Advantages of a pulsed CO2 laser in direct pulp capping: a long-term in vivo study.

BACKGROUND AND OBJECTIVE A previous study [Moritz et al., Z Stomatol 1996; 93:451-454] had shown that favourable results in direct pulp capping could be achieved using a continuous wave CO2 laser in addition to the conventional calcium hydroxide dressing technique. In this study, these results are compared to those achieved using a CO2 laser working in superpulsed mode. STUDY DESIGN/MATERIALS AND METHODS A total of 260 direct pulp capping procedures were carried out; 130 were performed with a superpulsed CO2 laser, followed by a calcium hydroxide dressing, and 130 conventionally by applying only a calcium hydroxide preparation. Recall examinations were performed after 1 week and monthly for 18 months after treatment. A final examination was carried out 2 years after treatment. Thermal tests were used for vitality assessments and laser Doppler flowmetry for direct measurement of pulpal blood flow. RESULTS In the group of pulps treated with the superpulsed CO2 laser, the last recall examination at 2 years revealed that 93% of the teeth had remained vital. In the control group, the success rate was considerably lower (66.6%). Exposure site sizes and average patient age were nearly identical in both groups. CONCLUSION The CO2 laser seems to be a valuable aid in direct pulp capping; the efficiency of laser treatment can be increased by using a pulsed CO2 laser.