Comparison of Mineral Trioxide Aggregate (MTA), Biodentine, and Calcium-Enriched Mixture Cement in Pulpotomy Procedures

Abstract

Pulpotomy is still one of the pillars of vital pulp therapy, whereby the goal is to maintain the vitality of the functional pulpof the tooth, and to remove inflamed tissue. The decision of pulp-capping material is a strong determinant of the successof this procedure since biocompatibility of the material, its sealing power, and the ability to induce the growth of dentinbridges are strong determinants of the prognosis in the long-term. Mineral Trioxide Aggregate (MTA), Biodentine, andCalcium-Enriched Mixture(CEM) cement are the most popular bioactive cement to study in pulpotomy. MTA has shownstable clinical results because of its high sealing capacity and biological characteristics but limitations to its universal useare the time-consuming setting and difficulties in handling. Biodentine is an interesting dentin substitute with good handlingproperties and quicker setting, as well as, bioactivity, and less microleakage, and is a clinically appealing option. With itscalcium-based composition, CEM cement demonstrates antimicrobial property, dentinogenic potential, and cost-efficiencythat makes it a prospective material in the wide range of clinical solutions.Recent data indicate that there are similar clinical rates of success with these three materials, but that differences existin the characteristics of handling, radiographic results and the patient’s consideration. The use of advanced diagnosticsystems, including cone-beam computed tomography (CBCT), has also contributed to the possibility of measuring theoutcomes of healing and treatment and making evidence-based decisions regarding the choice of material. Together, theexisting literature facilitates the application of MTA, Biodentine, and CEM cement as the viable alternative in pulpotomy,and the choice has been usually under the influence of the case requirements, the preference of an operator, as well asavailability of materials. Long-term follow-ups should be done in the future to fine tune the clinical procedures and drawfinal guidelines on the use of these in the vital pulp therapy.