In Vitro Evaluation of Novel Resin-Modified Calcium Silicate Cements for Minimally Invasive Vital Pulp

Abstract

OBJECTIVES: This study aimed to evaluate the biological effects of one conventional calcium silicate-based cement (MTA Angelus) and three resin-modified formulations (TheraCal PT, TheraBase Ca, and TheraCal LC) on human dental pulp stem cells (hDPSCs), focusing on cytocompatibility, cellular behaviour, and odontogenic/mineralization potential. METHODS: hDPSCs were cultured with material extracts at different dilutions (1:1, 1:2, 1:4). Cytocompatibility was assessed using MTT assay, wound-healing migration, and immunofluorescence for cytoskeletal organization. Cell adhesion and morphology were examined by SEM, while material composition was analysed by EDX. Odontogenic/osteogenic differentiation was evaluated through qRT-PCR for ALP, RUNX2, COL1A1, DSPP, BSP, and ON at 3 and 7 days, and extracellular matrix mineralization was quantified by Alizarin Red S staining at 21 days. Results were compared with untreated controls (P < .05). RESULTS: MTA Angelus exhibited the most favourable biological performance (P < .001), with high cytocompatibility, strong upregulation of odontogenic genes, and abundant mineralized nodule formation. TheraCal PT showed intermediate outcomes, with higher gene expression and mineralization capacity than TheraBase Ca (P < .001). TheraBase Ca provided the best cytocompatibility and cell adhesion among resin-modified cements (P < .05) but induced moderate differentiation and mineralization. In contrast, TheraCal LC displayed the lowest cell viability, impaired migration, and limited mineralization potential (P < .001). CONCLUSION: MTA Angelus remains the benchmark material for vital pulp therapy due to its robust bioactivity, while TheraCal PT and TheraBase Ca emerge as promising resin-modified alternatives, each with distinct biological advantages. TheraCal LC, however, demonstrated limited cytocompatibility and regenerative potential. CLINICAL SIGNIFICANCE: These findings highlight the importance of material selection in vital pulp therapy. Resin-modified calcium silicate cements may serve as alternatives, but MTA Angelus continues to offer the most predictable biological outcomes for pulp preservation and repair.