Er:YAG Laser Assisted Pulpotomy In The Treatment Of Chronic Pulpitis:a Case Series

Objective: The preservation of vital pulp of human teeth and the integrity of natural dentition is a new direction of Stomatology.Root canal treatment is a routine therapy for chronic pulpitis and traumatic pulpal exposure.It is a method to eliminate infection by completely removing the pulp in the root canal.However,the loss of pulp and dentin in the treatment process leads to the decrease of the fracture resistance of the teeth after root canal treatment,which is prone to complications such as micro crack and vertical root fracture,resulting in the loss of the affected teeth and the destruction of the integrity of the natural dentition.There were many studies on the application of pulpotomy in chronic pulpitis at home and abroad.Since the application of Er:YAG laser in Stomatology,researchers have found that conventional treatment with Er:YAG laser can lead to better sterilization,control of inflammation,and promote the proliferation of pulp cells.This paper reported a series of cases of chronic pulpitis treated by Er:YAG laser assisted pulp amputation.It was intended to evaluate the clinical efficacy of Er:YAG laser assisted pulpotomy in the treatment of chronic pulpitis and preliminarily explore the factors affecting the treatment success,so as to provide reference for the future development of living pulp preservation technology.Methods: According to the strict inclusion and exclusion criteria,a total of 16 teeth diagnosed with chronic pulpitis were included,and treated with Er:YAG laser assisted pulpotomy.Clinical and radiological examinations were conducted at 1,3,6,9 months after the surgery to preliminarily evaluate the therapeutic effect.Results: All patients were followed up after treatment by telephone and clinical examination,from 1 to 9 months.The results showed that in 16 cases,1 case had sinus in the gum,none of the 15 cases presented obvious clinical symptoms,and 10 of them presented positive reaction of pulp electronic test.Radiological examination showed that there was no internal resorption and pulp calcification in all the cases.Only 1 case had low-density transmission image around the apical apex.And 2 cases formed calcification bridge under the materials.Among the 16 cases,15 cases were judged successful and 1 case failed.The whole success rate was 93.8%.Conclusion: The treatment of chronic pulpitis with Er:YAG laser assisted pulpotomy can achieve good results.In order to evaluate the exact effect of this treatment,further research is needed in the future,and the sample size should be expanded and the clinical follow-up time should be increased to provide more evidence for the clinical application of this therapy.