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AIM: This investigation aimed to observe the effects of Dycal, mineral trioxide aggregate (MTA), and TheraCal LC, as indirect pulp-capping materials in primary molars. MATERIALS AND METHODS: About 75 children with lower primary molars aged between 4 and 7 years suggested for IPC were selected and randomly allocated into: Group I - Dycal, group II - MTA, and group III - TheraCal LC. An immediate postoperative radiograph was taken after the procedure. Recall examination was done after 3 and 6 months for clinical and radiographic assessment. The radiographs were digitized, and the amount of thickness of dentin was assessed using Corel Draw software. The values were tabulated and subjected to paired t-tests and independent t-tests for intra and intergroup analysis, respectively. The p-value < 0.05 was considered statistically significant. RESULTS: There was a statistically significant increase in dentin thickness in the first 3 months compared to the 6-month follow-up. At the end of the research phase, TheraCal LC had more tertiary dentin deposited than MTA, followed by Dycal. CONCLUSION: TheraCal LC can be a reliable indirect pulp-capping agent in primary teeth. CLINICAL SIGNIFICANCE: Indirect pulp capping (IPC) is a very extensively employed treatment regimen to manage extensive caries. For many decades, calcium hydroxide has been regarded as the benchmark of pulp capping materials. With several advancements in materials for restoration, TheraCal LC a resin-modified, light-cured calcium silicate-filled liner serves as a pulp-capping agent and dentin protector, promoting pulp healing and preserving vitality as an obstacle cum protector of the dental pulp complex. How to cite this article: Thomas NA, Jobe J, Thimmaiah C, et al. Comparative Evaluation of Effectiveness of Calcium Hydroxide, MTA, and TheraCal LC in Indirect Pulp Capping in Primary Molars: In Vivo Study. J Contemp Dent Pract 2024;25(4):365-371.

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Background The aim was to evaluate and compare the efficacy of TheraCal LC, mineral trioxide aggregate (MTA), and Biodentine as direct pulp capping (DPC) materials in patients with pulpal exposure in the posterior teeth. Methodology A total of 54 samples were assessed for eligibility. Out of this, 12 teeth samples failed to meet the inclusion criteria. Finally, 42 teeth samples were selected which were randomly distributed into three groups (n = 14). Groups A, B, and C received the intervention of MTA, Biodentine, and TheraCal LC, respectively. The assessment was performed clinically to check for postoperative pain, tenderness, and neural sensibility, and the radiographs were used to check the presence of periodontal ligament (PDL) space widening, calcified barrier, and periapical radiolucency at the follow-up of 21 days, three months, and 12 months. The outcomes depended on the clinical and radiographic success rates recorded at 12 months of recall. Results Overall successful outcome of DPC clinically at different periods was 97.61% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. The overall radiographic success rate of DPC at different time periods was 83.33% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. Conclusion Resin-based calcium-silicate agent (TheraCal LC) showed good efficacy and can be used in practice with the predictability of a good success rate both clinically and radiographically. Thus, TheraCal LC can be utilized as an alternative to MTA or Biodentine in clinical practice, with the predictability of similar successful outcomes in patients with pulpal exposure in the posterior teeth.

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Aim: The aim of the study is to evaluate and compare the shear bond strength (SBS) and modes of failure of different reinforced glass ionomer cement restorative materials such as GC IX, GC Gold Label 2 LC, Amalgomer CR, Equia Forte, and Secure Core Z to TheraCal LC. Methodology: A total of 50 acrylic blocks, each containing a cylindrical hole in the center were prepared from self-cure acrylic resin and randomly divided into five groups and restored, namely Group A - TheraCal LC + GC Fuji IX, Group B - TheraCal LC + GC Gold Label 2 LC, Group C - TheraCal LC + Amalgomer CR, Group D - TheraCal LC + Equia Forte, and Group E - TheraCal LC + Secure Core Z. All the specimens were stored in artificial saliva at 37°C for 24 h before testing. The statistical tests used for the analysis of the result were: one-way ANOVA, Tukey multiple comparison test, and the Chi-squared test, and P < 0.05 is considered as the level of significance. Results: Equia Forte showed the highest SBS, while GC type IX showed the lowest SBS with TheraCal LC. Conclusion: Equia Forte can be the restorative material of choice when TheraCal LC is used as a base materials for better clinical efficacy.

