Calcium Silicate vs CaOH — ORE Part 1 MCQ

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ModerateDental MaterialsCalcium Silicate vs CaOHORE Part 1

In a vital permanent tooth requiring direct pulp capping, what is the principal advantage of a hydraulic calcium silicate cement, such as MTA or Biodentine, over calcium hydroxide?

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Correct answer: D — More predictable pulp healing with a continuous hard-tissue barrier

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as D · D = shown as E

A is correct. Compared with calcium hydroxide, hydraulic calcium silicate cements provide more predictable direct pulp-capping success and promote a thicker, more continuous hard-tissue barrier with less pulpal inflammation. This reflects their bioactivity, biocompatibility and favourable seal. B is incorrect because these materials are generally more expensive. C is not a class advantage: setting characteristics vary; conventional MTA may set relatively slowly. D is incorrect because calcium hydroxide itself has substantial antibacterial activity through its high pH. E is unreliable: handling and technique sensitivity depend on the particular product, and are not the principal reason to select a calcium silicate cement.

Reference: Herbst SR, Pitchika V, Herbst CS, Kosan E, Schwendicke F. Effectiveness of calcium hydroxide compared to hydraulic calcium silicate cements for direct pulp capping in managing deep caries in vital permanent teeth: A systematic review and meta-analysis. International Endodontic Journal, 2025. https://pubmed.ncbi.nlm.nih.gov/28855762/