Journal of Lasers in Medical Sciences

Abstract

Introduction: Maintaining pulp vitality in mature permanent teeth with deep caries is challenging, especially when initial vitality tests are negative.
Case Presentation: A 45-year-old male presented with extensive caries in the maxillary left lateral incisor, asymptomatic but non-responsive to cold testing, and with delayed electric response. Selective caries removal was performed without anesthesia to assess sensitivity. Photobiomodulation (PBM) using a 635-nm diode laser (100 mW, 4 J/cm²) was applied over deep dentin near the pulp with a 2-mm tip. Subsequent sessions irradiated buccal and lingual surfaces with an 8-mm tip. Pulp sensitivity returned by the fifth session, and after seven sessions, the tooth was restored with composite resin. A well sealed adhesive restoration was placed without a liner.
Conclusion: At 6-month follow-up, it remained vital and asymptomatic with normal radiographic findings. Diode laser PBM may restore pulp reactivity in mature teeth, supporting conservative vital pulp therapy.