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Aim 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.Methodology Seventy adults aged 18 to 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 one 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 6, 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 non-symptomatic 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). KaplanMeier survival analysis and log-rank test was 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. Accepted ArticleThis article is protected by copyright. All rights reserved.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 MTA 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.

The present study is the first of its nature to analyse and compare deep carious lesion management between three European countries. It shows that there is an urgent need to practically educate dentists in less invasive strategies.

ObjectivesTo investigate how heat development in the pulp chamber and coronal surface of natural teeth with and without cusps subjected to irradiance using light-emitting diode (LED)–light-curing units (LCUs) is associated with (i) irradiance, (ii) time, (iii) distance, and (iv) radiant exposure.Materials and methodsThree different LED-LCUs were used. Their irradiance was measured with a calibrated spectrometer (BlueLight Analytics Inc., Halifax, Canada). An experimental rig was constructed to control the thermal environment of the teeth. The LED-LCU tip position was accurately controlled by a gantry system. Tooth surface temperature was measured by thermography (ThermaCAM S65 HS, FLIR Systems, Wilsonville, USA) and pulp chamber temperature with a thermocouple. LED-LCU tip distance and irradiation times tested were 0, 2, and 4 mm and 10, 20, and 30 s, respectively. Ethical permission was not required for the use of extracted teeth.ResultsMaximum surface and pulp chamber temperatures were recorded in tooth without cusps (58.1 °C  ± 0.9 °C and 43.1 °C ± 0.9 °C, respectively). Radiant exposure explained the largest amount of variance in temperature, being more affected by time than irradiance.ConclusionsAt all combinations of variables tested, repeated measurements produced consistent results indicating the reliability of the method used. Increased exposure time seems to be the factor most likely to cause tissue damage.Clinical relevanceRisk of superficial tissue damage at irradiances >1200 mW/cm2 is evident. There is a risk of pulp damage when only thin dentin is left at higher irradiances (>1200 mW/cm2). Clinicians should be aware of LED-LCU settings and possible high temperature generated.

There is no uniform treatment method of deep carious lesions among dentists in Northern Norway.