Direct pulp-capping with calcium enriched mixture in primary molar teeth: a randomized clinical trial

Area of Science:

• Dentistry
• Pediatric Dentistry
• Dental Materials Science

Background:

• Direct pulp capping (DPC) is a vital dental procedure for preserving pulp vitality in primary teeth.
• Mineral Trioxide Aggregate (MTA) is a widely used biomaterial for DPC, but novel alternatives are being explored.
• Calcium Enriched Mixture (CEM) cement presents a new option for DPC in pediatric dental care.

Purpose of the Study:

• To compare the clinical and radiographic success rates of DPC using CEM cement versus MTA.
• To evaluate the efficacy of CEM cement as a direct pulp capping agent in primary molar teeth.
• To provide evidence-based recommendations for biomaterial selection in pediatric DPC.

Main Methods:

• A randomized clinical trial involving 42 primary molars in 21 children aged 5-8 years.
• Blinded assessment of operators and patients, with teeth randomly assigned to either CEM cement or MTA groups.
• Standardized caries removal, pulp exposure management, biomaterial capping, amalgam restoration, and 6-month follow-up with clinical and radiographic evaluations.

Main Results:

• Thirty-eight teeth completed the 6-month follow-up (19 per group).
• Radiographic evaluations showed no failures in either group.
• Clinical success rates were 94.8% for CEM cement and 100% for MTA; one sinus tract was noted in the CEM group. Dentinal bridge formation was not observed in either group.

Conclusions:

• No statistically significant difference in treatment outcomes between CEM cement and MTA for DPC in primary molars.
• Both CEM cement and MTA demonstrate successful clinical and radiographic performance for direct pulp capping in primary teeth.
• CEM cement is a viable alternative to MTA for direct pulp capping procedures in pediatric dentistry.