الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This randomized controlled clinical trial was conducted to evaluate the clinical and radiographic outcomes of the use of Diode laser and Platelet Rich Fibrin in regenerative pulpotomy of mature permanent molars with irreversible pulpitis.
Thirty six patients with irreversibly inflamed mandibular permanent molars of age ranging from 18-40 years from those attending the diagnosis clinic at the Conservative Department, Faculty of Dentistry, Alexandria University, Egypt, were included in this study. Patients were equally divided randomly into three groups; one control and two test groups. After Pulpotomy, group I (n=12); the control group; definitive hemostasis was achieved using cotton pellet moistened with 2.5% NaOCl applied for 2-4mins, then the radicular pulp was capped with PRF and covered with Biodentine. group II, definitive hemostasis was achieved using 970nm Diode laser, then the radicular pulp was capped directly with Biodentine. group III, definitive hemostasis was achieved using the diode laser as group I then radicular pulp was capped using PRF then covered with Biodentine. The cavities in all groups were restored immediately using RMGIC then covered with resin composite restorations. All patients were recalled after one week to check the postoperative pain recorded by the patient on the Numerical Rating Pain Scale (NRS). Patients in all groups returned to the clinic for clinical and radiographic evaluation after three, six, nine and 12 months.
CBCT imaging was done immediate post operatively and at the end of the follow up to assess the outcome of the treatments, to detect any pathological changes that might have developed and to evaluate the newly formed calcifications/dentine bridges under the capping materials.
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The postoperative pain results analysis showed statistically significant difference in the degree of decrease of pain in the first day (post-operative) in the favor of group III (Laser + PRF + Biodentine), however, there was no statistically significant difference in the degree of pain by the end of the seventh day (post-operative). During the 12-month follow-up period, six patients were lost and did not continue till the end of the follow up period. The results of the clinically and radiographically follow up showed that all the three groups had high success rate all through the follow up period and that there was no statistically significant difference in the clinical and radiographic success rate between the three groups. Regarding the CBCT outcomes, there was a statistically significant difference in the degree of radiodensity of the newly formed calcification (dentine bridge) between group II and group III in favor of group III (Laser + PRF + Biodentine), specifically at the distal area. However, there was no statistically significant difference between the control group and either of the two test groups. The results also showed that there was no statistically significant difference in the size of the newly formed calcification (dentine bridge) among the three groups of the clinical trial (P<0.05).