Skip to main content

Laser-Activated Irrigation (LAI)

  • Chapter
Lasers in Endodontics

Abstract

The complex anatomy of the root canal system and the limited penetration depth of the commonly used irrigants into the dentine limit the ability to clean, debride and disinfect three-dimensionally and completely the root canal system. Erbium family lasers represent the cutting-edge technology for the activation of irrigants in endodontics. LAI is introduced here, emphasising all the different techniques proposed. The mechanism of LAI and all the conditions that influence LAI efficiency and safety are described including the wavelength to use, the energy, the pulse duration and pulse frequency, tip design and tip position into the canal or in the pulp chamber. Studies on applications of LAI for smear layer removal and canal decontamination are fully debated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gulabivala K, Ng YL, Gilbertson M, Eames I. The fluid mechanics of root canal irrigation. Physiol Meas. 2010;31:R49–84.

    Article  PubMed  Google Scholar 

  2. Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dent Clin North Am. 2010;54:291–312.

    Article  PubMed  Google Scholar 

  3. Peters OA, Schonenberger K, Laib A. Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro-computed tomography. Int Endod J. 2001;34:221–30.

    Article  PubMed  Google Scholar 

  4. Ricucci D, Siqueira Jr JF. Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures. J Endod. 2010;36:1–15.

    Article  PubMed  Google Scholar 

  5. Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. J Endod. 2010;36:1558–62.

    Article  PubMed  Google Scholar 

  6. Macedo RG, Wesselink PR, Zaccheo F, Fanali D, Van Der Sluis LW. Reaction rate of NaOCl in contact with bovine dentine: effect of activation, exposure time, concentration and pH. Int Endod J. 2010;43:1108–15.

    Article  PubMed  Google Scholar 

  7. de Gregorio C, Estevez R, Cisneros R, Paranjpe A, Cohenca N. Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study. J Endod. 2010;36:1216–21.

    Article  PubMed  Google Scholar 

  8. De Moor R. High-power lasers in endodontics – fiber placement for laser-enhanced endodontics: in the canal or at the orifice? J LA&HA. 2014;2014:20–8.

    Google Scholar 

  9. De Moor R, Meire M. Laser activated irrigation. Part 2: does the position of the fiber matters? Laser. 2014;3:12. 14, 16–8.

    Google Scholar 

  10. DiVito EE, Colonna MP, Olivi G. The photoacoustic efficacy of an Er:YAG Laser with radial and stripped tips on root canal dentin walls: an SEM evaluation. J Laser Dent. 2011;19:156–61.

    Google Scholar 

  11. Peters OA, Bardsley S, Fong J, Pandher G, Divito E. Disinfection of root canals with photon-initiated photoacoustic streaming. J Endod. 2011;37:1008–12.

    Article  PubMed  Google Scholar 

  12. DiVito E, Peters OA, Olivi G. Effectiveness of the erbium:YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation. Lasers Med Sci. 2012;27:273–80.

    Article  PubMed  Google Scholar 

  13. DiVito E, Lloyd A. ER:YAG laser for 3-dimensional debridement of canal systems: use of photon-induced photoacoustic streaming. Dent Today. 2012;31:122,124–127.

    Google Scholar 

  14. Blanken JW, Verdaasdonk RM. Cavitation as a working mechanism of the Er, Cr:YSGG laser in endodontics: a visualization study. J Oral Laser Appl. 2007;7:97–106.

    Google Scholar 

  15. Blanken J, De Moor RJG, Meire M, Verdaasdonk R. Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 1: a visualization study. Lasers Surg Med. 2009;41:514–9.

    Article  PubMed  Google Scholar 

  16. de Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LW. Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J. 2009;42:1077–83.

    Article  PubMed  Google Scholar 

  17. Matsumoto H, Yoshimine Y, Akamine A. Visualization of irrigant flow and cavitation induced by Er:YAG laser within a root canal model. J Endod. 2011;37:839–43.

    Article  PubMed  Google Scholar 

  18. Gregorcic P, Jezersek M, Mozina J. Optodynamic energy-conversion efficiency during an Er:YAG-laser-pulse delivery into a liquid through different fiber-tip geometries. J Biomed Opt. 2012;17:075006.

    Article  PubMed  Google Scholar 

  19. George R, Meyers IA, Walsh LJ. Laser activation of endodontic irrigants with improved conical laser fiber tips for removing smear layer in the apical third of the root canal. J Endod. 2008;34:1524–7.

    Article  PubMed  Google Scholar 

  20. De Moor RJ, Blanken J, Meire M, Verdaasdonk R. Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 2: evaluation of the efficacy. Lasers Surg Med. 2009;41:520–3.

    Article  PubMed  Google Scholar 

  21. De Moor RJ, Meire M, Goharkhay K, Moritz A, Vanobbergen J. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod. 2010;36:1580–3.

    Article  PubMed  Google Scholar 

  22. Peeters HH, Suardita K. Efficacy of smear layer removal at the root tip by using ethylenediaminetetraacetic acid and erbium, chromium: yttrium, scandium, gallium garnet laser. J Endod. 2011;37:1585–9.

