Direct pulp capping is a minimally invasive method to preserve pulp integrity. We evaluated the treatment efficacy of Er:YAG laser irradiation combined with direct pulp capping for pulp exposure due to caries. A total of 21 patients with 22 teeth were enrolled in the conventional group (calcium hydroxide), and 24 patients with 25 teeth were enrolled in the laser‐assisted group (Er:YAG laser irradiation at settings of 10 Hz, 50 mJ; combined with calcium hydroxide). The cumulative success rate of the conventional group and the laser‐assisted group was 68.2% and 91.7% at 12 months, respectively. Results showed that the laser‐assisted procedure increased the survival time (β = 0.04, OR = 0.07), while proximal‐occlusal cavities in molars decreased the survival time (β = 0.03, OR = 12.5). Er:YAG lasers improve the effectiveness of conventional direct pulp capping (using Dycal) with limited side‐effects and can be applied clinically.
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