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Introduction: This study was performed to evaluate the clinical and radiographic effectiveness of TheraCal light cured (LC) comparison to mineral trioxide aggregate (MTA) and calcium hydroxide in direct pulp capping of primary molars over a period of 9 months. Materials and methods: A total of 90 primary molars from children aged between 5 and 8 years were included in this randomized clinical study based on inclusion and exclusion criteria and were randomly divided into three groups-group I, TheraCal LC; group II, MTA; and group III, calcium hydroxide. Direct pulp capping (DPC) was performed in noncontaminated pulpal exposure with hemostasis achieved within 2-3 minutes followed by restoring the tooth using glass ionomer cement (GIC). Subjects were followed up at 3, 6, and 9 months for clinical and radiographic evaluations. Results: At 9 months of follow-up, the overall success rate of direct pulp capping in groups I, II, and III were 60%, 72.41%, and 48.14%, respectively. Intergroup comparison showed nonsignificant differences (p >0.05). Conclusion: The outcomes of this study suggest the limited success of direct pulp capping in primary molars. However, among the three materials used in this study, MTA comparatively had better results. How to cite this article: Jha S, Namdev R, Singhal R, et al. Comparative Evaluation of Effectiveness of TheraCal LC, MTA, and Calcium Hydroxide in Direct Pulp Capping in Primary Molars: Randomized Clinical Study. Int J Clin Pediatr Dent 2023;16(S-2):S213-S219.

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BACKGROUND: Vital pulp therapy, based on the use of stem cells, has promising research and therapeutic applications in dentistry. It is essential to understand the direct effect of capping materials on the dental pulp stem cells of primary teeth, which contribute to the healing powers of the tooth. The aim of this study is to evaluate the effect of different capping materials (Calcium Hydroxide (DyCal®) - Glass Ionomer (Fuji IX®) and light-cured resin modified calcium silicate (TheraCal LC®)) on the viability, proliferation, and differentiation of stem cells from human exfoliated deciduous teeth (SHEDs). METHODS: SHEDs were isolated from extracted primary teeth, then divided into four groups and each of the capping materials were applied to the stem cells as follows: group I the controls, group II with Ca(OH)2, group III with the GIC, and group IV with the Theracal LC. For all groups assessment of viability and proliferation rate was done using the MTT cell proliferation assay. Also, Differentiation was evaluated by measuring the gene expression of Alkaline phosphatase enzyme activity (ALP) and Dentin matrix protein-1 (DMP1) through quantitative real-time PCR. Morphological assessment was conducted using Alizarin Red S staining. All evaluations were performed after 7 and 14 days of culture. RESULTS: TheraCal LC showed the highest values of proliferation, which was significant only compared to the control group after 2 weeks (p = 0.012). After one week, TheraCal LC showed the highest significant values of ALP and DMP1 compared to all other groups (p < 0.001). CONCLUSION: The three materials under study are biocompatible, maintain viability, and stimulate the proliferation and differentiation of SHEDs. However, TheraCal LC allows better proliferation of SHEDs than Dycal Ca(OH)2 and Fuji IX GIC.

