Success Rate of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in 1st Perments Molar with Pulp Exposed During Carious Tissue Removal

Abstract

Background: Direct pulp capping aims to preserve pulpal vitality after mechanical exposure during carious tissue removal, and outcomes depend on case selection, aseptic technique, and the biological and sealing characteristics of the capping material. Objective: To evaluate short-term clinical–radiographic success following direct pulp capping in permanent mandibular molars with mechanical carious exposure and controlled intraoperative bleeding, within a protocol that planned allocation to mineral trioxide aggregate or calcium hydroxide. Methods: A comparative clinical study was conducted at Bolan Medical College/SPH, Quetta (6 October 2019 to 7 April 2020) enrolling 60 patients aged 15–40 years with pinpoint pulp exposure during caries excavation and bleeding controlled within 2–3 minutes under rubber dam isolation. Teeth were managed using standardized capping and restorative protocols with scheduled clinical and radiographic follow-up at 3 and 6 months. Primary outcome was 6-month success defined by absence of symptoms, retained sensibility on thermal testing, and absence of periapical radiolucency; postoperative pain was planned for daily VAS assessment for 7 days. Results: The cohort comprised 35 males (58.33%) and 25 females (41.67%). Overall 6-month clinical–radiographic success was 90.00% (54/60; 95% CI 79.49–96.24). Conclusion: Direct pulp capping in selected mechanically exposed permanent mandibular molars achieved high 6-month success, but valid comparative inference between materials requires complete arm-level outcome and pain reporting.