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Direct pulp capping in primary molars using a resin-modified Portland cement-based material (TheraCal) compared to MTA with 12-month follow-up: a randomised clinical trial

Abstract

Aim

This study was to compare the success of resin-modified Portland cement-based material (TheraCal) with MTA in direct pulp capping (DPC) of primary molars.

Methods

Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5–7 years were included in this split-mouth randomised clinical trial. DPC for small non-contaminated pulp exposures using either TheraCal or MTA were randomly performed in symmetrical molars. Thereafter, teeth were restored with amalgam. Clinical and radiographic evaluations were performed at 6 and 12 month follow-ups. Data were analysed using Chi square test at a significance level of 0.05.

Results

At the final follow-up session 74 teeth were available. After 12 months, the overall success rates for MTA and TheraCal were 94.5 and 91.8%, respectively. The difference between outcomes of the two groups was not statistically significant (P > 0.05).

Conclusion

Within the limitations of the current study, radiographic and clinical findings revealed that TheraCal exhibited a comparable outcome to MTA in DPC of primary molars after 12 months.

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Fig. 1

References

  • Aminabadi NA, Huang B, Samiei M, Agheli S, Jamali Z, Shirazi S. A randomized trial using 3Mixtatin compared to MTA in primary molars with inflammatory root resorption: a novel endodontic biomaterial. J Clin Paediatr Dent. 2016;40(2):95–102.

    Article  Google Scholar 

  • Aminabadi NA, Parto M, Emamverdizadeh P, Jamali Z, Shirazi S. Pulp bleeding color is an indicator of clinical and histohematologic status of primary teeth. Clin Oral Invest. 2017;21(5):1831–41.

    Article  Google Scholar 

  • Asgary S, Kamrani FA, Taheri S. Evaluation of antimicrobial effect of MTA, calcium hydroxide, and CEM cement. Iran Endod J. 2008;2(3):105–9.

    Google Scholar 

  • Asl Aminabadi N, Satrab S, Najafpour E, et al. A randomised trial of direct pulp capping in primary molars using MTA compared to 3Mixtatin: a novel pulp capping biomaterial. Int J Paediatr Dent. 2016;26(4):281–90.

    Article  PubMed  Google Scholar 

  • Bortoluzzi EA, Niu L-n, Palani CD, et al. Cytotoxicity and osteogenic potential of silicate calcium cements as potential protective materials for pulpal revascularisation. Dent Mater. 2015;31(12):1510–22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Camilleri J. Characterisation of hydration products of mineral trioxide aggregate. Int Endod J. 2008;41(5):408–17.

    Article  PubMed  Google Scholar 

  • Camilleri J. Hydration characteristics of Biodentine and Theracal used as pulp capping materials. Dent Mater. 2014;30(7):709–15.

    Article  PubMed  Google Scholar 

  • Cannon M, Gerodias N, Vieira A, Percinoto C, Jurado R. Primate pulpal healing after exposure and TheraCal application. J Clin Pediatr Dent. 2014;38(4):333–7.

    Article  PubMed  Google Scholar 

  • Cengiz E, Yilmaz HG. Efficacy of erbium, chromium-doped: yttrium, scandium, gallium, and garnet laser irradiation combined with resin-based tricalcium silicate and calcium hydroxide on direct pulp capping: a randomised clinical trial. J Endod. 2016;42(3):351–5.

    Article  PubMed  Google Scholar 

  • Cox C, Sübay R, Ostro E, Suzuki S, Suzuki S. Tunnel defects in dentin bridges: their formation following direct pulp capping. Oper Dent. 1995;21(1):4–11.

    Google Scholar 

  • Dammaschke T. The history of direct pulp capping. J Hist Dent. 2007;56(1):9–23.

    Google Scholar 

  • Dammaschke T, Leidinger J, Schäfer E. Long-term evaluation of direct pulp capping—treatment outcomes over an average period of 6.1 years. Clin Oral Investig. 2010;14(5):559–67.

    Article  PubMed  Google Scholar 

  • Davidovich E, Wated A, Shapira J, Ram D. The influence of location of local anaesthesia and complexity/duration of restorative treatment on children’s behaviour during dental treatment. Pediatr Dent. 2013;35(4):333–6.

    PubMed  Google Scholar 

  • Formosa L, Mallia B, Camilleri J. A quantitative method for determining the anti washout characteristics of cement-based dental materials including mineral trioxide aggregate. Int Endod J. 2013;46(2):179–86.

    Article  PubMed  Google Scholar 

  • Fuks AB. Pulp therapy for the primary and young permanent dentitions. Dent Clin N Am. 2000;44(3):571.

    PubMed  Google Scholar 

  • Gandolfi MG, Taddei P, Siboni F, et al. Development of the foremost light-curable calcium-silicate MTA cement as root-end in oral surgery. Chemical–physical properties, bioactivity and biological behaviour. Dent Mater. 2011;27(7):e134–e57.

    Article  PubMed  Google Scholar 

  • Gandolfi M, Siboni F, Prati C. Chemical–physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. Int Endod J. 2012;45(6):571–9.

    Article  PubMed  Google Scholar 

  • Ghajari MF, Jeddi TA, Iri S, Asgary S. Direct pulp-capping with calcium enriched mixture in primary molar teeth: a randomised clinical trial. Iran Endod J. 2010;5(1):27–30.

    Google Scholar 

  • Ghajari MF, Jeddi TA, Iri S, Asgary S. Treatment outcomes of primary molars direct pulp capping after 20 months: a randomised controlled trial. Iran Endod J. 2013;8(4):149–52.

    Google Scholar 

  • Gong V, Franca R. Nanoscale chemical surface characterization of four different types of dental pulp-capping materials. J Dent. 2017;58:11–8. 

