# Should the Application of Diode Laser Completely Replace Conventional Pulpotomy of Primary Tenth?
## 4 Discussion
Taking into consideration all the aforementioned studies, it is necessary to point out that the differences in the results obtained in the conducted research are caused by numerous factors that determine the long-term success of the procedures, such as proper case selection, strict aseptic protocol, parameters of the laser used, and patient cooperation for the procedure. Information in the available literature data states that permanent restoration materials can affect the outcome of pulpotomy due to their biological and physical properties [56]. With this in mind, our study took into account the material of the final restoration as a factor (Figure 2), in which a statistically significant difference was observed between the group of subjects designated to diode laser pulpotomy with composite as the final restoration material in comparison to conventional pulpotomy with glass ionomer cement in all three observed time points. Taking these results into account, we partially reject the null hypothesis. The influence of restoration quality on the outcome of pulpotomy has been proven [40; 46; 57]. By comparing the success of the therapy according to clinical parameters depending on the material of the final restoration in this study, the advantage of the composite material compared to the glass ionomer cement was noticed in the interval of 6 months (\(p\) = 0.045), while in the intervals of 12 and 24 months there was no significant difference between compared materials. Furthermore, the USPHS criteria decreased through the intervals of 6, 12, and 24 months in both tested final restoration materials, of which the composite showed greater stability. Additionally, the relationship between the quality of restoration according to the USPHS and the success of clinical parameters after pulpotomy was analyzed on each follow-up indicates an undoubted connection between the quality of the final restoration and the performed procedure. These results could be explained by the fact that although composites, due to their hardness and strength, are suitable for the molar region where the occlusal forces are stronger, they can develop a marginal crack due to polymerization shrinkage [57]. On the other hand, glass ionomers are bioactive materials and therefore acceptable for primary dentition, but due to weaker physical-mechanical properties, they are prone to wear [57]. It is necessary to emphasize the limitations of this research. First, in this study, there was a relatively short follow-up period (only up to 24 months), which is why the long-term outcomes of the therapy and procedures performed could not be predicted with certainty. Another possible limitation is the lack of evaluation at the histological level, given that it relied entirely on the clinical and radiographic profile as well as the results of the performed procedures, which can sometimes lead researchers in the wrong direction of thinking. For the above reasons, this research warrants the need for further studies to be conducted on larger sample sizes and with longer follow-up periods (e.g., five-year follow-up) in order to reach valid conclusions.