    Article  PubMed  Google Scholar 

  23. Deleu E, Meire MA, De Moor RJ. Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci. 2013;30:831–5.

    Article  PubMed  Google Scholar 

  24. Robertson CW, Williams D. Lambert absorption coefficients of water in the infrared. J Opt Soc Am. 1971;61:1316–20.

    Article  Google Scholar 

  25. Meire MA, Poelman D, De Moor RJ. Optical properties of root canal irrigants in the 300–3,000-nm wavelength region. Lasers Med Sci. 2014;29:1557–62.

    Article  PubMed  Google Scholar 

  26. Stock K, Hibst R, Keller U. Comparison of Er:YAG and Er:YSGG laser ablation of dental hard tissues. SPIE. 1997;3192:0277-786X/97.

    Google Scholar 

  27. Perhavec T, Diaci J. Comparison of Er:YAG and Er, Cr:YSGG dental lasers. J Oral Laser Appl. 2008;8:87–94.

    Google Scholar 

  28. Moritz A. Oral laser application. Berlin: Quintessence Verlags-GmbH; 2006. p. 258–77.

    Google Scholar 

  29. Paltauf G, Schmidt-Kloiber H. Photoacoustic waves excited in liquids by fiber-transmitted laser pulses. J Acoust Soc Am. 1998;104:890–7.

    Article  Google Scholar 

  30. Doukas AG, Birngruber R, Deutsch TF. Determination of the shock wave pressures generated by laser-induced breakdown in water. Laser–tissue interactions SPIE. 1990;1202:61–70.

    Google Scholar 

  31. Levy G, Rizoiu I, Friedman S, Lam H. Pressure waves in root canals induced by Nd: YAG laser. J Endod. 1996;22:81–4.

    Article  PubMed  Google Scholar 

  32. Meire MA, De Prijck K, Coenye T, Nelis HJ, De Moor RJ. Effectiveness of different laser systems to kill Enterococcus faecalis in aqueous suspension and in an infected tooth model. Int Endod J. 2009;42:351–9.

    Article  PubMed  Google Scholar 

  33. Michiels R, Vergauwen TEM, Mavridou A, Meire M, De Bruyne M, De Moor RJG. Investigation of coronal leakage of root fillings after smear layer removal with EDTA or Nd:YAG lasing through capillary flow porometry. Photomed Laser Surg. 2010;28 Suppl 2:S43–50.

    PubMed  Google Scholar 

  34. Hmud R, Kahler WA, George R, Walsh LJ. Cavitational effects in aqueous endodontic irrigants generated by near-infrared lasers. J Endod. 2010;36:275–8.

    Article  PubMed  Google Scholar 

  35. Hmud R, Kahler WA, Walsh LJ. Temperature changes accompanying near infrared diode laser endodontic treatment of wet canals. J Endod. 2010;36:908–11.

    Article  PubMed  Google Scholar 

  36. Benedicenti S, Cassanelli C, Signore A, Ravera G, Angiero F. Decontamination of root canals with the gallium-aluminum-arsenide laser: an in vitro study. Photomed Laser Surg. 2008;26:367–70.

    Article  PubMed  Google Scholar 

  37. Alfredo E, Souza-Gabriel AE, Silva SR, Sousa-Neto MD, Brugnera-Junior A, Silva-Sousa YT. Morphological alterations of radicular dentine pretreated with different irrigating solutions and irradiated with 980-nm diode laser. Microsc Res Tech. 2009;72:22–7.

    Article  PubMed  Google Scholar 

  38. Olivi G, Olivi M, Kaitsas V, Benedicenti S. Morphological changes after 810 nm diode laser irradiation of prepared, wet root canals: SEM investigations. Dentista Moderno. 2013:122–8.

    Google Scholar 

  39. Moon YM, Kim HC, Bae KS, Baek SH, Shon WJ, Lee W. Effect of laser-activated irrigation of 1320-nanometer Nd:YAG laser on sealer penetration in curved root canals. J Endod. 2012;38:531–5.

    Article  PubMed  Google Scholar 

  40. van Leeuwen TG, van de Veen MJ, Verdaasdonk RM, Borst C. Non contact tissue ablation by Holmium:YSGG laser pulses in blood. Lasers Surg Med. 1991;11:26–34.

    Article  PubMed  Google Scholar 

  41. Flotte TJ, Doukas A. Laser induced pressure effects. Laser Tissue Interactions SPIE. 1992;1646:295–300.

    Google Scholar 

  42. Song WD, Hong MH, Lukyanchuk B, Chong TC. Laser-induced cavitation bubbles for cleaning of solid surfaces. J Appl Phys. 2004;95:2952–6.

    Article  Google Scholar 

  43. Brennen CE. Cavitation and bubble dynamics. Oxford: Oxford University Press; 1995.

    Google Scholar 

  44. Prosperetti A. Bubbles Phys Fluids. 2004;16:1852–65.

    Article  Google Scholar 

  45. Jiang C, Chen M-T, Gorur A, Schaudinn C, Jaramillo DE, Costerton JW, Sedghizadeh PP, Vernier PT, Gundersen MA. Nanosecond pulsed plasma dental probe. Plasma Process Polym. 2009;6:479–83.

