Dental caries is one of the greatest challenges faced to the integrity of the tooth. Dental caries is a biofilm—mediated, sugar—driven, multifactorial disease, which occurs throughout life, in primary and permanents dentitions, damaging the tooth crown, as suggested by several and recent studies . The dentist needs to acquire deeper understanding of the factors involved with caries management. To provide patients with best caries therapy and, risk assessment strategies, the, caries should be detection detected of caries at the earliest by using various advanced methods and techniques like, non-cavitated lesion management and conservative treatment modalities of management specific to defects, conservative caries removal and appropriate material selection. The basis for the current approach for caries removal in deep caries management is to understanding the changes that occur in tooth ultrastructure with the method and the rate of caries process progression is the basis for the current biological approach for caries removal especially in case deep caries management.
Traditional treatment for carious exposed pulps has been root canal treatment. To overcome this myth, deep caries management plays a significant role in persevering the vitality of the dental pulp. The main motto of operative therapy of deep carious lesions is the conservation of pulpal vitality of such teeth, which presents real task for dental clinicians. The complete caries excavation procedure is generally accepted by the clinicians over the stepwise excavation process for the treatment of deep caries management protocol [2,3,4]. In this treatment aspect, when the remaining dentinal thickness is less than 0.5 mm, the pulp is protected with a pulp protecting base. At present, there is substantial research done in dental materials focal point designed for the recognition of the dental materials which aid in production formation of strong dentinal bridge, other than long standing basic calcium hydroxide which is considered as gold standard material for pulp capping . This is done basically to avoid uncontrolled necrotic zone created by calcium hydroxide [6, 7]. Calcium hydroxide is bound to have other disadvantages like disintegration in the oral fluids,  formation of tunnel defects in dentinal bridges which lead to destruction over a period of time [3, 4, 7, 8]. Numerous materials such as hydroxyapatite, zinc oxide eugenol, tricalcium phosphate, bioceramics, propolis, dentin adhesives have been tried on pulp. These specific components (e.g. hydroxyapatite, tricalcium phosphate) have been found to exert a pivotal role in several osteoconductive and osteoinductive process, as suggested by several and recent studies . Tricalcium phosphate and its constituents like hydroxyapaptite have proven to enhance bone regeneration by escalating osteoconductivity for bone growth and improving bone remineralization by increasing the ion and growth factors release for osteoinductivity . Recently introduced Mineral Trioxide Aggregate (MTA) is one of the successful materials for the therapeutic treatment of deep caries lesions. Mineral Trioxide Aggregate, better known as MTA was introduced by Mahmoud Torabinejad in 1993. ProRoot® MTA (Dentsply Maillefer) a tricalcium based cement, has accentuated its usage in dentistry over the years in a successful way. Dentinal bridge formed with MTA when compared to that of calcium hydroxide, created effective hermetic seal which can unify with the dentin walls . Literature search about MTA has shown various advantages like biocompatibility,  good sealing ability,  and being insoluble in oral fluids . These beneficial effects have made it possible as a pulp capping agent for the treatment of deep caries management.
A lot of comparative studies has been conducted previously on treatment aspect of deep carious lesions,  nevertheless only a handful of them have studied the comparative effects of calcium hydroxide and MTA in the management of deep carious lesions . Only few studies have studied the beneficial effects of MTA. This in vivo study discusses cases of clinical management of deep carious lesions using MTA in the institutional set up with a follow up over one year.