A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis

The root walls of immature permanent teeth are often weak, thin, and short, making regenerative endodontic treatment (RET) necessary. The goal of RET is to create a favorable environment for further root development. A biomimetic approach is essential for thorough disinfection, followed by the prese...

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Main Authors: Dijana D. Mitic, Maja S. Milosevic Markovic, Igor D. Jovanovic, Dragan D. Mancic, Kaan Orhan, Vukoman R. Jokanovic, Dejan Lj. Markovic
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Biomimetics
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Online Access:https://www.mdpi.com/2313-7673/10/4/216
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author Dijana D. Mitic
Maja S. Milosevic Markovic
Igor D. Jovanovic
Dragan D. Mancic
Kaan Orhan
Vukoman R. Jokanovic
Dejan Lj. Markovic
author_facet Dijana D. Mitic
Maja S. Milosevic Markovic
Igor D. Jovanovic
Dragan D. Mancic
Kaan Orhan
Vukoman R. Jokanovic
Dejan Lj. Markovic
author_sort Dijana D. Mitic
collection DOAJ
description The root walls of immature permanent teeth are often weak, thin, and short, making regenerative endodontic treatment (RET) necessary. The goal of RET is to create a favorable environment for further root development. A biomimetic approach is essential for thorough disinfection, followed by the preservation and potential stimulation of stem cells from surrounding tissue to enable root regeneration and continued development. The objective of this study was to assess temperature changes on the external root surface, structural alterations in the internal root walls following irradiation with a 940 nm diode laser, and the biocompatibility of stem cells from the apical papilla (SCAPs). Irradiation was performed with varying output powers (0.5 W, 1 W, 1.5 W, and 2 W) in continuous mode for 5 s over four consecutive cycles. Thermographic measurements during irradiation, the micro-CT analysis of root samples, and mitochondrial activity of SCAPs were evaluated. The heating effect correlated directly with a higher output power and thinner root walls. A 1 W output power was found to be safe for immature teeth, particularly in the apical third of the root, while 1.5 W could be safely used for mature mandibular incisors. Diode laser irradiation at 1 W and 1.5 W significantly stimulated SCAPs’ mitochondrial activity within 24 h post-irradiation, indicating a potential photobiostimulatory effect. However, no significant changes were observed at lower (0.5 W) and higher (2 W) output powers. The area of open tubular space inside the root canal was significantly reduced after irradiation, regardless of the applied power. Additionally, irradiation contributed to the demineralization of the dentin on the inner root walls. Future studies should explore the impact of irrigants used between irradiation cycles, the potential benefits of conical laser tips for more even energy distribution, and a thorough analysis of how disinfection protocols affect both the dentin structure and stem cell viability.
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spelling doaj-art-b62ffdba42894795b34075e0138e56a22025-08-20T03:14:15ZengMDPI AGBiomimetics2313-76732025-04-0110421610.3390/biomimetics10040216A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological AnalysisDijana D. Mitic0Maja S. Milosevic Markovic1Igor D. Jovanovic2Dragan D. Mancic3Kaan Orhan4Vukoman R. Jokanovic5Dejan Lj. Markovic6School of Dental Medicine, University of Belgrade, 11000 Belgrade, SerbiaSchool of Dental Medicine, University of Belgrade, 11000 Belgrade, SerbiaFaculty of Electronic Engineering, University of Nis, 18000 Nis, SerbiaFaculty of Electronic Engineering, University of Nis, 18000 Nis, SerbiaDepartment of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, 06000 Ankara, TurkeyVinca Institute of Nuclear Sciences, University of Belgrade, 11000 Belgrade, SerbiaSchool of Dental Medicine, University of Belgrade, 11000 Belgrade, SerbiaThe root walls of immature permanent teeth are often weak, thin, and short, making regenerative endodontic treatment (RET) necessary. The goal of RET is to create a favorable environment for further root development. A biomimetic approach is essential for thorough disinfection, followed by the preservation and potential stimulation of stem cells from surrounding tissue to enable root regeneration and continued development. The objective of this study was to assess temperature changes on the external root surface, structural alterations in the internal root walls following irradiation with a 940 nm diode laser, and the biocompatibility of stem cells from the apical papilla (SCAPs). Irradiation was performed with varying output powers (0.5 W, 1 W, 1.5 W, and 2 W) in continuous mode for 5 s over four consecutive cycles. Thermographic measurements during irradiation, the micro-CT analysis of root samples, and mitochondrial activity of SCAPs were evaluated. The heating effect correlated directly with a higher output power and thinner root walls. A 1 W output power was found to be safe for immature teeth, particularly in the apical third of the root, while 1.5 W could be safely used for mature mandibular incisors. Diode laser irradiation at 1 W and 1.5 W significantly stimulated SCAPs’ mitochondrial activity within 24 h post-irradiation, indicating a potential photobiostimulatory effect. However, no significant changes were observed at lower (0.5 W) and higher (2 W) output powers. The area of open tubular space inside the root canal was significantly reduced after irradiation, regardless of the applied power. Additionally, irradiation contributed to the demineralization of the dentin on the inner root walls. Future studies should explore the impact of irrigants used between irradiation cycles, the potential benefits of conical laser tips for more even energy distribution, and a thorough analysis of how disinfection protocols affect both the dentin structure and stem cell viability.https://www.mdpi.com/2313-7673/10/4/216940 nm diode laserregenerative endodontic treatmentimmature permanent teethSCAPsmicro-CTthermographic measurement
spellingShingle Dijana D. Mitic
Maja S. Milosevic Markovic
Igor D. Jovanovic
Dragan D. Mancic
Kaan Orhan
Vukoman R. Jokanovic
Dejan Lj. Markovic
A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis
Biomimetics
940 nm diode laser
regenerative endodontic treatment
immature permanent teeth
SCAPs
micro-CT
thermographic measurement
title A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis
title_full A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis
title_fullStr A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis
title_full_unstemmed A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis
title_short A Biomimetic Approach to Diode Laser Use in Endodontic Treatment of Immature Teeth: Thermal, Structural, and Biological Analysis
title_sort biomimetic approach to diode laser use in endodontic treatment of immature teeth thermal structural and biological analysis
topic 940 nm diode laser
regenerative endodontic treatment
immature permanent teeth
SCAPs
micro-CT
thermographic measurement
url https://www.mdpi.com/2313-7673/10/4/216
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