Bioceramic Materıals in Vital Pulp Therapy of Prımary Teeth: A Contemporary Approach from Mta to New-Generatıon Calcıum Silicate-Based Materials

Maintaining primary teeth in the oral cavity until the time of physiological exfoliation is important for mastication, speech, esthetics, preservation of arch integrity, and guidance of permanent tooth eruption. Preserving pulp vitality in the treatment of deep dentinal caries has become one of the fundamental goals of modern pediatric dentistry. In the past, materials such as formocresol, ferric sulfate, and calcium hydroxide were used in pulpotomy techniques; however, advances in pulp biology and the development of bioactive materials have shifted treatment strategies from fixation or devitalization toward pulp preservation and support of biological healing. In this evolution, the high biocompatibility, sealing ability, capacity to create an alkaline environment, and ability to support mineralized tissue formation of mineral trioxide aggregate (MTA) have played an important role. Nevertheless, disadvantages of some MTA formulations, including long setting time, difficult handling, high cost, and discoloration, have led to the development of new calcium silicate-based materials. Biodentine, NeoMTA Plus, NeoMTA 2, and NeoPutty were developed to improve handling characteristics, physical properties, and color stability. Current clinical studies, systematic reviews, and meta-analyses report that MTA and Biodentine show high and generally comparable clinical and radiographic success rates in primary-tooth pulpotomy. Although new-generation premixed materials also show promising short- and medium-term results, their long-term clinical evidence is not as extensive as that for MTA and Biodentine. The aim of this review is to evaluate the biological properties, clinical applications, advantages, disadvantages, and current clinical evidence for calcium silicate-based bioceramic materials used in vital pulp therapy of primary teeth [1-4].