Non-Cochrane · intervention · PM42649488
Efficacy of theracal as pulp capping material in permanent dentition: a systematic review and meta-analysis.
Mohamed Maged Ahmed, Waly Rim, Mahmoud Shahd, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-09008-9
Findings
14 findings
| Population | ||||
|---|---|---|---|---|
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | Biodentine | Clinical and/or radiographic success rate All timepoints combined (overall total in forest plot) | RR 0.97 [0.90, 1.04] GRADE not reported 3 studies · 564 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | Biodentine | Clinical and/or radiographic success rate 12 months | RR 0.91 [0.80, 1.04] 67 [-150, 30] per 1000 Moderate Downgraded: risk of bias 2 studies · 254 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | Biodentine | Clinical and/or radiographic success rate 6 months | RR 1.00 [0.91, 1.09] 0 [-76, 76] per 1000 Moderate Downgraded: risk of bias 3 studies · 310 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | calcium hydroxide | Clinical and/or radiographic success rate 6 months | RR 1.03 [0.92, 1.16] -24 [-64, 129] per 1000 Moderate Downgraded: risk of bias 3 studies · 289 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | calcium hydroxide | Clinical and/or radiographic success rate All timepoints combined (overall total in forest plot) | RR 1.03 [0.94, 1.12] GRADE not reported 3 studies · 546 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | calcium hydroxide | Clinical and/or radiographic success rate 12 months | RR 1.02 [0.88, 1.17] -15 [-90, 127] per 1000 Moderate Downgraded: risk of bias 2 studies · 257 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | MTA | Clinical and/or radiographic success rate 6 months | RR 0.99 [0.91, 1.08] 9 [-77, 68] per 1000 Moderate Downgraded: risk of bias 3 studies · 312 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | MTA | Clinical and/or radiographic success rate 12 months | RR 0.88 [0.78, 1.00] 90 [-97, 0] per 1000 Moderate Downgraded: risk of bias 2 studies · 257 participants |
| Permanent teeth with vital pulp undergoing direct pulp capping | TheraCal LC | MTA | Clinical and/or radiographic success rate All timepoints combined (overall total in forest plot) | RR 0.95 [0.89, 1.02] GRADE not reported 3 studies · 569 participants |
| Permanent teeth with vital pulp undergoing indirect pulp capping | TheraCal LC | calcium hydroxide | Clinical and/or radiographic success rate 6 months | RR 1.04 [0.95, 1.15] -39 [-48, 145] per 1000 Moderate Downgraded: risk of bias 2 studies · 64 participants |
| Permanent teeth with vital pulp undergoing indirect pulp capping | TheraCal LC | calcium hydroxide | Clinical and/or radiographic success rate 12 months | RR 1.02 [0.89, 1.17] -20 [-108, 167] per 1000 Moderate Downgraded: risk of bias 2 studies · 98 participants |
| Permanent teeth with vital pulp undergoing indirect pulp capping | TheraCal LC | calcium hydroxide | Clinical and/or radiographic success rate All timepoints combined (overall total in forest plot) | RR 1.00 [0.96, 1.05] GRADE not reported 3 studies · 200 participants |
| Permanent teeth with vital pulp undergoing indirect pulp capping | TheraCal LC | light-cured calcium hydroxide | Clinical and/or radiographic success rate All timepoints combined (overall total in forest plot) | RR 1.06 [0.95, 1.18] GRADE not reported 2 studies · 82 participants |
| Permanent teeth with vital pulp undergoing indirect pulp capping | TheraCal LC | light-cured calcium hydroxide | Clinical and/or radiographic success rate 6 months | RR 1.05 [0.93, 1.18] -48 [-67, 173] per 1000 Moderate Downgraded: risk of bias 2 studies · 54 participants |
Included primary studies 15
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Peskersoy 2020 Efficacy of different calcium silicate materials as pulp-capping agents: Randomized clinical trial. PMID:33854725 | 2021 | 2 other reviews | not stated | not extracted yet |
| Awadhesh 2025 Comparative evaluation of four different calcium-based medicaments as an indirect pulp capping agent: An in vivo study. PMID:41169767 | 2025 | 1 other review | not stated | not extracted yet |
