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| case report vital pulp therapy Figs. 4a & b: X-ray examination immediately after VPT. Figs. 5a & b: X-ray examination five weeks after VPT. A successful treatment was observed clinically (positive thermal pulp vitality test) and with radiographic examination. Fig. 4a Fig. 4b Fig. 5a Fig. 5b Laser parameters The laser parameters were as follows: – 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). contact Follow-up Dr Masoud Shabani Deputy for Research, Ardabil University of Medical Sciences, Ardabil, Iran Conservative Dentistry, RWTH International Academy, Aachen, Germany m.shabani@arums.ac.ir 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 deter- mined two days after the procedure via telephone 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 deter- mined to be one month after the procedure. Finally, 16 roots 4 2017 after one month follow-up, a successful treatment was observed clinically (positive thermal pulp vitality test) and with radiographic examination (Figs. 5a & b). Discussion Diode laser is extensively used in many dental prac- tices.9 Laser-tissue interaction with high power diode lasers is based on photothermal effects contrary to LLLT, where there is no photothermal effect, but based on photochemical mechanisms.10,11 Since LLLT is dose-dependent,12 the laser parameters have to be respected carefully.13,14 The precise molecular mecha- nisms for LLLT are not too clear, but the clinical effects on pain control, inflammation reduction and wound healing are well investigated.15–17 Gupta et al. reported that laser pulpotomy showed clinical and radio- graphical results superior to those of electro-surgery and ferric sulfate pulpotomy in human primary mo- lars, using high power diode laser in order to achieve good coagulation.18 Uloopi et al. applied LLLT in pul- potomy and noted that this treatment modality can be considered for primary teeth pulpotomy and its success was comparable to MTA pulpotomy tech- nique.19 It is obvious that the use of diode laser appli- cation in pulpotomy can be twofold. In this case, higher power was first used for good coagulation and LLLT was then used in for pain reduction and anti-in- flammatory purposes. Conclusion Diode laser based on the protocol applied in this study can successfully be used in Vital Pulp Therapy._