Abstract：
OBJECTIVE: This study systematically reviewed the clinical and radiographic outcomes of laser versus conventional pulpotomy in primary teeth. It also compared the success and effectiveness of different lasers to enhance the understanding and use of laser pulpotomy as an alternative treatment.
METHODS: An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05.
RESULTS: Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy.
CONCLUSIONS: Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.
METHODS: An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05.
RESULTS: Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy.
CONCLUSIONS: Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.
摘要：
目的：本研究系统回顾了激光与传统牙髓切除术的临床和影像学结果。它还比较了不同激光的成功和有效性，以增强对激光牙髓切除术作为替代治疗的理解和使用。
方法：从1999年1月1日至2023年12月31日，在PubMed和Cochrane进行了电子搜索。使用MeSH术语和文本单词搜索英语发表的文章。仅包括样本量超过10个，随访超过6个月的随机对照试验。利用ReviewManager5.4软件进行Meta分析和森林样地评价。两名审阅者使用RoB2工具评估了偏见的风险，第三名审阅者解决了差异。使用随机效应模型将成功率组合以确定临床和影像学结果。我们使用具有95%置信区间（CI）的风险比作为主要效应指标，并将显著性水平设定为0.05。
结果：只有18项研究在电子检索后符合纳入标准。其中,13项研究评估了激光联合甲酚牙髓切除术的临床和影像学结果，2项研究与硫酸铁牙髓切除术比较，以及其余的三氧化矿物质聚集体（MTA）牙髓切除术研究。各种研究显示了不同程度的偏见。激光牙髓切除术和甲酚之间的临床成功率（p=0.47；RR：1.01；95％CI0.98-1.04；I2=0％；p=0.70）和影像学成功率（p=0.94；RR：1.00；95％CI0.91-1.09；I2=64％；p=0.001）没有显着差异。同样，激光牙髓切除术与硫酸铁或MTA牙髓切除术无显著差异。
结论：二极管激光和LLLT可以被认为是乳牙中甲酚的替代牙髓切断剂。然而,需要高质量的试验来证实这些发现的准确性和可靠性.
方法：从1999年1月1日至2023年12月31日，在PubMed和Cochrane进行了电子搜索。使用MeSH术语和文本单词搜索英语发表的文章。仅包括样本量超过10个，随访超过6个月的随机对照试验。利用ReviewManager5.4软件进行Meta分析和森林样地评价。两名审阅者使用RoB2工具评估了偏见的风险，第三名审阅者解决了差异。使用随机效应模型将成功率组合以确定临床和影像学结果。我们使用具有95%置信区间（CI）的风险比作为主要效应指标，并将显著性水平设定为0.05。
结果：只有18项研究在电子检索后符合纳入标准。其中,13项研究评估了激光联合甲酚牙髓切除术的临床和影像学结果，2项研究与硫酸铁牙髓切除术比较，以及其余的三氧化矿物质聚集体（MTA）牙髓切除术研究。各种研究显示了不同程度的偏见。激光牙髓切除术和甲酚之间的临床成功率（p=0.47；RR：1.01；95％CI0.98-1.04；I2=0％；p=0.70）和影像学成功率（p=0.94；RR：1.00；95％CI0.91-1.09；I2=64％；p=0.001）没有显着差异。同样，激光牙髓切除术与硫酸铁或MTA牙髓切除术无显著差异。
结论：二极管激光和LLLT可以被认为是乳牙中甲酚的替代牙髓切断剂。然而,需要高质量的试验来证实这些发现的准确性和可靠性.
