Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of Er,Cr:YSGG laser with endodontical radial firing tips on the outcome of endodontic treatment: blind randomized controlled clinical trial with six-month evaluation

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Clinical reports stating the efficacy of novel root canal disinfection protocols are an important focus in endodontic research. This blind randomized clinical trial assessed the clinical efficacy of the erbium, chromium:yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser radial firing tips (RFT) versus the concomitant use of 3 % sodium hypochlorite and interim calcium hydroxide paste in necrotic teeth with chronic apical periodontitis. We hypothesized to find similar or improved bone healing in the laser-assisted endodontic treatment. Thirty-six anterior and premolar teeth were randomly assigned. In group 1, teeth were prepared with 3 % sodium hypochlorite for irrigation and calcium hydroxide as inter-appointment dressing; in group 2, teeth were prepared with saline solution and irradiated with Er,Cr:YSGG laser using RFT2 (140 μs, 37.5 mJ, 20 Hz) and RFT3 (140 μs, 62.5 mJ, 20 Hz) in the first and second appointment, respectively, four times each, moving at 2 mm s−1 from apical to coronal. The primary outcome measure was changed in apical bone density at 6 months, using the periapical index (PAI) for blind radiographic evaluation. Twenty-nine patients were examined and subjected to statistical analysis, 12 in group 1 and 17 in group 2. There was one treatment failure in group 1. Both groups gave similar outcomes exhibiting statistically significant decreases in PAI scores.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Siqueira JF Jr, Rocas IN, Alves FR, Silva MG (2009) Bacteria in the apical root canal of teeth with primary apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107(5):721–726

    Article  PubMed  Google Scholar 

  2. Rocas IN, Siqueira JF Jr (2008) Root canal microbiota of teeth with chronic apical periodontitis. J Clin Microbiol 46(11):3599–3606

    Article  PubMed  CAS  Google Scholar 

  3. Siqueira JF Jr (2002) Endodontic infections: concepts, paradigms, and perspectives. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94(3):281–293

    Article  PubMed  Google Scholar 

  4. Fabricius L, Dahlen G, Sundqvist G, Happonen RP, Moller AJ (2006) Influence of residual bacteria on periapical tissue healing after chemomechanical treatment and root filling of experimentally infected monkey teeth. Eur J Oral Sci 114(4):278–285

    Article  PubMed  Google Scholar 

  5. Carson KR, Goodell GG, McClanahan SB (2005) Comparison of the antimicrobial activity of six irrigants on primary endodontic pathogens. J Endod 31(6):471–473

    Article  PubMed  Google Scholar 

  6. Siqueira JF Jr, Magalhaes KM, Rocas IN (2007) Bacterial reduction in infected root canals treated with 2.5 % NaOCl as an irrigant and calcium hydroxide/camphorated paramonochlorophenol paste as an intracanal dressing. J Endod 33(6):667–672

    Article  PubMed  Google Scholar 

  7. Siqueira JF Jr, Lopes HP (1999) Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 32(5):361–369

    Article  PubMed  Google Scholar 

  8. Katebzadeh N, Sigurdsson A, Trope M (2000) Radiographic evaluation of periapical healing after obturation of infected root canals: an in vivo study. Int Endod J 33(1):60–66

    Article  PubMed  CAS  Google Scholar 

  9. Molander A, Warfvinge J, Reit C, Kvist T (2007) Clinical and radiographic evaluation of one- and two-visit endodontic treatment of asymptomatic necrotic teeth with apical periodontitis: a randomized clinical trial. J Endod 33(10):1145–1148

    Article  PubMed  Google Scholar 

  10. Weiger R, Rosendahl R, Lost C (2000) Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions. Int Endod J 33(3):219–226

    Article  PubMed  CAS  Google Scholar 

  11. Berutti E, Marini R, Angeretti A (1997) Penetration ability of different irrigants into dentinal tubules. J Endod 23(12):725–727

    Article  PubMed  CAS  Google Scholar 

  12. Estrela C, Pimenta FC, Ito IY, Bammann LL (1999) Antimicrobial evaluation of calcium hydroxide in infected dentinal tubules. J Endod 25(6):416–418

    Article  PubMed  CAS  Google Scholar 

  13. Torabinejad M, Handysides R, Khademi AA, Bakland LK (2002) Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94(6):658–666

    Article  PubMed  Google Scholar 

  14. Violich DR, Chandler NP (2010) The smear layer in endodontics—a review. Int Endod J 43(1):2–15

    Article  PubMed  CAS  Google Scholar 

  15. George R, Meyers IA, Walsh LJ (2008) 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 34(12):1524–1527

    Article  PubMed  Google Scholar 

  16. Takeda FH, Harashima T, Kimura Y, Matsumoto K (1998) Comparative study about the removal of smear layer by three types of laser devices. J Clin Laser Med Surg 16(2):117–122

    PubMed  CAS  Google Scholar 

  17. Fegan SE, Steiman HR (1995) Comparative evaluation of the antibacterial effects of intracanal Nd:YAG laser irradiation: an in vitro study. J Endod 21(8):415–417

    Article  PubMed  CAS  Google Scholar 

  18. Gutknecht N, van Gogswaardt D, Conrads G, Apel C, Schubert C, Lampert F (2000) Diode laser radiation and its bactericidal effect in root canal wall dentin. J Clin Laser Med Surg 18(2):57–60

    PubMed  CAS  Google Scholar 

  19. Moritz A, Gutknecht N, Schoop U, Goharkhay K, Doertbudak O, Sperr W (1997) Irradiation of infected root canals with a diode laser in vivo: results of microbiological examinations. Lasers Surg Med 21(3):221–226

