Antibacterial Effect of Light-Activated Calcium Silicate Versus Calcium Hydroxide on Permanent Carious Molars Treated With Step-Wise Excavation: A Randomized Clinical Trial

Abstract

Aims and Objectives: to evaluate the antibacterial action of Theracal (light-cured calcium silicate) liner in comparison to Biner LC (light-cured calcium hydroxide) liner on permanent carious molars treated with step-wise excavation in 6 months follow-up. Materials and Methods:A total of 48 patients were assigned in this study. Participants were divided into two groups randomly according to the type of liner that was placed and sample of dentin that will be taken before placement of liner and after placement (6 months). Application of both materials was done according to the manufacturers' instructions after the excavation of caries on the cavity walls and dentin sample was taken from the central carious lesion for microbiological analysis, then the cavities were sealed with conventional glass ionomer cement as a temporary restoration. After 6 months, the cavities were reopened, temporary restorations and pulp capping material were removed, and second dentin sample was taken for microbiological analysis. Caries was excavated to firm dentin and teeth were restored with permanent resin composite restorations. Agar Diffusion test and Digital Colony Counter were conducted for the study. The measuring unit of the bacterial count was CFU/ml.Results: There was no statistically significant difference between the two groups for Streptococcus Mutants and Lactobacillus Bacterial count after 6 months. Conclusion:1-Antibacterial activity of the resin-modified calcium silicate has nearly the same effect as the light-cured Calcium Hydroxide, however still doubtful to be used as the gold standard for pulp capping material. 2-Regardless the pulp capping material used, avoiding bacterial contamination and marginal sealing is essential in preserving the tooth vitality with deep Class I carious lesions.

Clinical Efficacy of Biomimetic Bioactive Biomaterials for Dental Pulp Capping: A Systematic Review and Meta-Analysis

“…Regarding sealing ability, an in vitro study showed that TheraCal LC had a significantly higher internal gap at the dentinal surface when compared to MTA and Biodentine; however, MTA and Biodentine had comparable results in sealing ability [ 37 ]. Concerning the microbiological effect, a randomized clinical study was conducted using permanent carious molars treated with indirect capping and found that the reduction of the bacterial count in both Streptococcus mutans and Lactobacillus was using Biner LC (light-cured hydroxy calcium phosphate) or TheraCal LC [ 38 ]. Moreover, in vivo subcutaneous implantation test performed in rats showed irregular collagen formation and tissue inflammation; such study informed that inflammation in the liver and kidney tissue of the rats was more severe with the use of TheraCal LC, possibly attributable to the light-cured compounds [ 39 ].…”