Indirect Pulp Treatment for Deep Carious Lesions in Mature Permanent Teeth: A Preventive, Minimally Invasive Clinical Approach

Background: Indirect pulp treatment (IPT) is a conservative approach aimed at preserving pulp vitality in teeth with deep carious lesions. In adult patients, however, evidence comparing different liner materials remains limited. Objectives: To assess the 12-month clinical and radiographic outcomes of IPT performed with Biodentine and resin-modified glass ionomer cement (RMGIC) in mature permanent teeth. Methods: A split-mouth clinical study was conducted in adult patients presenting with deep carious lesions in vital permanent teeth. Following selective caries removal, IPT was completed using Biodentine or RMGIC under a standardized operative protocol. Clinical and radiographic evaluations were performed at baseline and after 12 months. Outcomes included pulp vitality, postoperative pain, and radiographic changes. Results: At 12 months, pulp vitality was preserved in over 90% of treated teeth in both groups, with no statistically significant differences between materials. Teeth treated with Biodentine showed lower postoperative pain scores at 24 h compared with those treated with RMGIC, although this difference resolved within the first postoperative week. Radiographic outcomes were comparable between groups, with a low incidence of periapical changes. Conclusions: Within the limits of this interim analysis, IPT performed with either Biodentine or RMGIC resulted in similar clinical and radiographic outcomes in mature permanent teeth. These findings indicate that pulp vitality preservation can be achieved using different liner materials when minimally invasive principles and effective coronal sealing are applied. Extended follow-up is required to evaluate long-term durability.