Clinical and radiographic outcomes of three calcium silicate-based cements in primary tooth pulpotomy: a randomized clinical trial

Background: Advancements in technology have enabled successful outcomes to be achieved in primary tooth pulpotomy treatments using various materials. This randomized clinical trial aimed to compare the 12-month clinical and radiographic success rates of three calcium silicate-based cements with different physical forms in primary tooth pulpotomy. Methods: A total of 112 primary second molars from 70 children were block-randomized into three groups: ProRoot® MTA (powder–liquid form, n = 38), NeoPutty® (ready-to-use putty form, n = 36), and TheraCal PT® (light-cured, resin-modified calcium silicate, n = 38). Teeth underwent pulpotomy followed by stainless steel crown restoration. Clinical and radiographic success rates were evaluated at 1, 3, 6, and 12 months. Statistical analysis was performed at a significance level of 0.05. Results: At the 12-month follow-up, the clinical and radiographic success rates were 97.2% and 91.7% for NeoPutty® MTA, 97.4% and 84.2% for ProRoot® MTA, and 91.9% and 67.6% for TheraCal PT®, respectively. Radiographically, TheraCal PT® demonstrated significantly lower success compared to the other materials (p = 0.026). Conclusion: Although the light-cured TheraCal PT® demonstrated clinical outcomes comparable to those of MTA-based materials, its inferior radiographic performance raises concerns regarding its long-term effectiveness. Trial registration: The study was registered retrospectively at ClinicalTrials.gov (https://clinicaltrials.gov) with the ID NCT06874062 (2025-03-03).