title: Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide.
abstract: OBJECTIVE
  The aim of this multicentre, parallel-group randomized clinical trial was to compare the effectiveness of mineral trioxide aggregate (MTA) and a conventional calcium hydroxide liner (CH) as direct pulp capping materials in adult molars with carious pulpal exposure.
  
  
  METHODS
  Seventy adults aged 18-55 years were randomly allocated to two parallel arms: MTA (White ProRoot, Dentsply, Tulsa Dental, Tulsa, OK, USA; n = 33) and CH (Dycal®, Dentsply DeTrey GmbH, Konstanz, Germany; n = 37). The teeth were temporized for 1 week with glass-ionomer (Fuji IX, GC Corp, Tokyo, Japan) and then permanently restored with a composite resin. The subjects were followed up after 1 week and at six, 12, 24 and 36 months. The primary outcome was the survival of the capped pulps, and the secondary outcome was postoperative pain after 1 week. Survival was defined as a nonsymptomatic tooth that responded to sensibility testing and did not exhibit periapical changes on radiograph. At each check-up, the pulp was tested for sensibility and a periapical radiograph was taken (excluding the radiographs taken at the 1-week follow-up). Kaplan-Meier survival analysis and log-rank test were used to assess the significant difference in the survival curves between groups. Chi-square test was used to assess the association between the materials and preoperative and postoperative pain.
  
  
  RESULTS
  At 36 months, the Kaplan-Meier survival analysis showed a cumulative estimate rate of 85% for the MTA group and 52% for the CH group (P = 0.006). There was no significant association between the capping material and postoperative pain.
  
  
  CONCLUSIONS
  Mineral trioxide aggregate performed more effectively than a conventional CH liner as a direct pulp capping material in molars with carious pulpal exposure in adult patients. This study has been registered at ClinicalTrials.gov, number NCT01224925.
authors.affiliation: Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Kundzina
authors.affiliation: Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Stangvaltaite
authors.affiliation: Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway.
authors.forename: H M
authors.initials: HM
authors.lastname: Eriksen
authors.affiliation: Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Kerosuo
mesh_terms: D000293:Adolescent; D000328:Adult; D017607:Aluminum Compounds / Q000627:therapeutic use*; D017610:Calcium Compounds / Q000627:therapeutic use*; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D003731:Dental Caries / Q000628:therapy*; D003785:Dental Pulp Capping / Q000379:methods*; D004338:Drug Combinations; D006801:Humans; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D057872:Pulp Capping and Pulpectomy Agents / Q000627:therapeutic use*; D017640:Silicates / Q000627:therapeutic use*; 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: biomaterial(s); caries treatment; cement; clinical outcome; clinical studies/trials; pulp biology