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Background: Perforation repair materials should have excellent sealing ability and dislodgement resistance. While several materials have been employed for perforation repair, newer calcium-silicate materials, such as Biodentine and TheraCal LC, have shown promising outcomes. Aims: This study aimed to evaluate the effect of different irrigants on the dislodgement resistance of Biodentine and TheraCal LC when used for perforation repair in simulated conditions. Methods and Material: 3% sodium hypochlorite, 2% chlorhexidine gluconate, and 17% EDTA were evaluated for their effect on the dislodgement resistance of Biodentine and TheraCal LC. 48 permanent mandibular molars were selected for the study. The samples were divided into two groups: Group I - Biodentine and Group II - TheraCal LC, with 24 samples each. Statistical Analysis: The mean dislodgement resistance and standard deviation of Group I (Biodentine) and Group II (TheraCal LC) were compared and Failure pattern analysis was done. Results: Biodentine showed a significant decrease in push-out bond strength after contact with 3% NaOCl, 2% CHX, and 17% EDTA whereas, TheraCal LC showed no significant decrease in push-out bond strength after exposure to 3% NaOCl, 2% CHX, and 17% EDTA. Conclusions: Overall, TheraCal LC can be considered good perforation repair material with excellent physical and biological properties.

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BACKGROUND: The aim of the present study was to compare the biological and mechanical properties of a novel dual-cure, resin-modified calcium silicate material, Theracal PT® (TP), with those of Theracal LC® (TL) and BiodentineTM (BD). METHODS: The cell counting kit-8 was used on human dental pulp cells to test cell the viability of the three materials. Antibacterial activity of TP, TL, and BD against Enterococcus faecalis was investigated under anaerobic conditions. The ability of the materials to support odontogenic differentiation was studied by examining the relative gene expression of osteocalcin (OCN), osteopontin (OPN), and Collagen I (ColI) using real-time polymerase chain reaction. For mechanical property tests, microhardness was evaluated using the Vickers microhardness (VHN) test, and the bond strength to the resin was evaluated using a shear bond test machine. RESULTS: There was no significant difference in cell viability between TL and TP after 48 h, and BD showed the highest cell viability, while TP showed the highest antibacterial effect. At the 12-h time point, there was no significant difference in ColI and OCN expression between BD and TP, but TP showed a higher expression of OPN than BD. However, at the 48-h time point, ColI and OCN showed higher levels of expression for BD than for TP and TL. At the same time point, only OPN had a higher diffusion for TP than for BD. TP demonstrated a VHN of approximately 30-35. This value was higher than that of TL and lower than that of BD. In contrast to VHN, the shear bond strength to resin was significantly higher for TL and TP than for BD. CONCLUSION: TP showed lower biocompatibility than BD but higher OPN expression and antibacterial effects than BD and TL. TP showed higher shear bond strength than BD and higher VHN than TL and BD at the 24-h time point.

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Introduction: This study aimed to compare the micro-shear bond strength (µSBS) performances of two resin-based calcium silicate-based cement (CSC) (TheraCal PT and TheraCal LC), Biodentine, and two modified-MTA CSC materials (NeoMTA 2 and BioMTA+) to bulk-fill restorative material. Materials and Methods: Fifty 3D printed cylindrical resin blocks with a central hole were used (2 mm in depth and 4 mm in diameter). CSCs were placed in the holes (per each group n = 10) and incubated for 24 h. Cylindrical polyethylene molds (2 mm in height and diameter) were used to place the bulk-fill restorative materials on the CSCs and polymerize for 20 s. Then, all specimens were incubated for 24 h at 37 °C at a humidity of 100%. Specimen's µSBSs were determined with a universal testing machine. Data were analyzed with one-way ANOVA (Welch) and Tamhane test. Results: Statistically higher µSBS was found for TheraCal PT (29.91 ± 6.13 MPa) (p < 0.05) respect to all the other materials tested. TheraCal LC (20.23 ± 6.32 MPa) (p > 0.05) reported higher µSBS than NeoMTA 2 (11.49 ± 5.78 MPa) and BioMTA+ (6.45 ± 1.89 MPa) (p < 0.05). There was no statistical difference among TheraCal LC, NeoMTA 2 and Biodentine (15.23 ± 7.37 MPa) and between NeoMTA 2 and BioMTA+ (p > 0.05). Conclusion: Choosing TheraCal PT as the pulp capping material may increase the adhesion and µSBS to the bulk-fill composite superstructure and sealing ability.

