Vital pulp therapy (VPT) aims to preserve the health and function of the dental pulp following pulpal exposure. Direct pulp capping (DPC) is a conservative treatment modality in which a biocompatible material is placed directly over an exposed pulp to promote healing and reparative dentin formation. The outcome of DPC depends on appropriate case selection, control of infection, management of the pulp exposure, and selection of a suitable capping material.

This case series presents the clinical management and follow-up of four permanent posterior teeth with deep carious lesions and pinpoint pulpal exposures treated using different pulp-capping materials. Following clinical examination, pulp sensibility testing, radiographic assessment, isolation, and management of the exposure, DPC was performed using Dycal, Biodentine, mineral trioxide aggregate (MTA), and platelet-rich fibrin (PRF) in four individual cases. The treated teeth were restored and followed clinically and radiographically for 12 months.

Follow-up assessment focused on symptoms, pulp sensibility, percussion and palpation, mobility, soft-tissue findings, periodontal ligament space, lamina dura, periapical status, root resorption, and evidence of dentin bridge formation where assessable. The cases illustrate the potential of conservative pulp therapy to maintain pulp vitality in appropriately selected permanent teeth.