Purpose: Direct pulp capping represents the borderline between restorative and endodontic dentistry. The aim of this investigation was to asses the effectiveness of an Er,Cr:YSGG laser (2780 nm, Waterlase, Biolase) combined with the use of calcium hydroxide cement base in direct pulp capping. Materials and Methods: A total of 25 carious cavities in 25 patients were selected for investigation and treatment. The total number was split into two treatment groups, dependant upon the clinical condition. Group A: 13 teeth; these cavities did not display exposure of the pulp. Group B: 12 teeth; these cavities displayed a vital exposure of the pulp. Both groups underwent cavity preparation to remove caries and define restorative form. After cavity preparation, group A was treated with the laser using the following parameters: a 600-μm tip at 1 W, 20 pps for 60 s (water 55%, air 65%) in focused mode for disinfection, and at 1 W, 20 pps for 30 s (water 15%, air 25%) in defocused mode to perform dentin melting. Group B was treated with the same parameters as above, followed by a defocused irradiation at 0.5 W, 20 pps for 10 s, with no water and 45% air, to coagulate the pulp. In all cases, the treated area was protected by a base of calcium hydroxide prior to being restored with a totaletch bonding system and a flowable microhybrid composite. Results: All cases treated with the Er,Cr:YSGG laser proved positive clinical pulp vitality after 6 months. At the 48-month follow-up, group A revealed two teeth with negative vitality (equal to 84.6% success), and in group B, another two teeth with negative pulp vitality (83.3% success) were found.
Conclusions: The Er,Cr:YSGG laser appears to be effective as an adjunct in pulp capping procedures. To obtain more conclusive and statistically significant results, it may be necessary to repeat the treatment regime, using a larger sample.

Keywords: erbium:YAG laser, Er,Cr:YSGG laser, pulp capping, calcium hydroxide