Lasers Med Sci. 2025 Dec 1;40(1):504. doi: 10.1007/s10103-025-04764-6.
ABSTRACT
To evaluate and compare clinical outcomes, radiographic healing and regenerative biomarkers in laser-irradiated and non-irradiated groups undergoing regenerative endodontics in immature permanent teeth over a 12-month follow-up period. Twenty-eight patients with necrotic immature roots were assigned to one of two groups: a control group (n = 14) receiving standard regenerative endodontic procedure (REP) with a mock laser application, or an experimental group (n = 14) receiving standard REP with adjunctive low-level laser therapy (LLLT). Both groups underwent initial medication with double antibiotic paste. In the experimental group, a diode dental laser (810 nm, 4.5 J/cm², 0.3 W, 9 s) was applied to the apical third every 48 h for 14 days. After 21 days, intracanal bleeding was induced, and blood samples were collected for regenerative marker analysis using ELISA. Mineral trioxide aggregate was placed, followed by coronal restoration. Clinical symptoms and radiographic healing were monitored over 12 months, with statistical analysis performed using the independent t-test at a 95% confidence level. Clinically, both groups demonstrated high success rates (85.7% in the laser group vs. 78.6% in the control group; p = 0.83). No statistically significant differences were observed when pain and radiographic parameters were compared over time between the groups. Considering the biomarkers, only DSPP expression was significantly higher in the laser group (p = 0.03). For the other biomarkers (VEGF, TGF-β, MMP-8, PDGF-BB), the laser group showed numerically higher mean values, but these differences did not reach statistical significance (all p > 0.05). This study demonstrates that adjunctive low-level laser therapy (LLLT) during regenerative endodontic procedures produced comparable clinical and radiographic outcomes to standard treatment, with a significant increase in DSPP expression suggesting early molecular activation. While these findings indicate potential regenerative benefits, larger multicenter studies with extended follow-up are required to validate LLLT as an adjunct in clinical protocols. Trial registration: This trial was registered in the Clinical Trials Registry India (CTRI) under registration number CTRI/2024/01/062114 dated 31/01/2024.
PMID:41320703 | DOI:10.1007/s10103-025-04764-6
