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Reversible PulpitisNCT07147036

Effectiveness of Biodentine v/s Calcium Hydroxide as Indirect Pulp Capping Materials

A study testing Biodentine - Indirect Pulp Capping and Calcium Hydroxide - Indirect Pulp Capping in people with Reversible Pulpitis, run by Zahoor khan at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study compares the clinical and radiographic effectiveness of Biodentine and Calcium Hydroxide as indirect pulp capping materials in mature permanent teeth with reversible pulpitis. A total of 76 patients were randomly assigned to two groups. Read more about this study

Who is it for?
Ages 20 to 45 years
Conditions the study is for
Reversible Pulpitis
What is being tested?
Biodentine - Indirect Pulp Capping and Calcium Hydroxide - Indirect Pulp Capping
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
76 participants
Where
1 sitePakistan
Study dates
5 Feb 2023to 5 Feb 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Participants must meet all of the following criteria to be included in the study:
  • Age: 20 to 45 years.
  • Tooth Type: Mature permanent teeth (maxillary or mandibular).
  • Caries Status: Occlusal carious lesions without previous restorations.
  • Pulpal Diagnosis: Reversible pulpitis confirmed by:
  • Patient history and clinical examination
Show all 10Show fewer
  • Positive response to thermal (cold) and electric pulp tests
  • No tenderness to percussion
  • Radiographic Assessment: Carious lesion corresponding to ICDAS radiographic score RC-5.
  • Periapical Status: No signs of periapical radiolucency or root resorption on radiograph.

Who cannot join

  • Participants will be excluded if they meet any of the following:
  • Teeth exhibiting signs of irreversible pulpitis or pulp necrosis.
  • Tenderness to percussion on clinical examination.
  • Pulp exposure during caries removal.
  • Systemic conditions that may interfere with healing or immune response, including:
  • Chronic systemic illness
Show all 9Show fewer
  • Immunocompromised status
  • Pregnancy
  • -Third molars (due to anatomical and treatment variability)

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • HITEC-IMS Taxila

    Rawalpindi, Punjab Province, 47080

Other trials in Pakistan

About this study

Official title: Comparison of Effectiveness of Biodentine Versus Calcium Hydroxide as Indirect Pulp Capping Material in Mature Permanent Teeth

This study compares the clinical and radiographic effectiveness of Biodentine and Calcium Hydroxide as indirect pulp capping materials in mature permanent teeth with reversible pulpitis. A total of 76 patients were randomly assigned to two groups. Outcomes were assessed over 12 weeks based on pain, periapical radiolucency, and PDL widening. The goal was to determine which material better preserves pulp vitality

Read the detailed description

Introduction:

Preservation of pulp vitality is critical for the long-term health and functionality of teeth. The pulp can be compromised due to caries, trauma, or iatrogenic factors. One conservative treatment to preserve pulp vitality in teeth with deep carious lesions and reversible pulpitis is indirect pulp capping (IPC).

Traditionally, Calcium Hydroxide (Ca(OH)₂) has been the gold standard material for IPC due to its antibacterial properties and its ability to stimulate the formation of reparative dentin. However, it has several limitations such as poor bonding to dentin, high solubility, and low mechanical strength, which may affect long-term success.

Biodentine, a newer bioactive dentin substitute, has emerged as a potential alternative due to its biocompatibility, bioactivity, antibacterial effect, good sealing ability, and high compressive strength. These properties suggest Biodentine may offer superior clinical outcomes in preserving pulp vitality when used as an indirect pulp capping material.

Objective:

To compare the clinical and radiographic effectiveness of Biodentine versus Calcium Hydroxide as indirect pulp capping agents in mature permanent teeth with reversible pulpitis.

