Application of Nd: YAG Laser to the Devitalization of Vital Pulp (Case Report)

Abstract

Case 1: A 72yr-old female was referred to our hospital from a general practitioner for root canal treatment on themandibular left and right first molars. Both molars were diagnosed as chronic ulcerative pulpitis and she had a medical historyof endocarditics.
Procedure To prevent infection, 250mg of antibiotic medicine was administered before and after treatment.
Gingivobuccal gingival areas were coated with Indian ink and irradiated with Nd: YAG laser irradiation for 30 sec at an energy level of 100mJ 15pps.
After laser anesthesia was successful, a low-speed round bur was used to penetrate into the chamber, and paraformaldehydewas applied to the exposed pulp.
One week later, endodontic treatment was performed with the conventional procedure.
Case 2: A 72-yr-old female was referred from a prosthodontic department for root canal treatment on the mandibular leftcanine and the left first premolar.
The canine was diagnosed as chronic ulcerative pulpitis and the premolar as dentin caries of intact pulp.
After laser anesthesia, a low-speed round bur was used to penetrate into the canine chamber without pain, however, penetration into the premolar pulp chamber could not be performed due to intolerable pain. Since severe pain was recognized duringthe cavity preparation, infiltration anesthesia was performed for endodontic treatment of pulpotomy.
As a result, Nd: YAG laser was effective as anesthesia for the devitalization of dentin and pulp tissues of chronic ulcerativepulpitis, but was not useful for controlling pain during pulpotomy of sound pulp.
In conclusion, it is suggested that Nd: YAG laser may be applied as anesthesia for dental treatments, which are contraindicationsof dental infiltration anesthesia.