Efficacy of Erbium: Yttrium Aluminium Garnet and Diode laser in enhancing the tissue regeneration ability and clinical outcome in regenerative endodontics

The study is designed to assess the success of revascularization in mature teeth with periradicular lesion and the effect of laser in enhancing the regenerative ability.

The experimental groups are

Group 1: Regenerative endodontic procedure (REP) procedure similar to American Association of Endodontists clinical considerations (2016) for immature teeth

Group 2: Diode Laser

Group 3: Er: YAG laser

A power analysis was established by G*power, version 3.0.1(Franz Faul universitat, Kiel, Germany). A sample size of 51 (17 per group) would yield 90% power to detect significant differences, with assuming the effect size of 0.2, (Eldessoky et al) and significance level at 0.05. Considering 20% attrition rate, total sample size is 51+12= 63 (21 per group)

Group 1 the standard revascularization procedure will be carried out as per the AAE guidelines which includes triple antibiotic paste in first appointment for disinfection followed by revaculrization and pRF placement in second appointment which is after 14 days.

in group 2 and group 3 laser assisted irrigation will be used for disinfection and triple antibiotic paste will not be used. during the revascualrization visit photobiomodulation with the respective laser will be done.

patients will be recalled at 1month, 3 months, 6 months, 12 months and 24 months for clinical assessment of symptoms, pulp sensibility tests, digital radiographic assessmnt. CBCT will be done at 12 month follow up to evaluate the regression of periapical lesion.