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Background: Minimally invasive techniques should be employed to maintain pulp vitality without affecting physiological tooth resorption for pediatric patients. This study aims to evaluate clinical and radiographic success of light cure calcium silicate and resin-modified glass ionomer (RMGI) as indirect pulp-capping agent in primary molars in children between 5 and 9 years. Materials and Methods: In this randomized clinical trial study, 40 primary molars with the International Caries Detection and Assessment System criteria 4-6 score were divided randomly into two groups after computerized randomization method. After caries excavation by minimally invasive dentistry principle, affected dentin was lined by either light cure calcium silicate (Group I) or RMGI (Group II) liner followed by composite restoration. Clinical success was determined with the absence of symptoms and bitewing radiographs were taken at baseline, 3, and 6 months' interval to measure increase in dentin increment using ImageJ software. Statistical analysis for intergroup comparison was done using Paired t-test, and Independent t-test was used for intragroup comparison. The level of statistical significance was set at P < 0.05. Results: Change in dentin increment seen from baseline to 6 months in Group I was 0.19 mm and in Group II was 0.20 mm (P = 0.924). Intragroup increment was statistically significant during all follow-up intervals for both the groups (Group I - P ≤ 0.001, Group II - P = 0.009). For baseline remaining dentin thickness >1.5 mm, statistically significant increase was observed in the dentin increment at 3 months' interval between both the groups. Conclusion: Both TheraCal LC and Vitrebond show acceptable clinical and radiographic results when used in primary molars as indirect pulp treatment agents. Both the liners are equivalent to each other in terms of feasibility and cost-effectiveness but TheraCal LC can be preferred due to better handling and avoiding the manipulation step thereby reducing treatment time.

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This study aimed to compare in vitro micro-shear bond strength (µSBS) of three different endodontic tricalcium silicate-based materials in contact with a bulk-fill resin-based composite. Thirty cylindrical resin blocks with a hole in the centre (2 mm in depth and 4 mm in diameter) were manufactured with a 3D printer and divided into three groups (n = 10), depending on the calcium silicate cement used: light curing TheraCal LC (Bisco, Schaumburg, IL, USA), liquid-powder NeoMTA 2 (NuSmile Avalon Biomed, Bradenton, FL, USA) and putty NeoPutty (NuSmile, Houston, TX, USA). Each sample was stored for 24 h at 37°C and 100% humidity. Then, after adhesive placement, the restorative material Filtek bulk-fill (3 M ESPE, St. Paul, MN, USA) was placed over the capping material using cylindrical plastic capsules (2 mm height and 2 mm) and polymerised for 20 s. Specimens were then tested in a universal testing machine for the compression load resulting in the µSBS. The data were compared with the one-way ANOVA (Welch) and the Tamhane test. The mean value was significantly higher in the TheraCal LC group than in the other two groups (p < 0.05). There was no significant difference between NeoMTA 2 and NeoPutty groups (p > 0.05). The majority of failure modes for all groups were cohesive within biomaterial. Using TheraCal LC in the pulp capping procedure can result in higher bond strength values to the tested bulk-fill resin-based composite than NeoMTA 2 and NeoPutty.

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OBJECTIVES: This study histologically compared the effect of TheraCal LC and biodentine on direct pulp capping using a rabbit model. MATERIALS AND METHODS: A direct pulp capping procedure was performed on 40 mandibular central incisors of 20 healthy, male New Zealand white rabbits. TheraCal LC and biodentine were applied to exposed pulp and 10 randomly selected rabbits were euthanized after the first and second week. Incisors were extracted and prepared for histological processing and examination to check the dentine bridge thickness, continuity, and extent of pulp inflammation. A blinded data analysis was performed, and groups were compared using a Wilcoxon signed-rank test while changes across time within each group were assessed using the Mann-Whitney U test. RESULTS: When comparing the dentine bridge thickness, biodentine showed a significantly thicker dentine bridge in the first and second week (mean 28.16 µm, 33.66 µm), while TheraCal LC showed a dentine bridge in the second week only (mean 15.93 µm). Regarding dentine bridge continuity, biodentine showed a significantly better dentine bridge in the first week. Additionally, there was no difference in the second week. Furthermore, there was no statistically significant difference between each of the materials regarding the extent of inflammation. CONCLUSIONS: Biodentine in vivo showed better results concerning thickness and continuity of the dentine bridge after direct pulp capping in rabbit incisors. Both biodentine and TheraCal LC had a similar inflammatory effect on the pulp. CLINICAL RELEVANCE: Biodentine is more successful as a direct pulp capping material compared to TheraCal LC.

