MARJORİE ZANINI, GİUSEPPE BALICE, OLİVİA KROURDAN, CHARLOTTE LZ, FRANÇOİS GUEYFFIER, DELPHİNE MAUCORTBOULCH, PATRİCE NONY, BRİGİTTE GROSGOGEAT, NELLY PRADELLEPLASSE
European Endodontic Journal - 2025;10(6):514-524
Objective: To evaluate the clinical efficacy of direct pulp capping (DPC) using Biodentine(TM), a calcium silicatebased cement, in cases of carious pulp exposure, focusing on pulp survival and treatment success. Methods: This study retrospectively included all patients with a diagnosis of reversible pulpitis and pulp exposure who participated in the "Deep Caries Treatment" (DECAT) randomised clinical trial. Follow-up was performed at 1, 2, and 3 years after treatment. The primary outcome was pulp survival, defined as the absence of pain, a positive response to pulp sensibility testing, and the presence of a healthy periapical status. The secondary outcomes were patient satisfaction, marginal integrity of the restoration, and overall survival (defined as both pulp survival and marginal integrity success combined). To account for censoring, pulp survival, marginal integrity success, and overall survival were analysed using actuarial survival methods. Results: Of the 36 patients included, the pulp survival, marginal integrity success, and overall survival rates at one year (95% confidence interval [CI]) were 91.2% (81.6%-100%), 97.1% (97.1%-100%) and, 88.2% (77.4%-99.1%) respectively. At two years, the conditional pulp survival (i.e., the probability of maintaining vitality among teeth that were vital at the beginning of each follow-up year) and overall survival rates were both 92.6% (82.7%-100%) and the marginal integrity rate was 100% (100%-100%). After three years, the conditional pulp survival rate, marginal integrity rate, and overall survival rate were 95.3% (86.4%-100%) 90.7% (78.4%-100%) and 86% (71.4%-100%) respectively. From the patient's perspective, the restorations were considered clinically satisfactory, with only one patient patient reporting functional concerns after two years. Conclusion: After three years of follow-up, direct pulp capping with Biodentine(TM) showed high rates of pulp vitality preservation, marginal integrity, and overall restoration survival. These findings support the clinical reliability of this approach for managing carious pulp exposure in teeth diagnosed with reversible pulpitis.
