburg, IL, USA) and to compare it with mineral trioxide aggregate (MTA) (Pro Root MTA, Dentsply Tulsa, Johnson City, TN, USA) and calcium hydroxide [Ca(OH)2] (Dycal, Dentsply De Trey Konstanz, Germany) biomaterials in IPC treatment.

Material and methods

A total of 295 teeth, including second primary molars and first permanent molars with IPC indications from healthy and cooperative children aged between 4–15 years, were included in this study. Teeth were divided into three groups according to the materials used for pulp capping. Indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth. Primary molars were restored with the compomer material, and permanent molars were restored with the resin composite material. Restorations were evaluated with the Modified United States Public Health Service (modified USPHS) criteria. Clinical and radiographic findings were evaluated for 24 months at follow-up. Statistics: Statistical analysis was performed using the IBM SPSS Statistics 22 (IBM SPSS, Turkey) program, with descriptive statistical methods (means, standard deviations) and Chi-square, Fisher’s exact test, and Yates’s continuity correction (p<0.05 significance level) to evaluate the data.

Results

There were no statistically significant differences between the materials (p>0.05). The respective success rates of ProRoot MTA, Theracal LC, and Dycal were 94.4%, 87.8%, and 84.6%. There was no statistically significant difference between primary and permanent teeth according to the modified USPHS criteria (p>0.05).

Conclusion

These results support the idea that the success of IPC is independent from the capping material. Recently produced calcium-silicate based materials can also be used for IPC. The most important factors are to apply the indirect pulp treatment carefully, avoiding bacterial contamination, and to seal the teeth with hermetic restoration. More clinical studies with longer follow-up periods are required for understanding the clinical efficiency of these materials.

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