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Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any variation between the effect of using TheraCal LC and other bioactive biomaterials for pulp capping is different, as measured by dentin increment and clinical success. The risk of bias was assessed using the Risk of Bias 2 and Newcastle−Ottawa tools for randomized clinical trials and observational studies. A search for relevant articles was performed on five databases. Additionally, the quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A summary of individual studies and a meta-analysis were performed. The odds ratio of data from clinical success was combined using a random-effects meta-analysis. The meta-analysis results showed homogeneity between the studies (I2 = 0%). They revealed that the clinical success showed no differences between the patients who received TheraCal LC, light-cured calcium silicate-based biomimetic biomaterial, for dental pulp capping or the comparator biomaterials (p > 0.5). However, the certainty of the evidence was low to moderate due to the risk of bias in the included studies.

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BACKGROUND: Direct pulp capping can conserve its vitality by placing materials that promote dentin bridge (DB) formation at the exposure site. This study aimed to determine whether TheraCal LC could produce a layer of reparative dentin. It also compared the histological differences between treatment with mineral trioxide aggregate (MTA) and TheraCal LC. MATERIAL AND METHODS: A sample of 20 maxillary and mandibular premolars, which had previously been indicated for extraction in orthodontic therapy, was taken from 10 patients and randomly divided into two halves, a TheraCal LC, and an MTA group. Pulpal exposure was achieved by similar class I preparations, which were restored with a resin-modified glass-ionomer and extracted after ten weeks, noting that these interventions have been performed on live teeth in the oral cavities. The newly formed dentin bridge thickness, the inflammation degree within the pulp tissue, and odontoblast function were thoroughly examined histologically and compared between the two groups using the Mann-Whitney test and an analysis software SPSS (statistical package for the social sciences, v.26, IBM, New York, N, USA), at a significance level of a=0.05. RESULTS: Dentin bridge composition in the TheraCal group had 80% effective tubules and 20% defective tubules, while in the MTA group, the proportions were 90% and 10%, respectively. Dentin bridge thickness in the TheraCal group was greater than 0.25 mm in 60%, and 0.1-0.25 mm in 40% of the sample compared to the MTA group, which had 70% greater than 0.25 mm, and 30% between 0.1 and 0.25 mm in dentin bridge thickness. Statistically, there was no significant difference between both groups (P=0.739). CONCLUSION: Statistically insignificant differences in dentin bridge composition and thickness produced by both TheraCal and MTA materials render them similar in their effectiveness in treating pulp exposures through pulp capping.

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OBJECTIVE: In a tooth with deep dentinal caries; judicious removal of infected dentin and isolating affected dentin from oral fluids with suitable biocompatible material is called indirect pulp therapy (IPT). This randomized clinical trial was done to evaluate and compare the efficacy of Biodentine, Theracal LC and. Dycal as an indirect pulp capping agent in young permanent teeth. STUDY DESIGN: IPT was performed in 60 young permanent molars with caries approaching pulp in 55 healthy children using Biodentine, Theracal and Dycal. A 2-3mm layer of GIC was placed over the intervening material followed by restoration of cavity with composite. Clinical and radiographic examinations were conducted at 3 weeks, 3 months, 6 months,12 months, 18 months and 24 months. The data was compared using chi-square test at a significance level of 0.05. RESULTS: By end of 24 months ,54 teeth presented for follow up with overall success rate of 100% in Theracal, 94.44% in Biodentine, and 77.78% in Dycal. Overall success of Theracal was statistically significant in comparison to Biodentine and Dycal at 24 months follow up (p= 0.03) Conclusions: Radiographic and clinical outcomes of Theracal and Biodentine suggest their use as an alternative material for IPT in young permanent molars with higher success.

