International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 16 , ISSUE 4 ( July-August, 2023 ) > List of Articles


Comparative Evaluation of Low-level Diode Laser and Electrosurgical Pulpotomy in Primary Molars

Sayani Roy

Keywords : Electrosurgery, Low-level diode laser therapy, Pulpotomy

Citation Information : Roy S. Comparative Evaluation of Low-level Diode Laser and Electrosurgical Pulpotomy in Primary Molars. Int J Clin Pediatr Dent 2023; 16 (4):612-618.

DOI: 10.5005/jp-journals-10005-2632

License: CC BY-NC 4.0

Published Online: 11-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: Considering the advantages of the nonpharmacotherapeutic techniques over the disadvantages of the pharmacotherapeutic agents, there is a need to evaluate clinically as well as radiographically various nonpharmacotherapeutic techniques to fortify them as replacements to the traditional pulpotomy. This study was conducted to evaluate and compare the clinical and radiographic outcomes of low-level diode laser (LLDL) and electrosurgical pulpotomy in primary molars. Materials and methods: Seventy primary molars were allocated to group I (n = 35) and group II (n = 35), which underwent LLDL pulpotomy and electrosurgical pulpotomy, respectively. Clinical and radiographic analysis of all the teeth in the two groups was performed at 1, 3, 6, 9, and 12 months, respectively. Pearson's Chi-squared test was utilized to evaluate the success of both treatment procedures (p < 0.05). Results: During the 12-month follow-up period, the differences between the groups pertaining to clinical and radiographical evaluation were statistically nonsignificant, although enhanced results were seen in the laser pulpotomy group. There was no significant difference in the success rate observed between the LLDL pulpotomy and electrosurgical pulpotomy group at the end of the 12-month follow-up period. Conclusion: The two pulpotomy techniques were found to be successful enough in strengthening the concept of a potent and safe nonpharmacotherapeutic approach in the management of pulpally involved primary molars. Clinical significance: This study further establishes nonpharmacological pulpotomy techniques as a favorable alternative to traditional pulpotomy methods.

