Assistant Professor, Altinbas University School of Dentistry, Department of Paediatric Dentistry, Istanbul, Turkey.
Professor, Istanbul University Faculty of Dentistry, Department of Paediatric Dentistry, Istanbul, Turkey.
Eur J Paediatr Dent. 2019 Jun;20(2):105-110. doi: 10.23804/ejpd.2019.20.02.04.
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.
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.
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.
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).
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.
间接盖髓术（IPC）是一种保存牙髓活力的治疗方法。已经有多种材料被用于该程序。本研究的目的是评估 TheraCal LC（Bisco Inc.，Schaumburg，IL，美国）与矿物三氧化物聚合体（MTA）（Pro Root MTA，Dentsply Tulsa，Johnson City，TN，美国）和氢氧化钙[Ca(OH)2]（Dycal，Dentsply De Trey Konstanz，德国）生物材料在 IPC 治疗中的放射学和临床结果，并将其进行比较。
本研究共纳入 295 颗牙齿，包括来自 4-15 岁健康且合作的儿童的第二乳磨牙和第一恒磨牙，这些牙齿有 IPC 指征。根据用于盖髓的材料将牙齿分为三组。使用 Dycal 对 91 颗牙齿进行间接牙髓治疗，使用 ProRoot MTA 对 89 颗牙齿进行间接牙髓治疗，使用 TheraCal LC 对 115 颗牙齿进行间接牙髓治疗。乳磨牙用复合树脂材料修复，恒磨牙用树脂复合材料修复。用改良美国公共卫生服务（modified USPHS）标准评估修复体。在随访 24 个月时，对临床和放射学发现进行评估。
使用 IBM SPSS Statistics 22（IBM SPSS，土耳其）程序进行统计分析，采用描述性统计方法（平均值、标准差）和卡方检验、Fisher 确切检验和 Yates 连续性校正（p<0.05 显著性水平）来评估数据。
各组材料之间无统计学差异（p>0.05）。ProRoot MTA、Theracal LC 和 Dycal 的成功率分别为 94.4%、87.8%和 84.6%。根据改良 USPHS 标准，乳磨牙和恒磨牙之间无统计学差异（p>0.05）。
这些结果支持这样一种观点，即 IPC 的成功与盖髓材料无关。最近生产的硅酸钙基材料也可用于 IPC。最重要的因素是仔细进行间接牙髓治疗，避免细菌污染，并使用密封修复体密封牙齿。需要进行更多具有更长随访时间的临床研究，以了解这些材料的临床效果。