    Article  Google Scholar 

  46. Peeters HH, Mooduto L. Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er, Cr:YSGG laser irradiation: an in vivo study. Clin Oral Investig. 2013;17:2105–12.

    Article  PubMed  Google Scholar 

  47. George R, Walsh LJ. Performance assessment of novel side firing safe tips for endodontic applications. J Biomed Opt. 2011;16:048004.

    Article  PubMed  Google Scholar 

  48. Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study. Int Endod J. 2009;42:144–55.

    Article  PubMed  Google Scholar 

  49. George R, Walsh LJ. Apical extrusion of root canal irrigants when using Er:YAG and Er, Cr:YSGG lasers with optical fibers: an in vitro dye study. J Endod. 2008;34:706–8.

    Article  PubMed  Google Scholar 

  50. George R, Walsh LJ. Laser fiber-optic modifications and their role in endodontics. J Laser Dent. 2012;20:24–30.

    Google Scholar 

  51. Seet AN, Zilm PS, Gully NJ, Cathro PR. Qualitative comparison of sonic or laser energisation of 4% sodium hypochlorite on an Enterococcus faecalis biofilm grown in vitro. Aust Endod J. 2012;38:100–6.

    Article  PubMed  Google Scholar 

  52. Guidotti R, Merigo E, Fornaini C, Rocca JP, Medioni E, Vescovi P. Er:YAG 2,940-nm laser fiber in endodontic treatment: a help in removing smear layer. Lasers Med Sci. 2014;29:69–75.

    Article  PubMed  Google Scholar 

  53. Licata ME, Albanese A, Campisi G, Geraci DM, Russo R, Gallina G. Effectiveness of a new method of disinfecting the root canal, using Er, Cr:YSGG laser to kill Enterococcus faecalis in an infected tooth model. Lasers Med Sci. 2015;30:707–12.

    Article  PubMed  Google Scholar 

  54. Martin SA. Conventional endodontic therapy of upper central incisor combined with cyst decompression: a case report. J Endod. 2007;33:753–7.

    Article  PubMed  Google Scholar 

  55. Peeters HH, De Moor RJ. Measurement of pressure changes during laser-activated irrigant by an erbium, chromium: yttrium, scandium, gallium, garnet laser. Lasers Med Sci. 2015;30(5):1449–55.

    Google Scholar 

  56. Guyton AC, Hall JE. Guyton & Hall physiology review. Philadelphia: Elsevier Saunders; 2006.

    Google Scholar 

  57. Ram Z. Effectiveness of root canal irrigation. Oral Surg Oral Med Oral Pathol. 1977;44:306–12.

    Article  PubMed  Google Scholar 

  58. George R, Walsh LJ. Thermal effects from modified endodontic laser tips used in the apical third of root canals with erbium-doped yttrium aluminium garnet and erbium, chromium-doped yttrium scandium gallium garnet lasers. Photomed Laser Surg. 2010;28:161–5.

    Article  PubMed  Google Scholar 

  59. Peeters HH, Mooduto L. Measurement of temperature changes during cavitation generated by an erbium, chromium: Yttrium, scandium, gallium garnet laser. OJST. 2012;2:286–91.

    Article  Google Scholar 

  60. Kuhn K, Rudolph H, Luthardt RG, Stock K, Diebolder R, Hibst R. Er:YAG laser activation of sodium hypochlorite for root canal soft tissue dissolution. Lasers Surg Med. 2013;45:339–44.

    Article  PubMed  Google Scholar 

  61. Ahmad M, Pitt Ford TR, Crum LA, Walton AJ. Ultrasonic debridement of root canals: acoustic cavitation and its relevance. J Endod. 1988;14:486–93.

    Article  PubMed  Google Scholar 

  62. Bolhari B, Ehsani S, Etemadi A, Shafaq M, Nosrat A. Efficacy of Er, Cr:YSGG laser in removing smear layer and debris with two different output powers. Photomed Laser Surg. 2014;32:527–32.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Sadık B, Arıkan S, Beldüz N, Yaşa Y, Karasoy D, Cehreli M. Effects of laser treatment on endodontic pathogen Enterococcus faecalis: a systematic review. Photomed Laser Surg. 2013;31:192–200.

    Article  PubMed  Google Scholar 

  64. Bago Jurič I, Plečko V, Anić I. Antimicrobial efficacy of Er, Cr:YSGG laser-activated irrigation compared with passive ultrasonic irrigation and RinsEndo(®) against intracanal Enterococcus faecalis. Photomed Laser Surg. 2014;32:600–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giovanni Olivi MD, DDS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Olivi, G., De Moor, R.J.G. (2016). Laser-Activated Irrigation (LAI). In: Olivi, G., De Moor, R., DiVito, E. (eds) Lasers in Endodontics. Springer, Cham. https://doi.org/10.1007/978-3-319-19327-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19327-4_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19326-7

  • Online ISBN: 978-3-319-19327-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics