# Should the Application of Diode Laser Completely Replace Conventional Pulpotomy of Primary Tenth?
###### Abstract  
Nowadays, the use of lasers in dental medicine has become an effective approach for numerous restorative and soft tissue therapeutic procedures. The use of different types of lasers depends on how the tissue interacts with the laser light and the purpose of treatment. Although some studies show the benefits of laser pulpotomy compared to the conventional method of pulpotomy, clinical studies are lacking. Moreover, the material used for a definitive restoration of endodontically treated primary teeth can also affect the outcome of the therapy. Therefore, this prospective study aimed to compare the clinical use of the diode laser and the conventional method of vital pulpotomy, as well as the influence of the material chosen for a definitive restoration for the outcome of the procedure. Patients were divided into two groups: conventional pulpotomy and 980 nm diode laser. Each group was then divided into two subgroups according to the type of material for the final restoration. By comparing the success of the therapy according to clinical parameters depending on the material of the final restoration, the advantage of the composite material compared to the glass ionomer cement was noticed at 6 months checkup (\(p=0.045\)). A strong positive correlation between the quality of the final restoration according to the United States Public Health Service (USPHS) criteria and the success of the clinical parameters was found in all investigated time points. There is no statistically significant difference between the diode laser and the conventional pulpotomy, however, the choice and quality of the final restoration significantly contribute to the outcome of therapy. diode lasers; endodontology; primary teeth +
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photopolymerization, teeth whitening, caries detection, and lasers for use in low doses [12]. Each of those laser types has its unique application in dental medicine [1]. The choice of laser depends on the optical affinity of the tissue and the wavelength at which the laser emits photons, that is, light particles [12]. There are four different ways of interaction between the laser and the tissue. The laser beam can be reflected from the surface (reflection), scattered (dispersion), absorbed into the tissue (absorption), or pass through the tissue unchanged (transmission) [13; 14]. The use of different types of lasers during the therapy of different tissues depends on the way the tissue interacts with the laser light and the desired effect for the purpose of treatment [15]. Thus, for example, low-power lasers are used in the prevention, diagnostics, and achieving bio-stimulating effects, in contrast to high-power lasers that have found their use in caries removal and laser surgery of hard and soft tissues [15]. In general, the laser effect on tissues is the result of the absorption and dispersion of laser radiation, and it depends on the wavelength of the radiation and the optical properties of the tissue [13; 14]. For example, if the laser light passes through the tissue, it will not have any effect on the tissue itself. The specific effect of the absorbed laser energy can be controlled by the physical settings of the laser: laser power, radiation time, size of the radiation surface, laser operation mode, water cooling, and laser working distance [13; 14]. The result of all these factors is the photodynamic, photochemical, and photothermal action of the laser [13; 14]. However, one should pay attention to the doses of reflected radiation, because they represent a possible danger for the surrounding tissues, as well as for health personnel [12]. In endodontics, the indications for the use of lasers include very common therapeutic interventions for deciduous teeth: pulp covering, pulpotomy, and root canal disinfection [16; 17]. For this purpose, low laser energy is used, which ensures good surface coagulation and decontamination in order to preserve the vitality of the residual pulp [18].