Comparative evaluation of four different calcium-based medicaments as an indirect pulp capping agent: An in vivo study

Abstract Context: The choice of material for indirect pulp capping (IPC) may affect long-term pulp vitality, particularly with newer bioactive cements. Aims: The aim of this study was to compare the clinical and radiographic efficacy of TheraCal LC, Binar LC, calcium-enriched mixture (CEM) cement, and calcium hydroxide as IPC agents in mature permanent teeth with deep carious lesions. Methods: In this prospective randomized trial, 52 patients with deep caries and reversible pulpitis were divided into four groups ( n = 13). Standardized IPC procedures and follow-ups at 21 days, 3 months, and 6 months included clinical and radiographic evaluations. Statistical Analysis Used: ANOVA and Tukey’s post hoc tests analyzed pain (Visual Analog Scale scores); Chi-square tests compared categorical variables. Results: All materials maintained pulp vitality without significant differences ( P > 0.05). CEM cement achieved 100% success with no radiographic abnormalities. TheraCal LC and Binar LC performed well, while calcium hydroxide showed slightly more failures and a higher incidence of PDL widening. Conclusions: All tested materials were effective IPC agents; however, bioactive materials (CEM cement and TheraCal LC) demonstrated superior clinical outcomes and sealing ability versus traditional calcium hydroxide.