  1. Parisay I, Ghoddusi J, Forghani M. A review on vital pulp therapy in primary teeth. Iran Endod J 2015;10(1):6–15.
  2. American Academy of Pediatric Dentistry. Pulp therapy for primary and immature permanent teeth. Reference Manual.2014;40(6):343–351.
  3. Fuks AB, Eidelman E. Pulp therapy in primary dentition. Curr Opin Dent 1991;1(5):556–563.
  4. Sweet CA. Procedure for treatment of exposed and pulpless deciduous teeth. J Am Dent Assoc 1930;17(6):1150–1153.
  5. Fuks AB, Bimstein E, Guelmann M, et al. Assessment of a 2% buffered glutaraldehyde solution in pulpotomized primary teeth of schoolchildren. ASDC J Dent Child 1990;57(5):371–375.
  6. Yadav P, Indushekhar KR, Saraf BG, et al. Comparative evaluation of ferric sulfate, electrosurgical and diode laser on human primary molars pulpotomy: an “in-vivo” study. Laser Ther 2014;23(1): 41–47. DOI: 10.5978/islsm.14-OR-05
  7. Waterhouse PJ, Nunn JH, Whitworth JM. An investigation of the relative efficacy of Buckley's formocresol and calcium hydroxide in primary molar vital pulp therapy. Br Dent J 2000;188(1):32–36. DOI: 10.1038/sj.bdj.4800380
  8. Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod 1993;19(12):591–595. DOI: 10.1016/S0099-2399(06)80271-2
  9. Niranjan K, Prasad MG, Vasa AAK, et al. Clinical evaluation of success of primary teeth pulpotomy using mineral trioxide aggregate®, laser and biodentin- an in vivo study. J Clin Diagn Res 2015;9(4):ZC35–ZC37. DOI: 10.7860/JCDR/2015/13153.5823
  10. Shayegan A, Atash R, Petein M, et al. Nanohydroxyapatite used as a pulpotomy and direct pulp capping agent in primary pig teeth. J Dent Child 2010;77(2):77–83.
  11. Fadavi S, Anderson AW. A comparison of the pulpal response to freeze-dried bone, calcium hydroxide, and zinc oxide-eugenol in primary teeth in two cynomolgus monkeys. Pediatr Dent 1996;18(1):52–56.
  12. Sakai VT, Moretti AB, Oliveira TM, et al. Pulpotomy of human primary molars with MTA and Portland cement: a randomised controlled trial. Br Dent J 2009;207:1–5. DOI: 10.1038/sj.bdj.2009.665
  13. Salako N, Joseph B, Ritwik P, et al. Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar. Dent Traumatol 2003;19(6):314–320. DOI: 10.1046/j.1600-9657.2003.00204.x
  14. Ratnakumari N, Thomas B. A histopathological comparison of pulpal response to Chitra-CPC and formocresol used as pulpotomy agents in primary teeth: a clinical trial. Int J Clin Pediatr Dent 2012;5(1):6–13. DOI: 10.5005/jp-journals-10005-1126
  15. Ranly DM. Pulpotomy therapy in primary teeth: new modalities for old rationales. Pediatr Dent 1994;16(6):403–409.
  16. Magnusson B. Therapeutic pulpotomy in primary molars: clinical and histological follow-up. II. Zinc oxide-eugenol as wound dressing. Odontol Revy 1971;22(1):45–54.
  17. Nakashima M. Induction of dentin formation on canine amputated pulp by recombinant human bone morphogenetic proteins (BMP)—2 and —4. J Dent Res 1994;73(9):1515–1522. DOI: 10.1177/00220345940730090601
  18. Fuks AB, Michaeli Y, Sofer-Saks B, et al. Enriched collagen solution as a pulp dressing in pulpotomized teeth in monkeys. Pediatr Dent 1984;6(4):243–247.
  19. Kuo HY, Lin JR, Huang WH, et al. Clinical outcomes for primary molars treated by different types of pulpotomy: a retrospective cohort study. J Formosan Med Assoc 2018;117(1):24–33. DOI: 10.1016/j.jfma.2017.02.010
  20. Srinivasan D, Jayanthi M. Comparative evaluation of formocresol and mineral trioxide aggregate as pulpotomy agents in deciduous teeth. Indian J Dent Res 2011;22(3):385–390. DOI: 10.4103/0970-9290.87058
  21. Alsanouni M, Bawazir OA. A randomized clinical trial of NeoMTA plus in primary molar pulpotomies. Pediatr Dent 2019;41(2):107–111.
  22. Uloopi KS, Vinay C, Ratnaditya A, et al. Clinical evaluation of low-level diode laser application for primary teeth pulpotomy. J Clin Diagn Res 2016;10(1):ZC67–ZC70. DOI: 10.7860/JCDR/2016/13218.7140
  23. Gupta G, Rana V, Srivastava N, et al. Laser pulpotomy- an effective alternative to conventional techniques: a 12 months clinicoradiographic study. Int J Clin Pediatr Dent 2015;8(1):18–21. DOI: 10.5005/jp-journals-10005-1277