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BACKGROUND/PURPOSE: Calcium hydroxide-based materials were the gold standard in vital pulp therapies for decades' despite of several shortcomings. However, calcium silicates have been discussed as an alternative to overcome these drawbacks. It was aimed to investigate the in-vivo effectiveness of different calcium silicates based materials in pulp capping in this study. MATERIALS AND METHODS: A parallel-design, randomized controlled trial with 213 patients who has deep dentin caries, vital pulps and without spontaneous pain or history of swelling was designed. 525 M teeth were randomized, blinded and allocated to one of the five groups for pulp capping treatment (n = 105). All teeth were followed up clinically and radiographically (after 1st, 6th, 12th and 36th months) by blinded investigators. The clinical and radiographic success, and the effect of the pulp exposure to the success rate analyzed with Wald chi-square and Z tests. RESULTS: Clinical and radiographic success of MTA+ (86.3%, 85.4%) and Biodentine (79.4%, 80.1%) were found the highest. Although results of Theracal LC group (72.1%, 73.6%) were better than Dycal group (69.4%, 70.2%), the difference was nonsignificant (p > 0.05). Only in light-cured groups, (TheraCal LC & LC Calcihyd) pulpal exposure size effected the success of the materials (p < 0.05). MTA+ and Biodentine resulted better scores, when compared with TheraCal LC in large pulpal exposures (p < 0.05). CONCLUSION: After 36-month follow-up, both MTA+ and Biodentine were found to be the appropriate material for direct pulp capping in permanent teeth. The filler ingredient of the Theracal-LC eases the usage of calcium silicates but decreases the success rate.

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AIMS: The aim of the study is to compare and evaluate the bonding ability of alkasite restorative material to TheraCal LC™ (TLC), Biodentine™ (BD), resin-modified glass ionomer cement (RMGIC) using an universal adhesive and characterizing their failure modes. SUBJECTS AND METHODS: Ninety extracted intact human molars were divided into three groups of (n = 30) as Group I (TLC), Group II (RMGIC), and Group III (BD). Each group was subdivided into two based on application of universal adhesive. Cention N was bonded to each sample. Shear bond strength analysis was performed. The data were analyzed using SPSS version 22 software. RESULTS: No significant difference was observed between Group I and Group II (P < 0.05) while Group III showed the least bond strength (P < 0.05). The modes of failure were predominantly cohesive in Groups I and III (TLC and BD) while RMGIC showed mixed and adhesive failures. CONCLUSIONS: The bond strength of Cention N to TLC and RMGIC was similar and significantly higher than that of BD following application of universal adhesive.

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BACKGROUND: The success of direct pulp capping (DPC) depends on the preoperative assessment of pulpal status, intraoperative judgment after pulp exposure, and the biomaterials used to cap the pulp. AIM: The study aims to compare the clinical and radiographic responses of the pulp-dentin complex after DPC with TheraCal LC, Biodentine, and current gold standard mineral trioxide aggregate (MTA) Plus. MATERIALS AND METHODS: Ninety vital permanent teeth with Class I deep carious lesions were randomly divided into three different groups. After the caries excavation, hemostasis was established using sodium hypochlorite at the site of pulp exposure on which the material was placed. Clinical and radiographic follow-ups were performed at 1-, 3-, and 6-month intervals. RESULTS: Overall success rates of MTA Plus, Biodentine, and TheraCal LC were statistically insignificant. CONCLUSIONS: TheraCal LC and Biodentine showed similar success rates when compared to MTA Plus and can be used as an agent in DPC.

