Which is the most effective biomaterial in indirect pulp capping? 4- year comparative randomized clinical trial

Purpose: The aim of this study is to compare the clinical outcomes of Mineral Trioxide Aggregate (MTA) and calcium hydroxide pulp capping after complete caries removal. Materials and methods: In 73 regular patients (47 women, 26 men; age 20.65±3.02 years), having at least one deep carious lesion was recruited. Following complete caries removal, the pulp was indirectly capped with either MTA(n=51) or calcium hydroxide (n =49), randomly. Final restoration with a resin-based composite in a single session was performed. Clinical parameters including pulp vitality, sensitivity to cold or heat stimulants, percussion tests and discomfort during chewing and color were recorded after 6 months, 1 year, 2- year, 3- year and 4- year. Data were analysed statistically (p<0.05). Results: After 4- year, the survival rates were 86% (for MTA), and 82.9% (for calcium hydroxide). Totally, 8 teeth from calcium hydroxide group and 7 teeth from MTA group were endodontically treated. No significant difference was detected between the groups in terms of pulp vitality (p=0.613). Grey discoloration rate was 63% in MTA group. Conclusion: Both pulp-capping materials, MTA and calcium hydroxide showed similar clinically successful performance in terms of pulp vitality in the treatment of deep dentin caries lesions after 4- year.