TheraCal is a light-cured, resin-modified calcium silicate material widely used in pediatric dentistry for vital pulp therapy. Its bioactive properties and ease of handling have positioned it as an alternative to traditional materials such as calcium hydroxide and mineral trioxide aggregate (MTA).
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✅ Introduction
Vital pulp therapy in primary dentition requires materials that promote pulp healing, dentin bridge formation, and bacterial control. TheraCal has emerged as a modern biomaterial combining calcium release and resin-based handling properties, addressing some limitations of conventional pulp-capping agents.
Its application in pediatric dentistry is increasing due to its clinical efficiency and reduced chair time, which are critical factors in managing young patients.
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TheraCal is a light-cured, resin-modified calcium silicate liner/base designed for direct and indirect pulp capping. It releases calcium ions, promoting mineralization and pulp healing.
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TheraCal LC (Light-Cured):
▪️ Most commonly used version
▪️ Indicated for pulp capping and as a liner
TheraCal PT (Pulpotomy Treatment):
▪️ Designed for pulpotomy procedures
▪️ Enhanced handling and consistency for coronal pulp therapy
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▪️ Calcium ion release → stimulates reparative dentin formation
▪️ Alkaline pH → antibacterial effect
▪️ Light-curing capability → immediate setting
▪️ Low solubility compared to calcium hydroxide
▪️ Resin-modified matrix → improved handling
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▪️ Direct pulp capping
▪️ Indirect pulp capping
▪️ Pulpotomy (TheraCal PT)
▪️ Base/liner under restorations
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▪️ Reduced chair time due to light curing
▪️ Immediate placement of restorative material
▪️ Improved seal and marginal adaptation
▪️ Enhanced patient cooperation in pediatric settings
▪️ Bioactivity supporting dentin bridge formation
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▪️ Presence of resin components may affect biocompatibility
▪️ Lower long-term evidence compared to MTA
▪️ Technique sensitivity (requires proper isolation)
▪️ Potential polymerization shrinkage
📊 Step-by-step Instructions: TheraCal Application in Pediatric Dentistry
| Clinical Step | Key Action | Clinical Consideration |
|---|---|---|
| Diagnosis and Case Selection | Confirm vital pulp and absence of irreversible pathology | Essential for treatment success |
| Cavity Preparation | Remove caries and clean the cavity | Avoid pulp overexposure when possible |
| Isolation | Apply rubber dam | Prevents contamination and moisture interference |
| Material Placement | Apply TheraCal in a thin layer (≤1 mm) | Do not overfill; ensure adaptation |
| Light Curing | Cure according to manufacturer instructions | Ensure adequate light intensity |
| Final Restoration | Place definitive restorative material | Immediate restoration is possible |
TheraCal represents a significant advancement in pulp therapy materials, particularly in pediatric dentistry where efficiency and ease of use are essential. Compared to traditional calcium hydroxide, it demonstrates superior physical properties and reduced solubility.
However, concerns remain regarding its resin content and long-term biological performance, especially when compared to materials such as MTA, which have extensive clinical validation. Current evidence supports its use in selective cases, but emphasizes the importance of proper case selection and technique.
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TheraCal is a promising biomaterial in pediatric dentistry, offering bioactivity, convenience, and improved clinical handling. While it is not a complete replacement for traditional materials, it serves as a valuable option in vital pulp therapy, particularly when efficiency is required. Further long-term studies are necessary to fully establish its clinical reliability.
🎯 Clinical Recommendations
▪️ Use TheraCal in well-selected vital pulp cases
▪️ Ensure proper isolation to optimize outcomes
▪️ Prefer TheraCal PT for pulpotomy procedures
▪️ Consider alternative materials (e.g., MTA) in cases requiring proven long-term success
▪️ Follow manufacturer instructions for curing time and thickness
📚 References
✔ Bortoluzzi, E. A., Niu, L. N., Palani, C. D., El-Awady, A. R., Hammond, B. D., Pei, D. D., ... & Tay, F. R. (2014). Cytotoxicity and osteogenic potential of silicate calcium cements as potential protective materials for pulpal revascularization. Dental Materials, 30(5), 475–483. https://doi.org/10.1016/j.dental.2014.02.002
✔ Gandolfi, M. G., Siboni, F., Prati, C. (2012). Properties of a novel light-cured calcium-silicate direct pulp capping material. International Endodontic Journal, 45(6), 571–579. https://doi.org/10.1111/j.1365-2591.2012.02014.x
✔ Hebling, J., Lessa, F. C. R., Nogueira, I., & de Souza Costa, C. A. (2019). Cytotoxicity of resin-based light-cured liners applied in deep cavities. Operative Dentistry, 44(3), E97–E105. https://doi.org/10.2341/17-282-L
✔ American Academy of Pediatric Dentistry. (2023). Pulp therapy for primary and immature permanent teeth. The Reference Manual of Pediatric Dentistry.
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