    Article  Google Scholar 

  • Ha WN, Kahler B, Walsh LJ. Clinical manipulation of mineral trioxide aggregate: lessons from the construction industry and their relevance to clinical practice. J Can Dent Assoc. 2015;81:f4.

    PubMed  Google Scholar 

  • Hebling J, Lessa F, Nogueira I, Carvalho RMD, Costa C. Cytotoxicity of resin-based light-cured liners. Am J Dent. 2009;22(3):137–42.

    PubMed  Google Scholar 

  • Hilton T, Ferracane J, Mancl L. Dentistry NP-bRCiE-b. Comparison of CaOH with MTA for direct pulp capping a PBRN randomised clinical trial. J Dent Res. 2013;92(suppl.no.1):16s–22s.

    Article  PubMed  Google Scholar 

  • Kennedy D, Kapala J. The dental pulp: biological considerations of protection and treatment. Text book of pediatric dentistry. Baltimore: Williams&Wilkins. 1985.

    Google Scholar 

  • Komabayashi T, Qiang Z, Eberhart R. Current status of direct pulp-capping materials for permanent teeth. Dent Mater J. 2016;35(1):1–12.

    Article  PubMed  Google Scholar 

  • Lee H, Shin Y, Kim S-O, et al. Comparative study of pulpal responses to pulpotomy with ProRoot MTA, RetroMTA, and TheraCal in Dogs’ teeth. J Endod. 2015;41(8):1317–24.

    Article  PubMed  Google Scholar 

  • Liang C, SUH BI. Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: a state-of-the-art review. Dent Mater J. 2017;36(1):1–7.

    Article  Google Scholar 

  • Nielsen M, Casey J, VanderWeele R, Vandewalle K. Mechanical properties of new dental pulp-capping materials. Gen Dent. 2015;64(1):44–8.

    Google Scholar 

  • Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review—part I: chemical, physical, and antibacterial properties. J Endod. 2010a;36(1):16–27.

    Article  PubMed  Google Scholar 

  • Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review—part III: clinical applications, drawbacks, and mechanism of action. J Endod. 2010b;36(3):400–13.

    Article  PubMed  Google Scholar 

  • Petrolo F, Comba A, Scansetti M, et al. Effects of light-cured MTA like material on direct pulp capping. Dent Mater. 2014;30:e151.

    Article  Google Scholar 

  • Poggio C, Arciola CR, Beltrami R, et al. Cytocompatibility and antibacterial properties of capping materials. Sci World J 2014;2014:1–10.

    Article  Google Scholar 

  • Poggio C, Ceci M, Dagna A, et al. In vitro cytotoxicity evaluation of different pulp capping materials: a comparative study. Arh Hig Rada Toksikol. 2015;66(3):181–8.

    Article  PubMed  Google Scholar 

  • Ranjkesh B, Isidor F, Dalstra M, Løvschall H. Diametral tensile strength of novel fast-setting calcium silicate cement. Dent Mater J. 2016;35(4):559–63.

    Article  PubMed  Google Scholar 

  • Sarkar N, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod. 2005;31(2):97–100.

    Article  PubMed  Google Scholar 

  • Sluyk S, Moon P, Hartwell G. Evaluation of setting properties and retention characteristics of mineral trioxide aggregate when used as a furcation perforation repair material. J Endod. 1998;24(11):768–71.

    Article  PubMed  Google Scholar 

  • Tomson PL, Grover LM, Lumley PJ, et al. Dissolution of bio-active dentine matrix components by mineral trioxide aggregate. J Dent. 2007;35(8):636–42.

    Article  PubMed  Google Scholar 

  • Tuna D, Ölmez A. Clinical long-term evaluation of MTA as a direct pulp capping material in primary teeth. Int Endod J. 2008;41(4):273–8.

    Article  PubMed  Google Scholar 

  • Tüzüner T, Alacam A, Altunbas D, Gokdogan F, Gundogdu E. Clinical and radiographic outcomes of direct pulp capping therapy in primary molar teeth following haemostasis with various antiseptics: a randomised controlled trial. Eur J Paediatr Dent. 2012;13(4):289–92.

    PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by Tabriz University of Medical Sciences. Special thanks to the staff at the Department of Paediatric Dentistry, and the children and parents for their participating in this study.

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Correspondence to A. Vafaei.

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Conflict of interest

Professor Leila Erfanparast declares that she has no conflict of interest with respect to the authorship and/or publication of this paper. Dr. Parastoo Iranparvar declares that she has no conflict of interest with respect to the authorship and/or publication of this paper. Professor Ali Vafaei declares that he has no conflict of interest with respect to the authorship and/or publication of this paper.

Research involving human participants

5–7 years old children were included in our study.

Ethical approval

All procedures performed in this study which involved human participants were in accordance with the ethical standards of the “Committee for Ethics in Research on Humans” at Tabriz University of Medical Sciences (Trial no. IR.TBZMED.REC.1395.994) and with the 1964 Helsinki Declaration of Human Rights and its later amendments or comparable ethical standards.

Informed consent

Each experiment was included in the study after reading, understanding, and completing the written informed consent document by his/her parent.

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Erfanparast, L., Iranparvar, P. & Vafaei, A. Direct pulp capping in primary molars using a resin-modified Portland cement-based material (TheraCal) compared to MTA with 12-month follow-up: a randomised clinical trial. Eur Arch Paediatr Dent 19, 197–203 (2018). https://doi.org/10.1007/s40368-018-0348-6

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  • DOI: https://doi.org/10.1007/s40368-018-0348-6

Keywords

  • Direct pulp cap
  • TheraCal
  • MTA
  • Primary molar