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AIM: The purpose of this in vitro study was to assess the shear bond strength (SBS) and bond failure types of a resin-composite to six pulp-capping materials used in primary teeth. STUDY DESIGN: Eight-disc specimens from each pulp-capping material (6 groups) to bond to Filtek™ Z350 XT Flowable using a standard PVC tube (2×2mm). All groups were prepared according to the instruction of the manufacturer. The SBS was measured with a crosshead speed of 0.5 mm/min using a universal testing machine. Failure mode evaluation was completed using Digital Microscope by two independent examiners. RESULTS: Urbical LC® showed the highest SBS (Mean±SD) followed by ProRoot® MTA and TheraCal LC® (35.422±2.910, 22.114±2.515, and 21.175±1.983) respectively. ANOVA showed significant differences between all groups (P=0.0001). Urbical LC® and Photac™ Fil QuickAplicap™ were statistically significant different from all other pulp-capping materials groups. ProRoot® MTA was statistically significant different than Biodentine® (P=0.0001) and Photac™ Fil (P=0.0001). The total number of bond failure was recorded for cohesive B failure/cohesive in the pulp-capping material (14) and adhesive failure (14). CONCLUSION: Most of the tested pulp-capping materials bonded to Filtek™ Z350 XT demonstrated clinically acceptable and high SBS. Urbical LC showed the highest SBS while Biodentine® showed the lowest SBS.

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BACKGROUND: This study evaluated the marginal adaptation, solubility and biocompatibility of TheraCal LC compared with mineral trioxide aggregate (MTA-Angelus) and Biodentine when used as a furcation perforation repair material. METHODS: The marginal adaptation was assessed by scanning electronic microscope and presence of any gap between the dentin surface and filling material in each quadrant of the sample was analyzed at 1000 X magnification. The solubility was measured after one week by the ISO standard method. Biocompatibility was evaluated by the inflammatory response and radiography after one month and three months of repair of experimental furcation perforations in dog's teeth. RESULTS: There were significant differences in the marginal adaptation, solubility and biocompatibility of the tested materials (P < 0.05). TheraCal LC showed the highest frequency distribution of gap presence that was followed by the MTA-Angelus then Biodentine. The least soluble material after one week was TheraCal LC that was followed by the MTA-Angelus and Biodentine. After one month and three months, TheraCal LC showed the highest inflammatory response and highest frequency distribution of radiolucency that was followed by the Biodentine then MTA-Angelus. CONCLUSION: Unlike Biodentine, TheraCal LC is incapable of alternating the MTA in furcation perforation repair due to its poor biocompatibility and poor marginal adaptation.

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This study aimed to analyze the effects of pulp capping materials on gene expression changes in primary tooth-derived dental pulp cells using next-generation sequencing. Dental pulp cells were extracted and treated with mineral trioxide aggregate (MTA), Biodentine (BD), or TheraCal LC (TC). Cell viability assays were performed. Total RNA was extracted and analyzed through mRNA sequencing. Bioinformatic analysis of differential gene expression in dental pulp cells exposed to BD or TC versus MTA was performed. MTA, BD, and TC exposure had no significant effect on pulp cell viability (p > 0.05). Gene sets associated with inflammatory response (p = 2.94 × 10-5) and tumor necrosis factor alpha (TNF-α) signaling via the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway (p = 2.94 × 10-5) were enriched in all materials. In BD-treated cells, Wnt/ß-catenin signaling (p = 3.15 × 10-4) gene sets were enriched, whereas enrichment of interferon gamma (IFN-γ) response (p = 3 × 10-3) was observed in TC-treated cells. In gene plot analysis, marked increases in receptor activator of nuclear factor kappa-Β ligand (RANKL) expression were seen in TC-treated cells over time. Despite the similar cell viabilities exhibited among MTA-, BD-, and TC-treated cells, patterns of gene networks differed, suggesting that diverse functional gene differences may be associated with treatment using these materials.