Effect of LASER therapy Vs conventional techniques on clinical and radiographic outcomes of deciduous molar pulpotomy: A systematic review and meta-analysis.

V Chandran,V Sanjeevan,M Menon,R Venkitachalam,B Varma

doi:10.4317/jced.56436

Abstract

BackgroundTo systematically review the effectiveness primary molar pulpotomy based on the clinical and radiographic outcomes using lasers over the conventional therapies. Material and MethodsThis systematic review and meta-analysis included Randomized or Quasi-randomized trials comparing LASER with conventional pulpotomy therapies (formocresol, ferric sulphate, MTA or calcium hydroxide) with atleast 6-month follow-up period was included. Risk of bias of included studies was assessed and metanalysis was done using RevMan software. ResultsOf the 1383 articles that were searched, only 14 studies were included for qualitative synthesis and 10 for meta- analysis. There was no statistically significant difference in clinical success rate [OR 0.99, 95%CI (0.19,5.22)] or radiographic success rate [OR 0.77, 95%CI (0.31,1.87)] of LASER therapy compared to Formocresol in primary molar pulpotomy for 6 months. No statistically significant difference were found in clinical success rate [OR 1.04, 95%CI (0.35,3.07)] and radiographic success rate [OR 0.71, 95%CI (0.37,1.35)] at 12 month follow-up also. Comparison of LASER with Ferric Sulphate also did not show a statistically significant difference. ConclusionsMeta-analysis showed no statistically significant difference in clinical and radiographic outcomes of LASER pulpotomy with conventional pulpotomy (formocresol and ferric sulphate) at 6 and 12 months follow-up. However, there was considerable risk of bias in the included studies. Key words:Pulp therapy, Laser, formocresol.

Highlights

Dental pulp can be defined as a connective tissue of mesodermal origin, which is highly vascularized and innervated structure enclosed by dentin with communications to the periodontal ligament
There are three vital pulp therapy (VPT) options for treatment of deep dentin caries lesions approximating the pulp in vital primary teeth viz. indirect pulp cap, direct pulp cap (DPC) and pulpotomy (2)
The remaining vital radicular pulpal tissue were treated with different pulpotomy medicaments through three different mechanisms viz. devitalization, preservation and regeneration (5)

Summary

Introduction

Dental pulp can be defined as a connective tissue of mesodermal origin, which is highly vascularized and innervated structure enclosed by dentin with communications to the periodontal ligament. The objective/PICO statement of this study is to perform a systematic review and meta-analyses, to evaluate the effectiveness primary molar pulpotomy (Population) based on the clinical and radiographic outcomes (Outcomes) using LASERS (Intervention) over the conventional therapy, amongst the pulpotomy medicaments like Formocresol, MTA, Ferric sulfate and Calcium hydroxide (Control). Material and Methods: This systematic review and meta-analysis included Randomized or Quasi-randomized trials comparing LASER with conventional pulpotomy therapies (formocresol, ferric sulphate, MTA or calcium hydroxide) with atleast 6-month follow-up period was included. There was no statistically significant difference in clinical success rate [OR 0.99, 95%CI (0.19,5.22)] or radiographic success rate [OR 0.77, 95%CI (0.31,1.87)] of LASER therapy compared to Formocresol in primary molar pulpotomy for 6 months. Conclusions: Meta-analysis showed no statistically significant difference in clinical and radiographic outcomes of LASER pulpotomy with conventional pulpotomy (formocresol and ferric sulphate) at 6 and 12 months follow-up. There was considerable risk of bias in the included studies

Results

Discussion

Conclusion