REVIEW Laser-assisted pulpotomy in primary teeth: a systematic review PETER DE COSTER 1 , SIVAPRAKASH RAJASEKHARAN 2 & LUC MARTENS 2 1 Oral Biology, Dental School, Ghent University, Ghent, Belgium, and 2 Paediatric Dentistry and Special Care, Dental School, Ghent University, Ghent, Belgium International Journal of Paediatric Dentistry 2012; 00: 00–00 Objective. The purpose of this systematic review was to identify high-quality articles comparing laser with conventional pulpotomy procedures, and to assess whether laser treatment may offer an appreciable benefit over conventional approaches. Methods. A systematic search was implemented for MEDLINE, WEB of SCIENCE and Cochrane’s CENTRAL databases (1980–2012) to identify eligible studies. Two reviewers independently assessed the methodological quality of the articles (Κ = 0.89) using specific study design-related quality assessment forms (Dutch Cochrane Collaboration). Results. Seven articles met the inclusion criteria, of which five randomized control trials (RCT) and two case series (CS), involving Nd:YAG, Er:YAG, CO 2 and 632/980 nm diode lasers. Although het- erogeneity between pulpotomy studies was high, odds ratios (OR) were generally <1, indicating that laser is less successful than conventional pulpotomy techniques. Conclusion. Given the paucity and high heteroge- neity of high-quality articles, general recommen- dations for the clinical use of laser in pulpotomy in primary teeth can yet not be formulated. Introduction The purpose of dental pulp therapy is to maintain the vitality of an affected tooth to secure its presence in the dental arch. Depending on the extent of pulpal involve- ment, pulp therapy may include pulp cap- ping or pulpotomy procedures. 1 Pulpotomy therapy aims at maintaining a carious tooth by removing the coronal portion of the infected pulp, while preserving the unin- fected radicular pulpal tissue (MEDLINE MeSH). Various techniques and materials have been recommended for these purposes, such as formocresol, glutaraldehyde, ferric sulphate, calcium hydroxide, Mineral Triox- ide Aggregate (MTA), and laser therapy, but a consensus on the ideal pulpotomy tech- nique has not yet been reached. Although dilute formocresol has long been regarded as the gold standard for wound dressing of pulpotomized primary teeth, the results of recent meta-analyses 2,3 indicate that MTA and ferric sulphate might be considered appropriate alternatives presenting similar or even higher clinical and radiographic success rates. From a recent systematic review 4 according to specific standardized criteria, 5 however, there appears to exist insufficient evidence to support the long-term effective- ness of MTA as a pulpotomy medicament. Current evidence further provides inconclu- sive information regarding the performance of calcium hydroxide dressings on exposed pulps as compared to the above-mentioned products. 6–8 Over time, concerns have been raised over the potential cytotoxicity and mutagenicity of some of these products applied, 9,10 but the lack of relevant and high-quality randomized clinical trials (RCTs) makes it impossible to assess their long-term biological effects in vivo. Laser treatment has been granted a number of advantages with respect to haemorrhage control, absence of mechanical contact, and stimulation of regenerative cell lines in the dental pulp. Promising results concerning *Correspondence to: Prof Dr Peter J. De Coster, Dental School Ghent University – 0P8 185, De Pintelaan 9000, Ghent, Belgium. E-mail: peter. decoster@ugent.be © 2012 John Wiley & Sons Ltd, BSPD and IAPD 1 DOI: 10.1111/ipd.12014