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case report | Figs. 4a & b: X-ray examination immediately after VPT. laser 2 2017 11 Fig. 4a Fig. 4b X-ray examination X-ray examination showed a radiolucent lesion near the dental pulp. Diagnosis A reversible pulpitis was diagnosed. Interim restorative treatment (IRT) was applied with Glass Ionomer GC Fuji IX according to the man- ufacturer’s instruction without finger pressure (Fig. 3). Permanent filing was postponed for one month. Laser-assisted VPT procedure The laser parameters were as follows: Laser parameters Treatment delivery sequence After fulfillment of the consent form, the opera- tion area was anaesthetised by infiltration method and 2 % lidocaine with Epi 1:80,000, 1.8 ml (Darou Pakhsh, Tehran, Iran). The controlled area and proper placing of the laser warning signs were defined to se- cure the operating room. The protective goggles for patient, operator and assistant were checked. Fur- thermore, the patient's information (examination sheet and X-ray, consent form, etc.) was reviewed. Mouth rinsing was done by 0.2 % chlorhexidine oral rinse (Shahre Daru, Tehran, Iran) for one minute and then the surface of the tooth was cleaned by a swab wetted by the same chlorhexi- dine solution. Cavity preparation was performed by fissure diamond burs and then round stainless-steel burs. After caries removal, the pulpal bleeding was ob- vious and a partial pulpotomy was indicated. Partial pulpotomy was started with sterile round diamond bur on a high-speed handpiece to remove the inflamed pulp tissue gently via normal saline irrigation. Haemostasis was obtained by cotton pellet soaked in normal saline for five minutes and then followed by diode laser irradiation. CEM cement dressing was applied with a base of 2 mm CEM cement paste according to the manu- facturer’s instruction (Biunique Dent, Tehran, Iran) using a sterile plastic instrument and then the dry sterile cotton pellet was used for more adaptation of CEM cement to the cavity wall (Fig. 2). – For bleeding control: 980 nm (diode laser, Wuhan Gigaa, Wuhan, China), power 0.8 W, 8 Joule, fibre 400 µm, non-initiated fibre, CW, non-contact mode, 10 seconds in scanning mode (Fig. 1) – For pain reduction: 980 nm, output power 0.3 W, irradiation time 10 s, 3 Joule, spot size 3 mm, power density 4, 246 W/cm2 at the end of low- level handpiece. The cavity diameter was 4 mm, irradiation area 0.1256 cm2, power density at the target surface 2.388 W/cm2, dose 23, 88 J/cm2, non-contact (5 mm away from the exposure area), scanning mode, single dose Final result Excellent VPT was observed with no bleeding, no carbonisation and no char. The patient did not experience any discomfort and was satisfied. Radio- graphic examination was taken in order to follow the result of laser-assisted pulpotomy based on radiographic changes (Figs. 4a & b). Follow-up The first visit after VPT was one day after the pro- cedure. There was no pain, therefore, a second LLLT was not deemed necessary. The next visit was de- termined two days after the procedure via tele- phone conversation in order to check on the pain degree based on VAS scaling (Visual Analogue Scale). Since there were no symptoms, the final visit was determined to be one month after the proce- dure. Finally, after one month follow-up, a success- ful treatment was observed clinically (positive thermal pulp vitality test) and with radiographic examination (Figs. 5a & b).