Efficacy of theracal as pulp capping material in permanent dentition: a systematic review and meta-analysis

Vital pulp therapy (VPT) aims to preserve pulp vitality through minimally invasive approaches, including indirect pulp capping (IPC), direct pulp capping (DPC), and pulpotomy. TheraCal LC, a light-cured resin-modified calcium silicate material, is widely used as a pulp-capping agent due to its favorable handling characteristics and bioactive properties. However, its clinical and radiographic efficacy remains insufficiently documented.

This systematic review and meta-analysis evaluated the effectiveness of TheraCal LC in IPC and DPC procedures and compared its performance with other pulp-capping materials, including mineral trioxide aggregate (MTA), calcium hydroxide, and Biodentine.

A comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted up to August 2025. Randomized controlled trials assessing TheraCal LC in IPC or DPC of permanent teeth were included. Study selection, data extraction, and risk of bias assessment (ROB-2) were performed independently by multiple reviewers. Meta-analyses were conducted using random-effects models, with subgroup analyses based on follow-up duration.

From 606 records identified across four databases, 11 clinical studies published between 2015 and 2025 met the inclusion criteria. These studies compared TheraCal LC with calcium hydroxide, Biodentine, and MTA in IPC and DPC. TheraCal LC demonstrated comparable clinical success rates to other materials, with consistently low pain scores and satisfactory dentin bridge formation during follow-up periods of 6-36 months. Risk of bias assessment indicated that most studies presented some concerns, primarily related to randomization and selective reporting, although overall methodological quality was acceptable.

TheraCal LC represents a viable alternative to MTA, calcium hydroxide, and Biodentine for direct and indirect pulp capping in permanent teeth.