Comparative Evaluation of Clinical and Radiographic Success Rates of Direct Pulp Capping in Primary Molars Using TheraCal LC, 3Mixtatin, and Nanohydroxyapatite: An In Vivo Study.

AIM AND

BACKGROUND

This in vivo study evaluated and compared the clinical and radiographic efficacy of three pulp capping agents-TheraCal light-cured (LC), 3Mixtatin, and nanohydroxyapatite (NHA)-for direct pulp capping (DPC) in primary molars. The goal aligns with the modern focus of pediatric dentistry on pulp revitalization and the preservation of primary teeth until exfoliation.

METHODS

Forty-five primary molars from children aged 3-9 years, exhibiting pinpoint pulp exposures (≤1 mm) with hemostasis achieved within 2-3 minutes, were randomly assigned (n = 15 per group) to receive TheraCal LC, 3Mixtatin, or NHA. All treatments were sealed with zinc oxide eugenol and restored with type IX glass ionomer cement. Clinical and radiographic assessments-evaluating pain, swelling, sinus tract, percussion sensitivity, mobility, secondary caries, root resorption, furcal radiolucency, and periodontal ligament (PDL) widening-were conducted at 3, 6, and 9 months. The collected data were analyzed using the Chi-square test with the aid of Statistical Package for the Social Sciences (SPSS) software.

RESULTS

TheraCal LC showed 100% success at 3 and 6 months, slightly declining at 9 months (86.7% clinical, 93.3% radiographic). 3Mixtatin showed a steep drop to 53.3% clinical and 60% radiographic success at 9 months, with notable sinus tract formation and furcal radiolucency (p < 0.01). NHA maintained 100% success at 6 months and 93.3% at 9 months both clinically and radiographically.

CONCLUSION

Nanohydroxyapatite exhibited the highest and most consistent success over the 9 months, outperforming both TheraCal LC and 3Mixtatin in sustaining pulp vitality.

CLINICAL SIGNIFICANCE: The success of DPC in primary teeth is largely influenced by the use of materials with optimal biological compatibility. NHA demonstrated superior outcomes, offering effective pulp preservation and reducing the need for invasive treatments.

HOW TO CITE THIS ARTICLE: Borusu BP, Naren P, Martha S, et al. Comparative Evaluation of Clinical and Radiographic Success Rates of Direct Pulp Capping in Primary Molars Using TheraCal LC, 3Mixtatin, and Nanohydroxyapatite: An In Vivo Study. Int J Clin Pediatr Dent 2026;19(2):215-222.