Study Design:

Type: Experimental comparative study

Setting: Department of Operative Dentistry \& Endodontics, HITEC-IMS, Taxila

Duration: 1 year (after IRB approval)

Sample Size: 76 patients (38 in each group), calculated using WHO sample size calculator

Sampling Technique: Non-probability consecutive sampling

Inclusion Criteria:

Patients aged 20-45 years

Teeth with occlusal carious lesions with ICDAS radiographic score RC-5

Vital teeth with signs of reversible pulpitis

No signs of root resorption

Exclusion Criteria:

Teeth tender to percussion

Irreversible pulpitis or non-vital pulp

Medically compromised or pregnant patients

Third molars or teeth with pulp exposure during caries excavation

Materials Used:

Group I: Biodentine (Septodont, France)

Group II: Calcium Hydroxide (Dycal)

Base Material: Self-cure Glass Ionomer Cement (Fuji, Japan)

Final Restoration: Light-cure composite resin

Disinfectant: 0.2% Chlorhexidine

Vitality Tests: Cold test and electric pulp test

Caries Removal: Round bur (#BR-45) under copious water spray

Isolation: Rubber dam

Procedure:

Pre-operative Steps:

Informed consent obtained

Patient assessment: history, clinical examination, vitality testing, radiographs

Operative Steps:

Group I (Biodentine):

Caries removed and cavity prepared

Biodentine mixed per manufacturer's instructions and placed

After 1 week, a GIC base applied

Final composite restoration placed

Post-op radiograph taken

Group II (Calcium Hydroxide):

Caries removed and cavity dried

0.5 mm Dycal applied and allowed to set (2-3 min)

GIC base placed immediately afterward

Final composite restoration after 1 week

Post-op radiograph taken

Follow-Up Intervals:

2 weeks

6 weeks

12 weeks

Evaluation Criteria:

Clinical Parameters:

Pain (reversible or persistent)

Tenderness to percussion

Response to pulp vitality tests

Radiographic Parameters:

Presence or absence of periapical radiolucency

Periodontal ligament (PDL) space widening

Data Collection Tool:

Data was recorded using a structured proforma (Annexure-C), documenting all clinical and radiographic parameters at baseline and follow-up intervals.

Statistical Analysis:

Software: SPSS Version 26

Quantitative Variables: Mean ± standard deviation (e.g., age, weight)

Qualitative Variables: Frequency and percentage (e.g., pain, radiographic changes)

Test Used: Chi-square test

Level of Significance: p < 0.05 considered statistically significant

Ethical Considerations:

Approved by Institutional Review Board (IRB) and College Ethical Committee

Written informed consent obtained in both English and Urdu

Patient confidentiality strictly maintained

Participants allowed to withdraw at any time without affecting treatment

Budget and Funding:

Funded by Dental College, HITEC-IMS, Taxila

No financial burden on participants

Estimated duration for study completion: 1 year

Expected Outcome:

The study aims to determine whether Biodentine, with its superior physical and biological properties, provides better clinical and radiographic outcomes in indirect pulp capping procedures compared to Calcium Hydroxide in mature permanent teeth.

Being tested
Biodentine - Indirect Pulp Capping, Calcium Hydroxide - Indirect Pulp Capping

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Biodentine - Indirect Pulp CappingProcedure or surgery

    Caries removal under rubber dam isolation using round bur (#BR-45) and water spray

    Tooth disinfection with 0.2% chlorhexidine

    Mixing of Biodentine (Septodont, France) in an amalgamator (30 seconds at 4000 rpm)

    Placement of Biodentine into the prepared cavity using an amalgam carrier and condensation

    After 1 week: Placement of self-cure GIC (Fuji, Japan) as a base

    Final restoration with light-cure composite resin

    Follow-up at 2, 6, and 12 weeks

  • Calcium Hydroxide - Indirect Pulp CappingProcedure or surgery

    Caries removal under rubber dam isolation using round bur (#BR-45) and water spray

    Tooth disinfection with 0.2% chlorhexidine

    Cavity dried with cotton pellet

    Placement of a 0.5 mm layer of Calcium Hydroxide (Dycal)

    After 2-3 minutes (setting time): Placement of self-cure GIC (Fuji, Japan)

    After 1 week: Final restoration with light-cure composite resin

    Follow-up at 2, 6, and 12 weeks

Study groups in NCT07147036
Study groupRoleWhat they receive
Biodentine GroupExperimentalParticipants receive Biodentine as the indirect pulp capping material
Receives: Procedure: Biodentine - Indirect Pulp Capping
Calcium Hydroxide GroupActive comparatorParticipants receive Calcium Hydroxide (Dycal) as the indirect pulp capping material
Receives: Procedure: Calcium Hydroxide - Indirect Pulp Capping

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Radiographic assessment by Periapical Index (PAI)

    PAI Scoring Criteria:

