Clinical efficacy of diode laser for pulpotomy in primary teeth: a meta-analysis of randomised controlled trials.

Abstract

Objective: To systematically evaluate the efficacy of diode laser for pulpotomy in primary teeth using meta-analysis.  Methods: Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched to include randomised controlled trials (RCTs) evaluating the efficacy of diode laser pulpotomy in primary teeth, with the control group receiving conventional treatment without diode laser. This meta-analysis was based on a systematic literature search. Meta-analyses were conducted based on different follow-up times and control groups to assess the clinical and radiographic success rates of diode laser pulpotomy.  Results: A total of 17 RCTs met the inclusion criteria, involving 1,018 primary teeth. Meta-analysis results based on different follow-up times (≤ 3 months, 6 months, 9 months, ≥12 months) showed similar clinical success rates (total: relative risk [RR], 1.01; 95% confidence interval [CI], 0.99-1.03; I2 = 0%) and radiographic success rates (total: RR, 0.99; 95% CI, 0.97-1.02; I2 = 0%) between diode laser pulpotomy and conventional treatment. Meta-analysis based on different control groups (formocresol-zinc oxide eugenol [FC-ZOE], ferric sulfate-zinc oxide eugenol [FS-ZOE], mineral trioxide aggregate-zinc oxide eugenol [MTA-ZOE], simvastatin gel-resin modified glass ionomer cement [SG-REGIC]) showed similar clinical success rates between diode laser pulpotomy and FC-ZOE (RR: 1.00; 95% CI: 0.98-1.02), MTA-ZOE (RR: 1.01; 95% CI: 0.94-1.09), and SG-REGIC (RR: 0.99; 95% CI: 0.83-1.17), but it was more likely to achieve clinical success compared to FS-ZOE (RR: 1.04; 95% CI: 1.01-1.07). In addition, diode laser pulpotomy showed similar radiographic success rates with different control groups.  Conclusion: Diode laser can be considered as an alternative treatment method to current conventional pulpotomy. However, further high-quality trials are needed to confirm the accuracy and reliability of these findings.