One of the biggest dilemmas in the treatment of deep caries lesions whether to restore it conservatively or to perform root canal treatment. In regard with this, there are two doctrine laid down which debated with the management of deep caries lesions. One doctrine debated that root canal treatment should be performed regardless of the pulpal status of the tooth. The second doctrine stated that the tooth can be treated conservatively with vital pulp therapy which helps in preservation of pulp. 
Vital pulp is the key factor for vital pulp therapy procedure. Pulp sensibility tests do not accurately dictate the vital status of the pulp. Hence, the treatment success of deep caries management depends on preservation of the vital component of the pulp while removing the diseased one. 
One more criterion for successful preservation of vital pulp is the placement of lining material. Over a decade, calcium hydroxide has been contemplated as the “gold standard” material for deep caries management procedure but due to certain disadvantages like tunnel defects, dissolution of material in oral fluids, etc. As an alternative to calcium hydroxide, the use of Mineral Trioxide Aggregate is in vogue. MTA being bioactive in nature incites the dental pulp cell proliferation, osteoblastic differentiation to form hard tissue in a shorter period of time and the dentinal interface had similar composition to hydroxyapatite.  MTA has been successfully used in various areas of endodontics as root end repair material, perforation repair, apexification etc. 
MTA is used in vital pulp therapy procedures and its outcome have shown tremendous successful results in direct and indirect pulp capping procedures thereby helping in dentinal regeneration and maintaining the pulpal vitality. 
Khaled Wagih Al–Saudi et al. histologically studied the pulpal repair after direct pulp capping procedure with MTA and concluded the formation of complete dentinal bridge formation without any inflammatory pulpal response. This is in accordance with the present clinical study which supports the fact that MTA is well used as pulp capping material.
The cases selected in this study were vital tooth without any history of spontaneous pain and periapical changes which played an important role for the success of the treatment Therefore, the condition of the pulp is very important for the conservative treatment modality. The degree of pulpal exposure and the pulpal bleeding highlights the severity of the pulpal inflammation.  For the direct pulp capping, various literature search has shown that “the amount of time to arrest the bleeding” should be between 5-10min, and this point is taken into consideration to differentiate between reversible and irreversible pulpitis.  However, in this study the time to arrest the bleeding was within the confined time, which indicated vital pulp.
Optimum clinical conditions like a) vital pulp, b) biomimetic pulp capping material like MTA, c) final restorative material play a very important role in the success of the treatment outcome. The success with this clinical study is mainly due to the nontoxic effect of Mineral Trioxide Aggregate on pulp and dentinal regeneration which will help in maintain the pulpal vitality and seals against all the microbes and the bacteria. In future, the clinical trial can be done with a larger study group.