Abstract
INTRODUCTION: Preserving pulp vitality is crucial for long-term tooth survival. Pulpotomy, which involves the removal of infected pulp while retaining healthy pulp, helps maintain tooth vitality and function. Although TheraCal LC has shown success as a pulp-capping agent, its use in pulpotomy remains unexplored. This study compared the clinical and radiographic success of TheraCal LC and mineral trioxide aggregate (MTA) in full pulpotomy of mature permanent molars in young patients with symptomatic irreversible pulpitis (SIP). MATERIALS AND METHODS: In this double-blinded, parallel, non-inferiority randomized controlled trial, 72 healthy children (aged 9-14, mean age = 11.72 ± 1.35 years) with cariously exposed mature permanent molars diagnosed with SIP were randomly assigned to receive either TheraCal LC or MTA (n = 36 each). Follow-ups were conducted up to 12 months. Data were analyzed using Mann-Whitney U, Chi-square, and Kaplan-Meier tests (α = 0.05). RESULTS: At 12 months, MTA showed significantly higher success (ITT - Intention to Treat: 94.4%, PP - Per Protocol: 100%) compared to TheraCal LC (ITT: 75%, PP: 79.4%) (p < 0.05). Seven failures occurred in the TheraCal LC group; none in the MTA group. Two patients in each group were lost to follow-up. Pain scores were significantly lower in the MTA group on days 1, 3, and 5 (p < 0.05). CONCLUSIONS: MTA demonstrated superior outcomes over TheraCal LC for full pulpotomy in young, mature permanent molars with SIP. STATEMENT OF CLINICAL RELEVANCE: The use of MTA in pulpotomy procedures for mature permanent molars with SIP results in enhanced clinical success rates when compared to TheraCal LC, offering valuable insight for evidence-based treatment planning.