Laser-Assisted vs Conventional Total Pulpotomy in Symptomatic Irreversible Pulpitis

Condition(s) studied

Investigational drug(s) / intervention(s)

Conventional Total Pulpotomy: Following removal of the coronal pulp tissue to the level of the canal orifices, initial bleeding control will be performed using a saline-moistened cotton pellet. Hemostasis will then be achieved using a cotton pellet moistened with 2.5% sodium hypochlorite for 2 minutes and repeated if necessary, without exceeding a total application time of 5 minutes. After hemostasis, approximately 2 mm of Biodentine will be placed over the remaining pulp tissue, followed by a glass ionomer base and composite resin restoration.

Laser-Assisted Total Pulpotomy: Following removal of the coronal pulp tissue to the level of the canal orifices, initial bleeding control will be performed using a saline-moistened cotton pellet. Hemostasis will then be achieved using an Er:YAG laser (2940 nm) with an H14 handpiece in SP mode at 20 mJ, 15 Hz, and 0.3 W. The laser will be applied approximately 1 mm from the pulp surface using a sweeping motion for 15 seconds and repeated until complete hemostasis is achieved. After hemostasis, approximately 2 mm of Biodentine will be placed over the remaining pulp tissue, followed by a glass ionomer base and composite resin restoration.

Study summary

his randomized controlled clinical trial will compare laser-assisted total pulpotomy with conventional total pulpotomy in permanent molar teeth diagnosed with symptomatic irreversible pulpitis. Participants will be randomly assigned to one of two treatment groups. In the conventional group, bleeding control will be achieved using sodium hypochlorite, whereas in the laser-assisted group, an Er:YAG laser will be used for hemostasis. In both groups, Biodentine will be placed over the remaining pulp tissue and the tooth will be permanently restored.

Postoperative pain will be assessed using a visual analog scale at 6, 12, and 24 hours and on days 3, 5, and 7 after treatment. Clinical and radiographic outcomes will also be evaluated during follow-up to determine treatment success. The study aims to determine whether laser-assisted total pulpotomy differs from conventional total pulpotomy in terms of postoperative pain and clinical and radiographic outcomes.

Eligibility

Primary outcome measure(s)

• Postoperative Pain Intensity — 6, 12, and 24 hours and 3, 5, and 7 days after treatment
  Postoperative pain intensity will be assessed using a 0-10 visual analog scale (VAS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity. Participants will record their pain scores using the provided follow-up forms.

Trial sites (1)