  24. El-Meligy O, Abdalla M, El-Baraway S, et al. Histological evaluation of electrosurgery and formocresol pulpotomy techniques in primary teeth in dogs. J Clin Pediatr Dent 2001;26(1):81–85. DOI: 0.17796/jcpd.26.1.w2243176tj661n8p
  25. Ruemping DR, Morton TH Jr, Anderson MW. Electrosurgical pulpotomy in primates- a comparison with formocresol pulpotomy. Pediatr Dent 1983;5(1):14–18.
  26. Fuks AB. Pulp therapy for the primary dentition. Pinkham, Cassamassimo, Fields Metigue, Nowak: Dentistry Infancy through adolescence. 4th edition, Saunders; 2005.p.384–385.
  27. Brugnera A, Garrini AEC, Pinheiro ALB, et al. Low-level laser therapy in treating dentinary hypersensibility: a histologic study and clinical application. Lasers Dent 2002;4950:46–53.
  28. Mjor IA. Dentin predentin complex and its permeability: pathology and treatment overview. J Dent Res 1985;64:621–627. DOI: 10.1177/002203458506400420
  29. Mareddy A, Mallikarjun SB, Shetty PV, et al. Histological evaluation of diode laser pulpotomy in dogs. J Oral Laser Appl 2010;10(1):7–16.
  30. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fractures. J Endod 1978;4(8):232–237. DOI: 10.1016/S0099-2399(78)80153-8
  31. Schroeder U. Effects of calcium hydroxide-containing pulp capping agents on pulp cell migration, proliferation and differentiation. J Dent Res 1985;64:541–548. DOI: 10.1177/002203458506400407
  32. Todea C, Kerezsi C, Balabuc C, et al. Pulp capping – conventional to laser-assisted therapy. J Oral Laser Appl 2008;8:146–155.
  33. Sun G, Tuner J. Low-level laser therapy in dentistry. Dent Clin North Am 2004;48(4):1061–1076. DOI: 10.1016/j.cden.2004.05.004
  34. Usumez A, Cengiz B, Oztuzcu S, et al. Effects of laser irradiation at different wavelengths (660, 810, 980 and 1,064 nm) on mucositis in an animal model of wound healing. Lasers Med Sci 2014;29(6):1807–1813. DOI: 10.1007/s10103-013-1336
  35. Gisoure FE. Comparison of three pulpotomy agents in primary molars: a randomised clinical trial. Iran Endod J 2011;6(1):11–14.
  36. Srinivasan V, Patchett CL, Waterhouse PL. Is there life after Buckley's formocresol? Part I- a narrative review of alternative interventions and materials. Int J Paediatr Dent 2006;16(2):117–127. DOI: 10.1111/j.1365-263X.2006.00688.x
  37. Huth KC, Paschos E, Hajek-Al-Khatar N, et al. Effectiveness of 4 pulpotomy techniques – randomized controlled trial. J Dent Res 2005;84(12):1144–1148. DOI: 10.1177/154405910508401210
  38. Dean JA, Mack RB, Fulkerson BT, et al. Comparison of electrosurgical and formocresol pulpotomy procedures in children. Int J Paediatr Dent 2002;12(3):177–182. DOI: 10.1046/j.1365-263x.2002.00355.x
  39. Bahrololoomi Z, Moeintaghavi A, Emtiazi M, et al. Clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy: a randomized clinical trial. Indian J Dent Res 2008;19(3):219–223. DOI: 0.4103/0970-9290.42954
  40. Nematollahi H, Shirazi AS, Mehrabkhani M, et al. Clinical at and radiographic outcomes of laser pulpotomy in vital primary teeth: a systematic review and meta-analysis. Eur Arch Paediatr Dent 2018;19(4):205–220. DOI: 10.1007/s40368-018-0358-4
  41. Durmus B, Tanboga I. In vivo evaluation of the treatment outcome of pulpotomy in primary molars using diode laser, formocresol, and ferric sulfate. Photomed Laser Surg 2014;32(5):289–295. DOI: 10.1089/pho.2013.3628
  42. Shaw DW, Sheller B, Barrus BD, et al. Electrosurgical pulpotomy: a 6-month study in primates. J Endod 1987;13(10):500–505. DOI: 10.1016/S0099-2399(87)80017-1
  43. Sheller B, Morton TH Jr. Electrosurgical pulpotomy: a pilot study in humans. J Endod 1987;13(2):69–76. DOI: 10.1016/S0099-2399(87)80158-9
  44. Shulman ER, McIver FT, Burkes EJ Jr. Comparison of electrosurgery and formocresol as pulpotomy techniques in monkey primary teeth. Paediatr Dent 1987;9(3):189–194.
  45. Ranly DM. Pulp therapy in primary teeth. A review and prospectus. Acta Odontol Pediatr 1982;3(2):63–68.
  46. Law AJ. Pulpotomy by electro-coagulation. NZ Dent J 1957;53:68–70.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.