Fadhil Wasan A, Noori Arass J
Dentistry, University of Sulaimani, Sulaymaniyah, IRQ.
Cureus. 2024 Jul 31;16(7):e65902. doi: 10.7759/cureus.65902. eCollection 2024 Jul.
Background Pulpotomy treatment is one of the vital pulp therapies that can play a major role in the preservation of primary teeth until their natural exfoliation. The objective of this current clinical trial was to assess the clinical and radiographical success of diode and Er,Cr:YSGG lasers as a viable alternative to formocresol (FC) and sodium hypochlorite in the primary molar pulpotomies. Materials and methods Sixty primary molars were selected and randomly allocated to four groups. All treatment groups followed the same clinical protocol, except for the techniques used for hemostasis of the pulpotomy sites. In group A, hemostasis was achieved by applying a 1:5 dilution of FC solution, whereas in group B, 3% sodium hypochlorite was applied to achieve hemostasis. In group C, exposure to a diode laser of 940 nm was performed, whereas for group D, erbium laser irradiation with Er,Cr:YSGG laser of 2,780 nm was employed to achieve hemostasis. Radicular pulp stamps were covered with a 2 mm layer of mineral trioxide aggregate (MTA) paste. Stainless steel crowns were utilized for the final restorations of the primary teeth. The clinical and radiographic outcomes were evaluated at the six- and 12-month follow-up intervals. The investigation was registered with the ClinicalTrials.gov Protocol and Registration System (ID: NCT06002646). Results The overall clinical and radiographic success rates of pulpotomy were 92.3% for FC, 89% for sodium hypochlorite, 98.3% for a diode laser, and 98.7% for Er,Cr:YSGG lasers. There were no statistically significant differences among the four groups (p > 0.05). Conclusions Both the diode and Er,Cr:YSGG lasers showed outcomes comparable to those of FC and sodium hypochlorite. Therefore, they could be promising alternatives to primary tooth pulpotomies.
活髓切断术是重要的牙髓治疗方法之一,在乳牙自然脱落前的保存中可发挥重要作用。本临床试验的目的是评估二极管激光和铒铬钇石榴石(Er,Cr:YSGG)激光在乳牙活髓切断术中作为甲醛甲酚(FC)和次氯酸钠可行替代方法的临床和影像学成功率。
选取60颗乳牙第一磨牙并随机分为四组。除活髓切断部位止血所用技术外,所有治疗组均遵循相同的临床方案。A组通过应用1:5稀释的FC溶液实现止血,而B组应用3%次氯酸钠实现止血。C组进行940 nm二极管激光照射,而D组采用2780 nm的Er,Cr:YSGG激光照射以实现止血。根管牙髓断端覆盖2 mm厚的三氧化矿物凝聚体(MTA)糊剂。采用不锈钢冠对乳牙进行最终修复。在6个月和12个月的随访间隔时评估临床和影像学结果。本研究已在ClinicalTrials.gov方案和注册系统注册(标识符:NCT06002646)。
活髓切断术的总体临床和影像学成功率分别为:FC组92.3%,次氯酸钠组89%,二极管激光组98.3%,Er,Cr:YSGG激光组98.7%。四组之间无统计学显著差异(p>0.05)。
二极管激光和Er,Cr:YSGG激光的治疗效果与FC和次氯酸钠相当。因此,它们有望成为乳牙活髓切断术的替代方法。