Diode Laser-Assisted Direct Pulp Capping Trial

Direct pulp capping (DPC) is a vital pulp therapy procedure intended to preserve pulpvitality and stimulate reparative dentin formation after pulp exposure. The clinicalsuccess of DPC depends on effective sealing of the exposure site, bacterial control, andmaintenance of pulpal health. Bioactive tricalcium silicate‐based materials such asBiodentine have demonstrated favorable biological and mechanical properties and arewidely used as pulp‐capping agents because of their biocompatibility, sealing ability,and dentin‐bridge induction potential.Despite the favorable outcomes of modern pulp‐capping materials, postoperative pain anddentin hypersensitivity remain common complications following DPC. These symptoms maynegatively affect patient comfort, treatment acceptance, and short‐term clinicaloutcomes. Adjunctive use of diode laser therapy has been proposed to improve thebiological environment of the exposed pulp by providing hemostasis, antimicrobial action,and photobiomodulation. Experimental and clinical evidence suggests that diode laserirradiation may reduce inflammation, stabilize cell membranes, improve microcirculation,and enhance cellular metabolism through increased adenosine triphosphate (ATP) synthesis,thereby reducing postoperative discomfort and promoting tissue healing.However, evidence regarding the effectiveness of diode laser therapy as an adjunct to DPCremains limited, particularly due to variations in laser parameters, treatment protocols,and pulp‐capping materials among previous studies. Therefore, this randomized controlledclinical trial was designed to evaluate the clinical effectiveness of adjunctive 808‐nmdiode laser therapy following direct pulp capping using Biodentine.A total of 60 teeth from 56 participants diagnosed with carious pulp exposure andfulfilling the eligibility criteria were included. Eligible teeth were randomly allocatedinto two groups using a computer‐generated 1:1 randomization sequence with allocationconcealment by sequentially numbered, opaque, sealed envelopes (SNOSE). In the controlgroup, direct pulp capping was performed using Biodentine following conventionalhemostasis and disinfection procedures. In the experimental group, adjunctive diode lasertherapy (808 nm) was applied for hemostasis and disinfection prior to Biodentineplacement, using standardized irradiation parameters.The primary outcomes of the study are postoperative pain intensity and dentinhypersensitivity. Postoperative pain is assessed using the Numerical Rating Scale (NRS,0‐10) and the duration until complete pain resolution is recorded. Dentinhypersensitivity is evaluated at 1, 3, and 6 months using a cold stimulus and NRSscoring. The secondary outcome is the clinical success rate at 6 months, determined byclinical and radiographic criteria including pulp vitality, absence of spontaneous pain,absence of tenderness to percussion, and absence of radiographic periapical pathology.The study hypothesizes that adjunctive diode laser therapy will significantly reducepostoperative pain and dentin hypersensitivity following direct pulp capping comparedwith conventional Biodentine treatment, while maintaining comparable clinical successrates at 6 months.