Comparative Evaluation of Platelet-Rich Fibrin and Mineral Trioxide Aggregate in the Direct Pulp Capping of Carious...

Objectives This study aimed to compare the clinical and radiographic outcomes of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) when used as direct pulp-capping agents in cariously exposed permanent teeth in adult patients. Materials and methods This randomized, parallel-group clinical trial included 20 permanent molars with carious pulp exposure in adults aged 18-45 years. Teeth exhibiting controlled bleeding, positive responses to pulp sensibility tests, and no radiographic evidence of periapical pathology were included. Eligible teeth were randomly allocated to receive either PRF or MTA as the direct pulp-capping material. Following placement of the capping agent, all teeth were restored using a resin-modified glass ionomer liner and resin composite restoration. Clinical evaluations, including cold test, electric pulp test, tenderness to percussion, tooth mobility, and periodontal probing depth, were performed at three and six months. Cone-beam computed tomography (CBCT) was conducted at six months to evaluate the presence and volume of dentin bridge formation. Results Nineteen of the 20 enrolled teeth completed the six-month follow-up (n = 19/20; 95%). CBCT analysis revealed significantly greater dentin bridge volume in the PRF group compared with the MTA group (0.01032 ± 0.00341 cc vs. 0.00778 ± 0.00120 cc; p = 0.049). All retained teeth in both groups demonstrated normal responses to cold and electric pulp testing (n = 19/19; 100%), with no tenderness to percussion or periodontal abnormalities. No adverse events were observed in the PRF group. One tooth in the MTA group developed symptoms of irreversible pulpitis at three months (n = 1/10; 10%) and required root canal treatment. Conclusion PRF demonstrated superior hard-tissue regenerative potential compared to MTA while maintaining comparable pulpal vitality. Within the limitations of this study, PRF may be considered a biologically advantageous alternative to MTA for direct pulp capping of carious exposures.