    Article  PubMed  CAS  Google Scholar 

  20. Varella CH, Pileggi R (2007) Obturation of root canal system treated by Cr, Er: YSGG laser irradiation. J Endod 33(9):1091–1093

    Article  PubMed  Google Scholar 

  21. Silva AC, Guglielmi C, Meneguzzo DT, Aranha AC, Bombana AC, de Paula Eduardo C (2010) Analysis of permeability and morphology of root canal dentin after Er, Cr:YSGG laser irradiation. Photomed Laser Surg 28(1):103–108

    Article  PubMed  Google Scholar 

  22. De Moor RJ, Blanken J, Meire M, Verdaasdonk R (2009) Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 2: evaluation of the efficacy. Lasers Surg Med 41(7):520–523

    Article  PubMed  Google Scholar 

  23. Eldeniz AU, Ozer F, Hadimli HH, Erganis O (2007) Bactericidal efficacy of Er, Cr:YSGG laser irradiation against Enterococcus faecalis compared with NaOCl irrigation: an ex vivo pilot study. Int Endod J 40(2):112–119

    Article  PubMed  CAS  Google Scholar 

  24. Wang QQ, Zhang CF, Yin XZ (2007) Evaluation of the bactericidal effect of Er, Cr:YSGG, and Nd:YAG lasers in experimentally infected root canals. J Endod 33(7):830–832

    Article  PubMed  Google Scholar 

  25. Arnabat J, Escribano C, Fenosa A, Vinuesa T, Gay-Escoda C, Berini L et al (2010) Bactericidal activity of erbium, chromium:yttrium-scandium-gallium-garnet laser in root canals. Lasers Med Sci 25(6):805–810

    Article  PubMed  Google Scholar 

  26. Abad-Gallegos M, Arnabat-Dominguez J, Espana-Tost A, Berini-Aytes L, Gay-Escoda C (2009) In vitro evaluation of the temperature increment at the external root surface after Er, Cr:YSGG laser irradiation of the root canal. Med Oral Patol Oral Cir Bucal 14(12):e658–e662

    Article  PubMed  CAS  Google Scholar 

  27. Ishizaki NT, Matsumoto K, Kimura Y, Wang X, Kinoshita J, Okano SM et al (2004) Thermographical and morphological studies of Er, Cr:YSGG laser irradiation on root canal walls. Photomed Laser Surg 22(4):291–297

    Article  PubMed  Google Scholar 

  28. Stabholz A, Sahar-Helft S, Moshonov J (2004) Lasers in endodontics. Dent Clin North Am 48(4):809–832, vi

    Article  PubMed  Google Scholar 

  29. George R, Walsh LJ (2010) 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 28(2):161–165

    Article  PubMed  Google Scholar 

  30. Gordon W, Atabakhsh VA, Meza F, Doms A, Nissan R, Rizoiu I et al (2007) The antimicrobial efficacy of the erbium, chromium:yttrium-scandium-gallium-garnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus faecalis. J Am Dent Assoc 138(7):992–1002

    PubMed  Google Scholar 

  31. Orstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2(1):20–34

    Article  PubMed  CAS  Google Scholar 

  32. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  PubMed  CAS  Google Scholar 

  33. Penesis VA, Fitzgerald PI, Fayad MI, Wenckus CS, BeGole EA, Johnson BR (2008) Outcome of one-visit and two-visit endodontic treatment of necrotic teeth with apical periodontitis: a randomized controlled trial with one-year evaluation. J Endod 34(3):251–257

    Article  PubMed  Google Scholar 

  34. Malkhassian G, Manzur AJ, Legner M, Fillery ED, Manek S, Basrani BR et al (2009) Antibacterial efficacy of MTAD final rinse and two percent chlorhexidine gel medication in teeth with apical periodontitis: a randomized double-blinded clinical trial. J Endod 35(11):1483–1490

    Article  PubMed  Google Scholar 

  35. Stoll R, Betke K, Stachniss V (2005) The influence of different factors on the survival of root canal fillings: a 10-year retrospective study. J Endod 31(11):783–790

    Article  PubMed  Google Scholar 

  36. Marquis VL, Dao T, Farzaneh M, Abitbol S, Friedman S (2006) Treatment outcome in endodontics: the Toronto study. Phase III: initial treatment. J Endod 32(4):299–306

    Article  PubMed  Google Scholar 

  37. Bender IB, Seltzer S (2003) Roentgenographic and direct observation of experimental lesions in bone: II. 1961. J Endod 29(11):707–712, discussion 1

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was not supported by any grants or manufacturers. The authors thank the AALZ - Aachen Dental Laser Center (Germany) for their personal motivation and Ms Daniela Abreu for the statistical evaluation done specifically for this study.

Author information

Authors and Affiliations

  1. Department of Endodontics, Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal

    M. R. Martins, M. F. Carvalho, I. P. Vaz & J. A. Capelas

  2. Department of Endodontics, Universidade Católica Portuguesa-CRB, Viseu, Portugal

    M. A. Martins

  3. Department of Conservative Dentistry, RWTH Academy, Aachen University, Aachen, Germany

    N. Gutknecht

  4. Department of Endodontics, Faculdade de Medicina Dentária, Universidade do Porto, R. Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal

    M. R. Martins

Authors
  1. M. R. Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. F. Carvalho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. P. Vaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. A. Capelas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. A. Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Gutknecht
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. R. Martins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Martins, M.R., Carvalho, M.F., Vaz, I.P. et al. Efficacy of Er,Cr:YSGG laser with endodontical radial firing tips on the outcome of endodontic treatment: blind randomized controlled clinical trial with six-month evaluation. Lasers Med Sci 28, 1049–1055 (2013). https://doi.org/10.1007/s10103-012-1172-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-012-1172-6

Keywords

Search

Navigation