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Combination effects of diode laser and resin-modified tricalcium silicate on direct pulp capping treatment of caries exposures in permanent teeth: a randomized clinical trial

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Abstract

Objective

The purpose of this randomized clinical trial was to evaluate efficiency of diode 808-nm (Picasso-AMD, USA) laser using power 1.5 W, continuous wave (CW), fiber diameter of 400 μm, non-initiated and in contact mode, tip angle set at 90°, beam divergence 16°, 2 s per an area with 1-mm diameter, power density 190.98 W/cm2, energy density 381.97 J/cm2, vertical and horizontal scanning movement on the exposure site, and laser irradiation combined with a resin-based tricalcium silicate material (TheraCal LC, Bisco, USA) in direct pulp capping in caries exposures of permanent teeth over a period of 6 months.

Material and methods

In this randomized clinical trial, a total of 20 anterior and posterior vital teeth without symptoms and radiographic changes of 14 patients between the age group of 15–35 years, of which randomly 10 teeth were considered, each for TheraCal LC, the exposed area was sealed with TheraCal paste and TheraCal combined with diode laser; the treated area was sealed with TheraCal paste after diode 808-nm laser irradiation. At the 1-, 3-, and 6-month recall examinations, the loss of vitality, spontaneous pain, reactions to thermal stimuli and percussion, and radiographic changes were considered failure. The samples were randomly divided using runs test. Measurements on the digitized radiograph were performed at the recalls. The data were analyzed by repeated measurements ANOVA using SPSS 25.

Results

Analysis had indicated that at the end of follow-ups, a statistically significant increase in dentin thickness with both groups (p value < 0.001) was found. Clinically, diode laser group has shown better results (p value < 0.001); however, radiographically, no significant difference was observed between groups (p value = 0.56). In both groups, the highest thickness of dentin formed was at the first month; 0.40 mm ± 0.19 mm (p value < 0.001).

Conclusion

Diode laser 808 nm under proper parameters combined with TheraCal LC can be recommended for direct pulp therapy in caries exposure of permanent teeth.

Clinical trial registration

This research was approved by Esfahan Medical University, Dental School, Azad Branch (KHUISF)) Esfahan, Iran [IR.IAU.KHUISF.REC.1397.261].

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Acknowledgments

This study was extracted from a thesis prepared by Iraj Yazdanfar in fulfillment of the requirements for the Specialist in Operative Dentistry at the KHUISF Esfahan University Azad Branch, Department for Restorative and Conservative Dentistry Esfahan, Iran. I also offer my special thanks to Professor Seyed Mostafa Mousavynasab, Dr. Parvin Mirzakuchaki, Dr. Maziar Mir, Dr. Kavan Ahmadi, Dr. Mehrdad Jalalian, Dr. Abolfazl Nejati, and Fatemeh Mehrabpour for their guidance with the scientific writing and his support in the publication of this paper.

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Authors and Affiliations

  1. Laser in Dentistry, RWTH University, Aachen, Germany

    Iraj Yazdanfar

  2. Restorative and Conservative Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

    Iraj Yazdanfar

  3. Department of Restorative and Conservative Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

    Mehrdad Barekatain

  4. Department of Endodontic, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

    Maryam Zare Jahromi

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  1. Iraj Yazdanfar
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  3. Maryam Zare Jahromi
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Correspondence to Mehrdad Barekatain.

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Yazdanfar, I., Barekatain, M. & Zare Jahromi, M. Combination effects of diode laser and resin-modified tricalcium silicate on direct pulp capping treatment of caries exposures in permanent teeth: a randomized clinical trial. Lasers Med Sci 35, 1849–1855 (2020). https://doi.org/10.1007/s10103-020-03052-9

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