Retrospective Study of Calcium Hydroxide and TheraCal for Pulp Capping

Objectives: To compare the clinical success rate of TheraCal (light-cured, resin-modified calcium silicate) to calcium hydroxide as pulp-capping materials in permanent teeth with closed apices.
Methods: This study involved a retrospective electronic record review. Post-operative data were collected from 60 patients for each material involving 69 teeth using calcium hydroxide and 79 teeth using TheraCal. From the treatment notes, the following data were recorded: the tooth number, patient age, patient gender, the rationale for using Theracal and calcium hydroxide, diagnosis of direct or indirect pulp cap, date of treatment, date of most recent dental appointment and treatment outcome. The inclusion criteria were: absence of signs and symptoms of irreversible pulpitis, and the patient must have been seen once for any other dental procedure at least three months after the pulpal treatment was performed. The treatment was categorized as clinically successful if the tooth was still present at the succeeding appointment and no further pulpal treatments or root canal therapy were needed. However, if the tooth was extracted or additional pulpal treatment was done, the tooth was categorized as unsuccessful.
Results: There was no significant difference between the clinical success rate of TheraCal (67 successful, 12 failures) for 84.8% and calcium hydroxide (59 successful, 10 failures) for 85.5% using Fisher’s exact test (p<0.05). Indirect pulp capping success for calcium hydroxide was 93% and for Theracal 88%. Direct pulp capping success for calcium hydroxide was 50% and for Theracal 69%. Neither the patient’s gender, arch location of the tooth or tooth type affected the outcome of direct or indirect pulp capping.
Conclusions: Based on this retrospective data, Theracal may be considered an equivalent treatment to calcium hydroxide as both a direct and indirect pulp capping material.