Comparative Evaluation of The Success of Biodentine, Silver Diamine Fluoride and Dycal When Used as An Indirect Pulp Capping Material in Primary Molars – A Clinical and Radiological Assessment.

Abstract

Introduction: Dental caries is a prevalent disease in primary teeth, often requiring treatment to preserve pulp vitality. Indirect pulp treatment (IPT) is a minimally invasive procedure aimed at preserving the pulp in deep carious lesions. Calcium hydroxide has been the traditional material for IPT, but newer materials like Biodentine and Silver Diamine Fluoride (SDF) offer advantages over calcium hydroxide. This study aimed to compare the clinical and radiological outcomes of Biodentine, SDF, and Dycal as IPT agents in primary molars. Materials and Methods: Forty-five primary molars in children aged 4–9 were randomly assigned to three groups: Biodentine, SDF, and Dycal. Clinical and radiographic assessments were conducted at baseline, 1 month, and 3 months after treatment. The mean distance between the pulp and the base of the restoration (Point A to Point B) was measured radiographically. Data were analyzed using statistical tests. Results: All three materials showed reparative dentin formation at 1 and 3 months. Biodentine demonstrated the highest amount of reparative dentin formation, followed by SDF and Dycal. Biodentine and SDF showed 100% clinical and radiographic success rates, with no adverse pulpal reactions. Dycal also showed positive outcomes, although less favorable compared to Biodentine and SDF. Conclusion: Biodentine, SDF, and Dycal are effective IPT materials for primary molars, with Biodentine demonstrating the highest reparative dentin formation. SDF can be considered an alternative in severe early childhood caries cases and uncooperative children. Further studies with larger sample sizes and histopathological investigations are needed to validate these findings.