Evaluation of dentin bridge formation and postoperative pain reduction after direct pulp capping using photobiomodulation therapy, platelet-rich fibrin, and mineral trioxide aggregate – A randomized clinical trial

Objective: Direct pulp capping (DPC) preserves pulp vitality and stimulates reparative dentin formation. Photobiomodulation therapy (PBMT) may enhance healing especially with platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA). This study aims to assess the effects of PBMT, alone or with PRF or MTA, on postoperative pain after DPC and on dentin bridge thickness using cone-beam computed tomography (CBCT). Materials and Methods: Sixty patients (17–45 years) with reversible pulpitis in permanent molars were randomly divided into three groups ( n = 20 each): Group A: MTA with PBMT (A 1 ) and without PBMT (A 2 ), Group B: PRF with PBMT (B 1 ) and without PBMT (B 2 ), and Group C: only PBMT. Clinical and radiographic follow-up was done at 3, 6, and 12 months. The thickness of the dentin bridge was measured at all the intervals using CBCT. Results: At 24 h, there was no significant reduction in pain compared to baseline across all the groups. However, in the first and second weeks, groups treated with PBMT showed a significant reduction in pain ( P = 0.00). CBCT revealed that PBMT-treated groups had greater dentin bridge development, particularly in Group B 2 . Conclusion: PBMT with PRF was associated with better pain reduction and dentin bridge formation than other interventions.