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Selecting an appropriate vital pulp therapy (VPT) for primary teeth with reversible pulpitis can sometimes be confusing for clinicians. Encouragingly, continuous developments in capping materials with bioactive properties help the selection of less-invasive treatments. This non-randomized clinical trial aimed to assess the clinical and radiographic success rates of indirect pulp treatment (IPT), direct pulp capping (DPC), partial pulpotomy (PP) and pulpotomy in primary molars utilizing TheraCal PT over a 12-month period. Different inclusion criteria were assigned for each treatment to assess the eligibility of each treatment type for specific clinical scenarios. Additionally, the association of tooth survival with some variables was assessed. The trial was registered at clinicaltrials.gov (NCT04167943) on 19 November 2019. Primary molars (n = 216) with caries extending into the inner dentin third or quarter were included. Selective caries removal was employed in IPT. Non-selective caries removal was employed in other groups, and treatment was decided according to pulp exposure characteristics, whereby the most conservative treatment was selected for the least clinically detectable pulp inflammation. Cox regression was performed to assess the effects of different variables on tooth survival using p ˂ 0.05 for detecting statistical significance. The 12-month combined clinical and radiographic success rates for IPT, DPC, PP and pulpotomy were 93.87%, 80.4%, 42.6% and 96.15%, respectively. Proximal surface involvement, provoked pain and first primary molars were associated with increased odds of treatment failure. According to the specified inclusion criteria, IPT, DPC and pulpotomy using TheraCal PT demonstrated acceptable results, while PP was associated with poor treatment outcomes. The odds of failure increased with proximal surface involvement, provoked pain and first primary molars. These results provide insights into different scenarios when managing deep carious lesions in primary teeth. The effects of clinical predictors on treatment outcomes may guide clinicians in case selection.

Objectives:The aim of this study was to evaluate and compare the antibacterial effect and smear layer removal ability of 12.5% turmeric extract solution, 2% chlorhexidine when used as root canal irrigants. Materials and Methods: For antibacterial effect, seventy extracted primary anterior teeth were divided into five groups; Group (I): n= 20 roots that were irrigated with 2% chlorhexidine solution, Group (II): n=20 roots that were irrigated with sterile saline, Group (III): n=20 roots that were irrigated with 12.5% turmeric solution, Group (IV): positive control group (n=5 roots), Group (V): negative control group (n=5 roots). Sterile paper points were used to absorb irrigating fluid and transferred to a test tube to measure the bacterial count. For smear layer removal ability, 15 roots were divided into three groups (5 roots each). After instrumentation, the roots were irrigated with (12.5% turmeric extract, 2% CHX and sterile saline). The smear layer removal ability was evaluated by a scanning electron microscope. Results: CHX group has a higher bacterial efficacy against E. faecalis than saline and turmeric irrigation solutions. The saline group had the highest (mean ±SD) total remaining smear layer followed by the turmeric group while the CHX group had the lowest (mean±SD). Conclusion: Both 12.5% turmeric and 2% CHX irrigation solution have an antibacterial effects against E. faecalis and ability to smear layer removal. In infected canals, 2%CHX is the preferred irrigation choice, it has more effective antibacterial activity than 12.5% turmeric solution. Turmeric extract can be used as a safe natural alternative to CHX.

Aim: To evaluate the clinical and radiographic success rates of indirect and direct pulp capping in primary molars with reversible pulpitis using a light cured tri-calcium silicate-based material.Methods: A total of 40 primary molars that had deep dentin caries and signs of reversible pulpitis in healthy cooperative children aged between 4-7 years were randomly allocated to two parallel groups. The first group received indirect pulp capping (IPC) using partial caries removal (PCR), while the second group received direct pulp capping (DPC) using complete caries removal (CCR). TheraCal (LC) was the capping material in both groups. Teeth were restored by high-strength glassionomer cement or a stainless-steel crown according to the extent of carious involvement. Teeth were assessed clinically and radiographically at 3, 6, 9, and 12 months. The data was statistically analyzed using Fisher's exact test for intergroup comparisons and Cochran's Q test followed by multiple pairwise comparisons utilizing multiple McNemar's tests with Bonferroni correction for intragroup comparisons. Significance level was set at p ≤ 0.05.Results: According to intention to treat analysis, the clinical success rates for IPC were 90% and 85% at 3, and 12 months, respectively. DPC showed 90% clinical success rate at 3 months and 70% at 12 months. Whereas the radiographic success rate for IPC was 90% at 3 months and 85% at 12 months. While radiographic success rate for DPC was 95% in the first 3 months and 70% after 12 months. There were no significant differences in clinical and radiographic success rates of IPC and DPC at all follow-up intervals (p > 0.05). Conclusion:Both IPC and DPC can be reliable treatment options in primary molars encouraging the selection of the most conservative treatment option as a biological management approach for deep caries in primary molars with reversible pulpitis.

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