| Bayoumy 2021 Clinical and microbiological evaluation of calcium silicate versus calcium hydroxide in two-step indirect pulp treatment: A randomized… DOI:10.4103/jioh.jioh_33_20 | 2021 | 1 other review | not stated | not extracted yet |
| Caliver 2024 (Semprum-Clavier) Clinical Comparison of Three Indirect Pulp Capping Restorative Protocols: A Randomized Controlled Prospective Study. PMID:38180467 | 2024 | 1 other review | not stated | not extracted yet |
| Iyer 2021 Comparative evaluation of different direct pulp capping agents in carious tooth: An in vivo study. PMID:35035155 | 2021 | 1 other review | not stated | not extracted yet |
| Rahman 2021 Comparative Evaluation of Indirect Pulp Therapy in Young Permanent Teeth using Biodentine and Theracal: A Randomized Clinical Trial. PMID:34192759 | 2021 | 1 other review | not stated | not extracted yet |
| Velioglu 2021 Dört Direkt Pulpa Kapaklama Materyalinin Klinik Takibinin Değerlendirilmesi: Bir Klinik Çalışma DOI:10.15311/selcukdentj.829044 | 2021 | 1 other review | not stated | not extracted yet |
| Abd El-Naby 2023 Randomized Clinical Trial to Compare the Efficacy of Two Calcium Silicate Based Materials in Treatment of Deep Carious Lesion. DOI:10.21608/ajdsm.2021.110343.1277 | 2023 | this review only | not stated | not extracted yet |
| Caliver 2024 Clinical Comparison of Three Indirect Pulp Capping Restorative Protocols: A Randomized Controlled Prospective Study DOI:10.2341/22-094-c | 2024 | this review only | not stated | not extracted yet |
| Cengiz 2015 Efficacy of Erbium, Chromium-doped:Yttrium, Scandium, Gallium, and Garnet Laser Irradiation Combined with Resin-based Tricalcium Silicate… DOI:10.1016/j.joen.2015.11.015 | 2016 | this review only | not stated | not extracted yet |
| Cengiz 2015 Efficacy of Erbium, Chromium-doped:Yttrium, Scandium, Gallium, and Garnet Laser Irradiation Combined with Resin-based Tricalcium Silicate… PMID:26723484 | 2016 | this review only | not stated | not extracted yet |
| Deshmukh 2024 Comparative Evaluation of Efficacy of Resin-modified Glass Ionomer Cement and Light-curable Tricalcium Silicate Cement as Indirect Pulp… DOI:10.5005/jp-journals-10024-3797 | 2025 | this review only | not stated | not extracted yet |
| Deshmukh 2024 Comparative Evaluation of Efficacy of Resin-modified Glass Ionomer Cement and Light-curable Tricalcium Silicate Cement as Indirect Pulp… PMID:40079993 | 2024 | this review only | not stated | not extracted yet |
| Mahapatra 2022 Comparative Evaluation of the Efficacy of Light-Cured Calcium Hydroxide and a Fourth-Generation Calcium Silicate Cement (TheraCal LC) as… PMID:36225416 | 2022 | this review only | not stated | not extracted yet |
| Rahman 2021 Comparative Evaluation of Indirect Pulp Therapy in Young Permanent Teeth using Biodentine and Theracal: A Randomized Clinical Trial DOI:10.17796/1053-4625-45.3.3 | 2021 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human studies involving permanent teeth with vital pulp undergoing direct pulp capping (DPC) or indirect pulp capping (IPC) | Permanent teeth with vital pulp, adults mostly aged 15 to 45 years and young permanent teeth; DPC and IPC (n=11 RCTs; 20 to 525 teeth/patients per study) |
| Intervention | TheraCal (TheraCal LC or TheraCal PT) as pulp-capping material | TheraCal LC (n=11) |
| Comparison | Calcium hydroxide, MTA, Biodentine, resin-modified calcium silicate materials, no treatment, or placebo | Calcium hydroxide, light-cured calcium hydroxide, MTA, Biodentine, CEM cement, RMGIC, no liner |
| Outcomes | Primary: clinical and/or radiographic success rate; secondary: dentin bridge formation, postoperative pain, pulp inflammation or necrosis | Success rate (pooled); pain and dentin bridge formation (narrative, Supplementary Table S3) |
| Study designs | Randomized controlled trials | RCTs (n=11) |
| Timing | Not specified | 6 to 36 months follow-up; pooled at 3, 6 and 12 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |