Clinical Oral Investigations

, Volume 23, Issue 9, pp 3491–3499 | Cite as

Clinical evaluation of direct pulp capping using a calcium silicate cement—treatment outcomes over an average period of 2.3 years

  • Carolin Sabine Harms
  • Edgar Schäfer
  • Till DammaschkeEmail author
Original Article



This study aims to assess the treatment outcomes of direct pulp capping with a calcium silicate cement (Biodentine) after caries excavation.

Materials and methods

A total of 245 teeth of 226 patients diagnosed to be clinical healthy or showing spontaneous pain were directly capped. The teeth were examined 0.19 to 7.4 (mean 2.3 ± 2.04) years after treatment. The following data were recorded: age and sex of the patient, type of tooth and restoration (glass ionomer cement [GIC], amalgam, composite resin, ceramic, gold) and symptoms before or after treatment. The evaluation of the treatment was carried out by sensibility and percussion testing and by the patient’s questioning. A positive sensibility test, a negative percussion test, the absence of swelling and discomfort were considered as treatment success. Survival analysis was performed using the Kaplan-Meier, log-rank, Chi-square and Fisher’s exact test, respectively.


After an average period of 2.3 years, 86.0% of the teeth remained vital; the survival rate after 7.4 years was 83.4%. The treatment outcome was significantly worse for cavities restored with GIC compared to all other restorative materials (p < 0.05). All other evaluated factors had no significant influence on the success rate (p > 0.05).


Exposed pulps of asymptomatic vital permanent teeth and teeth with spontaneous pain before treatment can be successfully capped directly using Biodentine. A subsequent restoration with GIC does not appear to be suitable as it significantly reduces the success of the treatment.

Clinical relevance

Direct pulp capping can be done successfully with this type of calcium silicate cement.


Biodentine Calcium silicate cement Direct pulp capping Treatment outcome 


Compliance with ethical standards

Conflict of interest

Carolin Sabine Harms declares that she has no conflict of interest.

Edgar Schäfer declares that he has no conflict of interest.

Till Dammaschke declares that he has no conflict of interest.

Ethical approval

All treatments were conducted strictly in full accordance with ethical principles, including the World Medical Association Declaration of Helsinki (version 2008).

Informed consent

The treatments were undertaken with the understanding and written consent of each patient and according to ethical principles, including the Declaration of Helsinki.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Periodontology and Operative DentistryWestphalian Wilhelms-UniversityMünsterGermany
  2. 2.Central Interdisciplinary Ambulance in the School of DentistryMünsterGermany

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