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Outcome of 940-nm diode laser-assisted endodontic treatment of teeth with apical periodontitis: a retrospective study of clinical cases

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Abstract

Objective

The aim of this retrospective study of clinical cases was to compare outcomes of laser-assisted endodontic treatment/retreatment using 940-nm diode laser and EDTA versus conventional use of NaOCl and EDTA or citric acid with or without Ca(OH)2 intersessions in teeth with apical periodontitis.

Materials and methods

Database of medical documentation in a private practice was screened for root canal treatments done during 2014–2017. Then all files of cases with apical periodontitis (N = 46) were taken for retrospective evaluation and divided into two groups: group 1—940-nm diode laser-assisted endodontic treatments/retreatments (N = 24); group 2—conventional treatments/retreatments (N = 22). The outcome measure was radiographic change in apical bone density, using the periapical index (PAI). Unrelated specialist endodontist was asked to give PAI scores for radiographs done before treatment and after treatment—short- and long-term follow-up or both if present. All available data was assessed for statistical evaluation.

Results

No statistically significant difference of PAI score between groups before treatment (p = 0.943) and after long-term follow-up (p = 0.22) was found. Both groups exhibited a statistically significant decrease in PAI scores in short-term and in long-term follow-up evaluation (p < 0.001). With laser group having first follow-up evaluation significantly earlier (p < 0.001) with significantly lower PAI score (p = 0.002) than conventional. Significantly more treatments in laser group were done without any chemical antibacterial substances (NaOCl, Ca(OH)2 or antibiotics), while in conventional, at least one was always used.

Conclusion

Results of this study suggests that 940-nm diode laser-assisted endodontic protocol is a reliable alternative to conventional treatment, allowing a decrease of chemical irrigation solutions, intracanal medication, and systemic antibiotic use and initiating faster healing of periapical lesion. However, to have stronger evidence, well designed randomised clinical trial studies are needed with larger sample size.

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Acknowledgements

Special thanks to the RWTH Aachen Dental Laser Centre AALZ for inspiration, encouragement and motivation, to a colleague and friend specialist endodontist Simona Biriukoviene who kindly evaluated radiographs with PAI scores, to Irena Nedzelskiene who did statistical analysis for this study and the last but not least for a specialist prosthodontist owner of the private practice where this study was done—Jonas Masilionis—father of the author.

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Authors and Affiliations

  1. J.Masilionio odontologijos klinika, Partizanu 27E-29, LT-49449, Kaunas, Lithuania

    Monika Masilionyte

  2. AALZ RWTH Aachen University, Pauwelsstraße 17, 52074, Aachen, Germany

    Monika Masilionyte & Norbert Gutknecht

  3. Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany

    Norbert Gutknecht

Authors
  1. Monika Masilionyte
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  2. Norbert Gutknecht
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Correspondence to Monika Masilionyte.

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The authors declare that they have no conflict of interest.

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Masilionyte, M., Gutknecht, N. Outcome of 940-nm diode laser-assisted endodontic treatment of teeth with apical periodontitis: a retrospective study of clinical cases. Laser Dent Sci 2, 169–179 (2018). https://doi.org/10.1007/s41547-018-0035-2

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  • DOI: https://doi.org/10.1007/s41547-018-0035-2

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