title: A randomized clinical trial on the use of medical Portland cement, MTA and calcium hydroxide in indirect pulp treatment.
abstract: OBJECTIVE
  Studies on indirect pulp treatment (IPT) show varying success rates of 73 to 97 %. The necessity of re-opening the cavity and the question of the optimal capping material is still under debate. The aim of this prospective in vivo study was to compare the clinical and microbiological outcomes of mineral trioxide aggregate (MTA), medical Portland cement, and calcium hydroxide on the dentin-pulp complex of permanent and primary teeth treated with two-step IPT.
  
  
  METHODS
  In 86 regular patients (51 % men; 49 % women; age 17.2 years ±13.8), one deep carious lesion each was treated with incomplete caries removal, randomly selected capping with either calcium hydroxide (n = 31), medical Portland cement (29) or white MTA (26), and re-entry (6.3 months ±1.0). Clinical (color, humidity, and consistency of dentin) and microbiological (Lactobacilli/Mutans Strep. counts) parameters were recorded at the first and second treatment.
  
  
  RESULTS
  The IPT had a high success rate of 90.3 % regardless of the material used (p = 0.72). The arrested lesions showed consistently darker, dry, and therefore, sclerotic dentine (p < 0.05) as well as a decrease in bacterial counts at re-entry (Lactobacilli p = 0.01/Mutans Strep. p = 0.07).
  
  
  CONCLUSIONS
  The findings of this study support the use of the IPT as a treatment for deep carious lesions preferably with non-resorbing materials such as MTA or medical Portland cement.
  
  
  CONCLUSIONS
  The findings of this study could promote the improvement of the IPT as a one-step treatment of deep carious lesions when the remaining demineralized dentin would be sealed with durable restorations.
authors.affiliation: Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany, petrou.marina@yahoo.com.
authors.forename: Marina Agathi
authors.initials: MA
authors.lastname: Petrou
authors.forename: Fadi Alhaddad
authors.initials: FA
authors.lastname: Alhamoui
authors.forename: Alexander
authors.initials: A
authors.lastname: Welk
authors.forename: Mohammed Basel
authors.initials: MB
authors.lastname: Altarabulsi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alkilzy
authors.forename: Christian
authors.initials: C
authors.lastname: H Splieth
mesh_terms: D000293:Adolescent; D000328:Adult; D017607:Aluminum Compounds; D017610:Calcium Compounds; D002126:Calcium Hydroxide; D002648:Child; D002675:Child, Preschool; D003738:Dental Cements; D003782:Dental Pulp / Q000187:drug effects*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D010087:Oxides; D017640:Silicates; D055815:Young Adult
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D003738:Dental Cements; D004338:Drug Combinations; D010087:Oxides; D017640:Silicates; C086631:mineral trioxide aggregate; D002126:Calcium Hydroxide
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