    Score Radiographic Features Interpretation

    1. Normal periapical structures Healthy PDL and periapical tissues
    2. Small changes in bone structure (slight PDL widening) Mild changes; potentially reversible
    3. Changes in bone structure with mineral loss Moderate periapical inflammation
    4. Well-defined radiolucent area Established periapical periodontitis
    5. Severe radiolucency with bone destruction Advanced periapical disease

    Application in my Study:

    At each follow-up (2, 6, 12 weeks), periapical radiographs should be:

    Evaluated using the PAI score

    Compared to baseline radiographs

    Scores ≤2 are generally considered favorable outcomes

    Scores ≥3 indicate disease or failure

    Measured: Follow-up Timeline for Each Patient: Patients will be evaluated at the following intervals after the indirect pulp capping procedure: Baseline (Initial Treatment) 2 weeks follow-up 6 weeks follow-up 12 weeks follow-up

  2. Visual Analog Scale (VAS) for Pain Measurement

    1. Pain Assessment

    Type: Spontaneous or provoked

    Tool: Patient history and Visual Analog Scale (VAS) for Pain Measurement

    Classification:

    No pain

    Mild/transient pain (indicative of successful pulp healing)

    Moderate to severe pain (suggestive of pulpal inflammation or failure)

    Interpretation:

    Absence of pain considered a positive outcome.

    Persistent or worsening pain may indicate treatment failure or progression to irreversible pulpitis

    Visual Analog Scale (VAS) for Pain Measurement

    Description:

    A 10 cm horizontal line representing a continuum of pain intensity.

    One end (0 cm) represents "No pain", and the other end (10 cm) represents "Worst possible pain".

    Scoring Criteria:

    VAS Score (cm) Pain Intensity 0 No pain 1-3 Mild pain 4-6 Moderate pain 7-10 Severe pain

    Application in my Study: Patients can be asked to mark their pain level on the scale at:

    Baseline

    2-week

    6-week

    12-week follow-up visits

    Measured: Patients pain level can be measured on the scale at: Baseline 2-week 6-week 12-week follow-up visits

  3. Tenderness to Percussion

    1. Tenderness to Percussion

    Tool: Blunt end of dental mirror gently tapped on the occlusal surface

    Response Categories:

    Absent: No discomfort or pain on percussion (favorable response)

    Present: Pain on percussion, indicating potential periapical inflammation or pulp degeneration

    Interpretation:

    Lack of tenderness is a favorable clinical outcome.

    Positive percussion response may suggest underlying periapical involvement or pulpal pathology.

    Measured: Patients tenderness to percussion will be checked at: Baseline 2-week 6-week 12-week follow-up visits

  4. Pulp Vitality Testing : Cold test (Endo-Ice or refrigerant spray on cotton pellet) and Electric Pulp Test (EPT)

    Pulp Vitality Testing

    Methods Used:

    Cold test (Endo-Ice or refrigerant spray on cotton pellet)

    Electric Pulp Test (EPT)

    Response Categories:

    Normal response: Short, sharp, non-lingering sensation (indicative of vital pulp)

    Exaggerated or lingering pain: Suggestive of reversible/irreversible pulpitis

    No response: Indicative of non-vital or necrotic pulp

    Interpretation:

    A normal response to cold or EPT at follow-up implies successful preservation of pulp vitality.

    No response or lingering pain may indicate pulp necrosis or treatment failure

    Measured: Patients tooth vitality testing will be done at: Baseline 2-week 6-week 12-week follow-up visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Aug 2025
  2. Study start5 Feb 2023
  3. Primary completion5 Feb 2024
  4. Study completion5 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07147036
Sponsor's protocol ID
Dental/HITEC/IRB/41
Status last verified
Sep 2025
First submitted
8 Aug 2025
Last updated
15 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Biodentine - Indirect Pulp Capping and Calcium Hydroxide - Indirect Pulp Capping in people with Reversible Pulpitis, run by Zahoor khan at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Radiographic assessment by Periapical Index (PAI) (time frame: Follow-up Timeline for Each Patient: Patients will be evaluated at the following intervals after the indirect pulp capping procedure: Baseline (Initial Treatment) 2 weeks follow-up 6 weeks follow-up 12 weeks follow-up). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2025.

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