Effect of diode laser pretreatment on dentin thickness and discoloration in deep caries treated with biodentine: a randomized clinical trial.

Preserving pulp vitality in deep carious lesions remains a clinical challenge. Indirect pulp capping with bioactive calcium silicate materials such as Biodentine has shown favorable biological outcomes, while diode laser irradiation has been proposed as an adjunct to enhance hemostasis, disinfection, and pulpal healing. However, evidence regarding their combined use is limited. This randomized controlled clinical trial compared the clinical and radiographic outcomes of indirect pulp capping using Biodentine alone and diode laser pre-treatment followed by Biodentine. Patients with deep carious lesions were randomly allocated to either Biodentine alone (Group I) or diode laser pre-treatment plus Biodentine (Group II). Changes in dentin thickness were evaluated using cone-beam computed tomography at baseline, 3 months, and 12 months. Tooth discoloration was assessed spectrophotometrically using CIE Lab* parameters, while pulp vitality, pain, and sensitivity were clinically recorded. Data were analyzed using repeated-measures ANOVA (p < 0.05). Both groups demonstrated significant increases in dentin thickness over time (p < 0.001). Group II exhibited significantly greater dentin formation at 3 and 12 months compared with Group I (p < 0.05). No significant differences in tooth discoloration were observed between groups, and all ΔE values remained within clinically acceptable limits. Pulp vitality was preserved in all cases, with significantly lower postoperative pain scores in the diode laser group. Within the limitations of this randomized clinical trial, diode laser pretreatment was associated with a greater increase in radiographically detectable dentin thickness following vital pulp therapy with Biodentine.