# Should the Application of Diode Laser Completely Replace Conventional Pulpotomy of Primary Tenth?
## 4 Discussion  
The quest for the optimal treatment technique for the pulp of primary teeth has been a challenge for clinicians for several decades. Given that there are still concerns about the use of formocresol considering its mutagenic, toxic, and carcinogenic effect on humans [34; 35; 36; 37; 38; 39], there seems to be a need for an acceptable and biocompatible method as an alternative to the conventional pulmonary. Considering some of the advantages, such as bleeding control, sterilization, and stimulation of pulp cell healing, among the therapeutic interventions, the use of lasers of different wavelengths is advocated as a possible alternative [40]. Since the laser beam in this process does not come into contact with the tissues, the cutting process does not mechanically affect or damage the irradiated tissues, while the laser itself has the potential to provide an aseptic working field [40]. Up to date, in the available literature, the effectiveness of a number of clinical protocols and medications in the pulp therapy of primary molars has been tested for the purpose of protecting the remaining pulp tissue and promoting healing [19]. Although many different techniques have been tested so far [41], a recent Cochrane review stated that there is no agreement on the most appropriate technique [42]. Among the investigated methods, the diode laser is mentioned as one of the most suitable laser wavelengths for application on the pulp to complete the pulmonary procedure \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline  & \multicolumn{4}{c}{**Correlations**} \\  & \multicolumn{4}{c}{**MD Pairwise Deleted**} \\  & \multicolumn{4}{c}{**Marked Correlations are Significant at \(p<0.01000\)**} \\ \hline \multirow{2}{*}{**Variable**} & **Success 6** & **Success** 12** & **Success** 12** & **Success** 12** & **Success** 12** & **Success** **Restauration** \\  & **mo.** & **Resaturation 6** & **mo.** & **Resaturation** & **mo.** & **Resaturation** \\  & & **mo.** & **Resaturation** & **mo.** & **Resaturation** \\ \hline Success 6 mo. & 1.000000 & 0.839654 * & & & & \\ Success restauration 6 mo. & 0.839654 * & 1.00000 & & & & \\ Success 12 mo. & & & 1.000000 & 0.776305 * & & & \\ Success restauration 12 mo. & & & 0.776305* & 1.000000 & & & \\ Success 24 mo. & & & & 1.000000 & 0.68467 * & 1.000000 \\ Success restauration 24 mo. & & & & 0.68467 * & 1.000000 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Correlation of the quality of restoration according to USPHS (Success restoration) and the success of clinical parameters (Success). Figure 2: Influence of pulotomy treatment and final restoration material on clinical success after 6, 12, and 24 months follow-up. LP—laser pulotomy; CP—conventional pulotomy; GIC—glass ionomer cement; a, b, and c—statistically significant difference (\(p<0.05\)). due to its high absorption rate [19]. In a very small package, a diode laser uses nearly microscopic chips of gallium arsenide or other useful semiconductors to produce coherent light. Differences within the energy levels in these semiconductors between conduction and valence band electrons provide the basis for laser action. The overall efficiency is therefore much higher and at the same time more practical [43]. The working mechanism of this type of laser is based on the emission of a beam of infrared light and the creation of a well-localized ablation of soft tissues, whereby the laser energy is converted into heat [19]. This reaction is most often accompanied by thermal peripheral tissue damage and tissue loading at the point of impact [44,45]. Due to the high absorption of the wavelength (980 nm) at which energy is produced in tissues such as the dental pulp, which have a very high water content, the diode laser used in this study is more suitable for pulotomy technique compared to other types of lasers [44,45].