Keywords :
Bioceramic material, Permanent molars, Young permanent molars
Citation Information :
Altaf G, Garg S, Gupta A, Sharma V. Clinical Effectiveness of Biomaterials in Indirect Pulp Therapy Treatment of Young Permanent Molars with Deep Carious Lesions: A Case–Control Study. Int J Clin Pediatr Dent 2024; 17 (11):1199-1205.
Aim: The present case–control study was planned to assess the comparative efficacy of resin-modified calcium silicate, resin-modified glass ionomer, and Dycal as pulp capping agents in indirect pulp therapy for deeply carious young permanent molars.
Materials and methods: Thirty deeply carious young posterior teeth were treated by indirect pulp therapy. During the treatment, the cavity floor was lined with TheraCal or resin-modified glass ionomer cement (RMGIC) in the study group and with Dycal (control group) followed by GC IX and composite restoration. The teeth were reviewed and evaluated clinically and radiographically after 6 and 12 months.
Results: None of the study subjects experienced pain in any of the three study groups up to 12 months. Maturogenesis was seen in all 30 study teeth. Maximum% gain in dentin formation was seen in group I (TheraCal), that is, 16.100 ± 2.42, followed by group II (RMGIC), that is, 11.6000 ± 1.42, and group III (Dycal), that is, 9.6000 ± 0.96, and the difference between group I and group II and group I and group III was highly significant (p < 0.0001). Dentin formation was observed earlier at 6 months in 82.5% of cases with mesio-occlusal (MO) cavities as compared to 62.5% of cases with disto-occlusal (DO) extension.
Conclusion: TheraCal LC may be preferred as a pulp capping agent in the management of deeply carious young permanent molars for better healing in less time.
Ricketts DNJ, Kidd EAM, Innes N, et al. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev 2006;(3):CD003808. DOI: 10.1002/14651858.CD003808.pub2
Thompson V, Craig RG, Curro FA, et al. Treatment of deep carious lesions by complete excavation or partial removal: a critical review. J Am Dent Assoc 2008;139(6):705–712. DOI: 10.14219/jada.archive.2008.0252
Opal S, Garg S, Sharma D, et al. In vivo effect of calcium hydroxide and resin-modified glass ionomer cement on carious dentin in young permanent molars: an ultrastructural and macroscopic study. Pediatr Dent 2017;39(1):1–8.
Maltz M, dos Santos Moura M, Jardim JJ, et al. Partial caries removal in deep lesions: 19-30 months follow-up study. Rev Fac Odontol Porto Alegre 2010;51(1):20–23. DOI: 10.22456/2177-0018.16367
Falster CA, Araujo FB, Straffon LH, et al. Indirect pulp treatment: in vivo outcomes of an adhesive resin system vs calcium hydroxide for protection of the dentin-pulp complex. Pediatr Dent 2002;24(3):241–248.
Gruythuysen RJM, van Strijp AJP, Wu MK. Long-term survival of indirect pulp treatment performed in primary and permanent teeth with clinically diagnosed deep carious lesions. J Endod 2010;36(9):1490–1493. DOI: 10.1016/j.joen.2010.06.006
Makkar S, Kaur H, Aggarwal A, et al. A confocal laser scanning microscopic study evaluating the sealing ability of mineral trioxide aggregate, biodentine and a new pulp capping agent-theracal. Dent J Adv Stud 2015;3(1):20–25. DOI: 10.1055/s-0038-1672009
Ekstrand KR, Ricketts DN, Kidd EA. Reproducibility and accuracy of three methods for assessment of demineralization depth of the occlusal surface: an in vitro examination. Caries Res 1997;31(3):224–231. DOI: 10.1159/000262404
Ismail AI, Sohn W, Tellez M, et al. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 2007;35(3):170–178. DOI: 10.1111/j.1600-0528.2007.00347.x
Bjørndal L, Larsen T, Thylstrup A. A clinical and microbiological study of deep carious lesions during stepwise excavation using long treatment intervals. Caries Res 1997;31(6):411–417. DOI: 10.1159/000262431
Kuzmanović Radman I, Djeri A, Arbutina A, et al. Microbiological findings in deep caries lesions. Serb Dent J 2016;63(1):7–14. DOI: 10.1515/sdj-2016-0001
ten Cate JM, van Duinen RN. Hypermineralization of dentinal lesions adjacent to glass-ionomer cement restorations. J Dent Res 1995;74(6):1266–1271. DOI: 10.1177/00220345950740060501
Grewal N, Salhan R, Kaur N, et al. Comparative evaluation of calcium silicate-based dentin substitute (Biodentine®) and calcium hydroxide (pulpdent) in the formation of reactive dentin bridge in regenerative pulpotomy of vital primary teeth: triple blind, randomized clinical trial. Contemp Clin Dent 2016;7(4):457–463. DOI: 10.4103/0976-237X.194116
Bhatt RA, Patel MC, Bhatt R, et al. A comparative evaluation of light cure calcium silicate and resin-modified glass ionomer as indirect pulp capping agent in primary molars: a randomized clinical trial. Dent Res J (Isfahan) 2023;20:18. DOI: 10.4103/1735-3327.369620
Cannon M, Gerodias N, Viera A, et al. Primate pulpal healing after exposure and TheraCal application. J Clin Pediatr Dent 2014;38(4):333–337. DOI: 10.17796/jcpd.38.4.m585322121536q71
Jung GY, Park YJ, Han JS. Effects of HA released calcium ion on osteoblast differentiation. J Mater Sci Mater Med 2010;21(5):1649–1654. DOI: 10.1007/s10856-010-4011-y
Arandi NZ, Rabi T. TheraCal LC: from biochemical and bioactive properties to clinical applications. Int J Dent 2018;2018:3484653. DOI: 10.1155/2018/3484653
Deepa VL, Dhamaraju B, Bollu IP, et al. Shear bond strength evaluation of resin composite bonded to three different liners: TheraCal LC, biodentine, and resin-modified glass ionomer cement using universal adhesive: an in vitro study. J Conserv Dent 2016;19(2):166–170. DOI: 10.4103/0972-0707.178696
Meraji N, Camilleri J. Bonding over dentin replacement materials. J Endod 2017;43(8):1343–1349. DOI: 10.1016/j.joen.2017.03.025
García-Mota LF, Hardan L, Bourgi R, et al. Light-cured calcium silicate based-cements as pulp therapeutic agents: a meta-analysis of clinical studies. J Evid Based Dent Pract 2022;22(4):101776. DOI: 10.1016/j.jebdp.2022.101776
İnci MA, Korkut E. Is bioactive glass an effective agent in pulp-capping treatments? A randomized controlled clinical trial with one-year follow-up. J Contemp Dent Pract 2022;23(11):1128–1135. DOI: 10.5005/jp-journals-10024-3428