Recent advances in medicaments used for indirect pulp treatment in primary teeth: A narrative review

Abstract

Dental caries remains one of the most widespread chronic disease affecting humans across the lifespan. In response to this challenge, therapeutic strategies have evolved toward minimally invasive, biologically driven approaches. Indirect Pulp Therapy (IPT) is recognized for its ability to manage deep carious lesions conservatively, particularly in primary teeth. A variety of materials have been utilized in IPT to maintain pulp vitality, provide a sufficient seal to the underlying dentin, and prevent any symptoms or signs after treatment. For a long time, calcium hydroxide has been recommended as the best material for IPT. To overcome the drawbacks of calcium hydroxide, a range of biocompatible materials like Resin modified glass ionomer (RMGI) with 2% chlorhexidine (CHX), Mineral trioxide aggregate (MTA), Biodentine, Propolis, TheraCal-LC, SDF, and Activa-Bioactive liner with good success rates in IPT of primary molars were listed. This review synthesizes recent advances in IPT medicaments from 2000 to 2024, evaluating their biological mechanisms, material properties, and clinical effectiveness. Modern alternatives to traditional calcium hydroxide, including bioactive, antimicrobial, and self-sealing materials, are assessed to support evidence-based decision-making in pediatric dental practice.