title: Treatment outcome of mineral trioxide aggregate or calcium hydroxide direct pulp capping: long-term results.
abstract: BACKGROUND
  This controlled, historic cohort study project continues a previously reported trial aiming to assess treatment outcome of direct pulp capping with mineral trioxide aggregate (MTA) versus calcium hydroxide (CH). Potential prognostic factors were re-evaluated on the basis of a larger sample size and longer follow-up periods.
  
  
  METHODS
  Clinical and radiographic outcomes of 229 teeth treated with direct pulp capping between 2001 and 2011 were investigated 24 up to 123 months post-treatment (median = 42 months). Pre-, intra-, and postoperative information was evaluated and statistically analyzed using a logistic regression model as well as generalized estimating equation logit models.
  
  
  RESULTS
  Two hundred five patients (229 teeth) were available for follow-up (74% recall rate). The overall success rates were 80.5% (95% confidence interval [CI], 74.5-86.5) of teeth in the MTA group (137/170) and 59% (95% CI, 46.5-71.5) of teeth in the CH group (35/59). Multivariate analyses (generalized estimating equation logit model) indicated a significantly increased risk of failure for teeth that were directly pulp capped with CH compared with MTA (odds ratio = 2.67; 95% CI, 1.36-5.25; P = .001). Teeth that were permanently restored ≥ 2 days after direct pulp capping had a significantly worse prognosis irrespective of the pulp capping material chosen (odds ratio = 3.18; 95% CI, 1.61-6.3; P = .004).
  
  
  CONCLUSIONS
  The results of this study indicate that MTA provides better long-term results after direct pulp capping compared with CH. Placing a permanent restoration immediately after direct pulp capping is recommended.
authors.affiliation: Department of Conservative Dentistry Division of Endodontics and Dental Traumatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. Electronic address: johannes.mente@med.uni-heidelberg.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Mente
authors.affiliation: Department of Conservative Dentistry Division of Endodontics and Dental Traumatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hufnagel
authors.affiliation: Department of Conservative Dentistry Division of Endodontics and Dental Traumatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Meltem
authors.initials: M
authors.lastname: Leo
authors.affiliation: Department of Conservative Dentistry Division of Endodontics and Dental Traumatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Michel
authors.affiliation: Department of Conservative Dentistry Division of Endodontics and Dental Traumatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Gehrig
authors.affiliation: Department of Prosthodontics, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Dimos
authors.initials: D
authors.lastname: Panagidis
authors.affiliation: Institute of Medical Biometry and Informatics, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Saure
authors.affiliation: Department of Conservative Dentistry Division of Endodontics and Dental Traumatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Pfefferle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017607:Aluminum Compounds / Q000627:therapeutic use*; D017610:Calcium Compounds / Q000627:therapeutic use*; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D003785:Dental Pulp Capping / Q000379:methods; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000379:methods; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D010514:Periodontal Pocket / Q000145:classification; D011379:Prognosis; D057872:Pulp Capping and Pulpectomy Agents / Q000627:therapeutic use*; D012390:Root Canal Therapy / Q000145:classification; D017640:Silicates / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D057872:Pulp Capping and Pulpectomy Agents; D017640:Silicates; C086631:mineral trioxide aggregate; D002126:Calcium Hydroxide
keywords: Calcium hydroxide; dental pulp capping; dental pulp exposure; human; mineral trioxide aggregate; treatment outcome