Effects of an Nd:YAP laser used for root canal disinfection in pulp regenerative therapy: a pilot study

This study aimed to compare the disinfection effects between a triple antibiotic paste and neodymium-doped yttrium aluminum perovskite (Nd:YAP) laser in pulp regenerative therapy and evaluate corresponding therapeutic effects based on apical radiographs and cone-beam computed tomography (CBCT). Sixty-six immature permanent teeth in 66 patients diagnosed with acute or chronic apical periodontitis were analyzed. All teeth were given pulp regenerative therapy. The patients were categorized into a control (triple antibiotic paste) and an experimental (Nd:YAP laser) group. Teeth in the experimental group were disinfected using an Nd:YAP laser, while those in the control group were disinfected using a triple antibiotic paste. Clinical and radiological examinations were performed every 3-6 months after treatment and followed up for 24 months. Statistical analysis was performed after clinical examination and showed that after one week of treatment, symptoms persisted in two teeth in the control group and two teeth in the experimental group. Two weeks later, the clinical symptoms disappeared in all teeth (p > 0.05). After 24 months of follow-up, the clinical symptoms recurred in two teeth in the control group and one tooth in the experimental group. On radiographic examination, 31 and 27 teeth showed continued root development, and three and two teeth showed no obvious root development in the control and experimental groups, respectively. The pulp sensibility test was positive in four teeth in both groups, with no significant difference between the two groups (p > 0.05). The results of this study suggest that endodontic irradiation with an Nd:YAP laser could be an effective alternative to triple antibiotic paste during disinfection of pulp regenerative therapy. Treatment outcomes were assessed using apical radiographs and CBCT, and no negative prognostic effects of the Nd:YAP laser on pulp regenerative therapy were found.