Establishment of safe and reliable pulp preservation therapy using Er: YAG laser

Abstract

In daily clinical practice, we are often faced with cases where pulp is guttationed when softened dentin is thoroughly removed, but we wish to preserve the pulp as much as possible. By removing the caries while remineralizing and rehardening the dentin with stepwise excision, the pulp can be preserved without guttation. In this report, we describe a case of pulp preservation using the Er:YAG laser to improve the accuracy of stepwise excision. Stepwise excision was performed according to the guidelines of the Japanese Society of Conservative Dentistry, and the pulp side was irradiated with Er:YAG laser (Erwin Adverl EVO: Morita; C400F 20pps, 30-40mj) before the pulp is covered with tannin and fluoride cement (The caries was gradually removed while remineralizing the teeth using a carboxylate cement (Hybond Temporary Cement Soft: shofu) containing tannin and a fluoride compound. As a result, a sufficiently hard remineralized image was observed after removal of the caries. This technique can be expected to activate the pulp and sterilize the fossa, and better remineralization can be expected.