Natural nanoparticles versus the gold standard in direct pulp capping: a randomized clinical trial

This study compared the efficacy of nanopropolis and nanocurcumin as direct pulp-capping agents to that of mineral trioxide aggregate (MTA) in recently erupted permanent molars, assessing the clinical and radiographic outcomes over six months. Thirty six permanent molars were randomly allocated to three groups (n = 12 each): MTA (control), nanopropolis and nanocurcumin. The study followed a double-blind design. Clinical and radiological evaluations assessed pain, percussion sensitivity and swelling preoperatively and one week, three months and six months afterwards. At one week, the nanocurcumin group showed significantly higher pain levels than the MTA and nanopropolis groups. The pain scores equalised by three months and remained stable until six months in all groups. Percussion sensitivity and swelling occurred in 8.3% of cases in the MTA group, 25% in the nanopropolis group and 16.7% in the nanocurcumin group. Nanopropolis and nanocurcumin provided clinical and radiographic outcomes comparable to MTA in direct pulp capping of recently erupted permanent molars. While MTA showed slightly superior attributes, the natural nanomaterials present viable alternatives. This study supports the potential use of bioactive nanomaterials derived from natural sources in vital pulp therapy, though longer-term investigations are warranted.