Successful Endodontic Management Using Er,Cr:YSGG Laser Disinfection of Root Canal in a Case of Large Periapical Pathology

Dr. Ambica Khetarpal¹, Dr.Ramanathan Ravi², Dr. Sarika Chaudhary¹, Dr. Sangeeta Talwar¹, Dr Mahesh Verma³ and Dr. Ambica Kathuria^1,

¹Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, Delhi, India

²Department of Community Dentistry, Penang International Dental College, Butterworth, Penang- Malaysia

³Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, Delhi, India

Cite this paper:
Dr. Ambica Khetarpal, Dr.Ramanathan Ravi, Dr. Sarika Chaudhary, Dr. Sangeeta Talwar, Dr Mahesh Verma and Dr. Ambica Kathuria. Successful Endodontic Management Using Er,Cr:YSGG Laser Disinfection of Root Canal in a Case of Large Periapical Pathology. International Journal of Dental Sciences and Research. 2013; 1(3):63-66. doi: 10.12691/ijdsr-1-3-6

Abstract

Total elimination of bacteria from infected root canal systems remains the most important objective of endodontic therapy. Biomechanical instrumentation of the root canal system has been suggested to achieve this task. However, because of the complexity of the root canal system, it has been shown that the complete elimination of debris and achievement of a sterile root canal system is still an ongoing challenge. The task of cleaning and disinfecting a root canal system which contains microorganisms gathered in a biofilm is very difficult; certain bacterial species become more virulent when harbored in biofilm, demonstrating stronger pathogenic potential and increased resistance to antimicrobial agents since biofilm has the ability to prevent the entry and action of such agents. The use of lasers in the field of endodontology represents an innovative approach to match these requirements. In general, dental lasers provide greater accessibility of formerly unreachable parts of the tubular network, due to their better penetration into dentinal tissues. The ability of lasers to remove smear layer and debris from the root canal wall and to open up the orifices of dentinal tubules can be exploited for disinfection of the root canal systems. This article describes the successful management of a case of lower anteriors with large periapical pathology. Er,Cr:YSGG laser was used as an adjunct to conventional root canal preparation that resulted in remarkable and faster healing of the periradicular lesion in lower anteriors.

Keywords:
endodontics root canal ErCr:YSGG laser disinfection healing anterior

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References:

[1]	Gomes B, Jacinto R, Pinheiro E, Sousa E, Zaia A, Ferraz C et al. Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens in endodontic lesions detected by culture and by PCR. Oral Microbiol Immunol 2005; 20(4):211-215.
[2]	Haapasalo M, Endal U, Zandi H, Coli JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endodont Topics 2005; 10: 77-102.
[3]	Clegg MS, Vertucci FJ, Walker C, Belanger M, Britto LR. The effect of exposure to irrigant solutions on apical dentin biofilms in vitro. J Endod 2006; 32: 434-37.
[4]	Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Endod Dent Traumatol 1990; 6, 124-149.
[5]	White RR, Hays GL, Janer LR. Residual antimicrobial activity after canal irrigation with chlorhexidine. J Endod 1997; 23(4): 229-31.
[6]	Gutknecht N, Franzen R, Schippers M, Lampert F. Bactericidal effect of a 980-nm diode laser in the root canal wall dentin of bovine teeth. J Clin Laser Med Surg 2004; 22: 9-13.
[7]	Oztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J. 2002; 35(1):73-8.
[8]	Altundasar E, Ozcelik B, Cehreli ZC, Matsumoto K. Ultramorphological and histochemical changes after Er,Cr:YSGG laser irradiation and two different irrigation regimes. J Endod 2006; 32:465-8.
[9]	Sousa-Neto MD, Silva Coelho FI, Marchesan MA, Alfredo E, Silva-Sousa YT. Ex vivo study of the adhesion of an epoxy based sealer to human dentine submitted to irradiation with Er:YAG and Nd:YAG lasers. Int Endod J 2005; 38:866-70.
[10]	WangX, SunY, KimuraY, KinoshitaJ, IshizakiNT, MatsumotoK. Effects of diode laser irradiation on smear layer removal from root canal walls and apical leakage after obturation. Photomed Laser Surg 2005; 23: 575-81.
[11]	Yamazaki R, Goya C, Yu DG, Kimura Y, Matsumoto K. Effects of erbium, chromium: YSGG laser irradiation on root canal walls: a scanning electron microscopic and thermographic study. J Endod 2001; 27:9-12.
[12]	Schoop U, Kluger W, Moritz A, Nedjelik N, Georgopoulos A, Sperr W. Bactericidal effect of different laser systems in the deep layers of dentin. Lasers Surg Med 2004; 35:111-116.
[13]	Gomes BP, Lilley JD, Drucker DB. Clinical significance of dental root canal microflora. J Dent 1996; 24:47-55.
[14]	Sjogren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997; 30:297-306.
[15]	Siqueira Jr JF, Rocas IN, Favieri A, Lima, KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod 2000; 26:331-4.
[16]	Berutti E, Marini R, Angerreti A. Penetration ability of different irrigants into dentinal tubules. J Endod 1997; 23:725-727.
[17]	Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res 1987; 66:1375-1379.
[18]	Vahdaty A, Pitt Ford TR, Wilson RF. Efficacy of chlorhexidine in disinfecting dentinal tubules in vitro. Endod Dent Traumatol 1993; 9:243-248.
[19]	Kouchi Y, Ninomiya J, Yasuda H, Fukui K, Moriyama T, Okamoto H. Location of streptococcus mutans in the dentinal tubules of open infected root canals. J Dent Res 1980; 59:2038-46.
[20]	Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. J Endod 1997; 23:725-727.
[21]	Odor TM, Chandler NP, Watson TF, Ford TR, McDonald F. Laser light transmission in teeth: a study of the patterns in different species. Int Endod J 1999; 32:296-302.
[22]	Stabholz A, Sahar-Helft S, Moshonov J. The use of lasers for cleaning and disinfecting of the root canal system. Alpha Omegan 2008; 101(4):195-201.
[23]	Vaarkamp J, ten Bosch JJ, Verdonschot EH. Propagation of light through human dental enamel and dentine. Caries Res 1995; 29:8-13.
[24]	Bergmans L, Moisiadis P, Teughels W, et al. Bactericidal effect of Nd: YAG laser irradiation on some endodontic pathogens ex vivo. Int Endod J 2006; 39:547-557.
[25]	Perin FM, França SC, Silva-Sousa YT, et al. Evaluation of the antimicrobial effect of Er:YAG laser irradiation versus 1% sodium hypochlorite irrigation for root canal disinfection. Aust Endod J 2004; 30:20-22.
[26]	Wang QQ, Zhang CF, Yin, XZ. Evaluation of the bactericidal effect of Er,Cr:YSGG and Nd: YAG lasers in experimentally infected root canals. J Endod 2007; 33:830-832.
[27]	Schoop U, Goharkhay K, Klimscha J, et al. The use of the erbium, chromium:yttrium-scandium-gallium-garnet laser in endodontic treatment: the results of an in vitro study. J Am Dent Assoc 2007; 138:949-955.
[28]	Gordon W, Atabakhsh VA, Meza F, et al. The antimicrobial efficacy of the erbium, chromium:yttrium-scandium-galliumgarnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus faecalis. J Am Dent Assoc 2007; 138:992-1002.
[29]	Schoop U, Barylyak A, Goharkhay K, et al. The impact of an erbium, chromium:yttrium-scandium-gallium-garnet laser with radial-firing tips on endodontic treatment. Lasers Med Sci 2009; 24:59-65.