COMPARATIVE EFFICACY OF DENTAL LASERS VERSUS MOUTHWASH IN ROOT CANAL DISINFECTION
Main Article Content
Keywords
Disinfection, Dental Lasers, Root Canal Treatment, Dentin Penetration, Bacterial Reduction.
Abstract
Introduction: In the realm of endodontic treatment, innovative laser technologies are emerging as promising alternatives to traditional chemo-mechanical methods for root canal disinfection. These laser techniques are reputed to penetrate deeper into dentin, offering enhanced bacterial eradication. This systematic review seeks to explore the efficacy of dental lasers in purifying root canals during endodontic procedures.
Methods: This review was conducted through a comprehensive search on PubMed and Medline, employing a series of specific keywords. The search was confined to articles published in English. Additionally, references from relevant articles were scrutinized for inclusion. The studies selected for review spanned a range of wavelengths from 600 to 2940 nm across the electromagnetic spectrum, encompassing technologies such as LED, halogen lamps, Nd:YAG, Er, Cr:YSGG, Er:YAG, and quartz tungsten halogen with blue light laser.
Results: From the 254 articles initially identified, nine met the inclusion criteria for this systematic review. A common limitation among these studies was the lack of justification for the sample size, with no power analysis reported. Furthermore, none of the studies implemented blinding during either the treatment or the outcome evaluation phases. The review noted significant heterogeneity in the application of the laser treatments.
Conclusions: The findings indicate that dental lasers are capable of significantly reducing bacterial populations within the root canal, though sodium hypochlorite remains superior in effectiveness. However, the laser's ability to extend its antibacterial effects beyond 1mm into the dentin suggests its utility in sealing dentinal tubules and eradicating bacteria such as Escherichia coli and Enterococcus faecalis. Consequently, integrating laser treatment with conventional rinsing solutions is advocated for enhanced canal disinfection.
References
2. Verma, S.K., et al., Laser in dentistry: An innovative tool in modern dental practice. National journal of maxillofacial surgery, 2012. 3(2): p. 124.
3. Kimura, Y., P. Wilder‐Smith, and K. Matsumoto, Lasers in endodontics: a review. International endodontic journal, 2000. 33(3): p. 173-185.
4. Plotino, G., et al., New technologies to improve root canal disinfection. Brazilian dental journal, 2016. 27: p. 3-8.
5. Holliday, R. and A. Alani, Traditional and contemporary techniques for optimizing root canal irrigation. Dental update, 2014. 41(1): p. 51-61.
6. Giardino, L., et al., Antimicrobial effectiveness of combinations of oxidant and chelating agents in infected dentine: an ex vivo confocal laser scanning microscopy study. International Endodontic Journal, 2018. 51(4): p. 448-456.
7. Pourhajibagher, M., Adjunctive antimicrobial photodynamic therapy to conventional chemo-mechanical debridement of infected root canal systems: A systematic review and meta-analysis. Photodiagnosis and Photodynamic Therapy, 2019. 26: p. 19-26.
8. de Souza, E.B., et al., High-power diode laser in the disinfection in depth of the root canal dentin. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2008. 106(1): p. e68- e72.
9. Walsh, L., The current status of laser applications in dentistry. Australian dental journal, 2003. 48(3): p. 146-155.
10. Coluzzi, D.J., Fundamentals of dental lasers: science and instruments. Dental Clinics, 2004. 48(4): p. 751-770.
11. Betancourt, P., et al., Er, Cr: YSGG laser- activated irrigation and passive ultrasonic irrigation: comparison of two strategies for root canal disinfection. Photobiomodulation, Photomedicine, and Laser Surgery, 2020. 38(2): p. 91-97.
12. Blanken, J.W. and R.M. Verdaasdonk, Cavitation as a Working Mechanism of the Er, Cr: YSGG Laser in Endodontics: A Visualization Study. Journal of Oral Laser Applications, 2007. 7(2).
13. Mohammadi, Z., Laser applications in endodontics: an update review. International dental journal, 2009. 59(1): p. 35-46.
14. Martín Biedma, B., et al., Comparative study of root canals instrumented manually and mechanically, with and without Er: YAG laser. Photomedicine and Laser Therapy, 2005. 23(5): p. 465-469.
15. Keiser, G., et al., Review of diverse optical fibers used in biomedical research and clinical practice. Journal of biomedical optics, 2014. 19(8): p. 080902.
16. Goya, C., et al., Effects of pulsed Nd: YAG laser irradiation on smear layer at the apical stop and apical leakage after obturation. International endodontic journal, 2000. 33(3): p. 266-271.
17. Saydjari, Y., T. Kuypers, and N. Gutknecht, Laser application in dentistry: irradiation effects of Nd: YAG 1064 nm and diode 810 nm and 980 nm in infected root canals—a literature overview. BioMed research international, 2017. 2016.
18. Wang, X., et al., Effects of diode laser irradiation on smear layer removal from root canal walls and apical leakage after obturation. Photomedicine and laser surgery, 2005. 23(6): p. 575-581.
19. Moura-Netto, C., et al., Nd: YAG laser irradiation effect on apical intracanal dentin-a microleakage and SEM evaluation. Brazilian dental journal, 2011. 22: p. 377-381.
20. Bahcall, J., et al., Preliminary investigation of the histological effects of laser endodontic treatment on the periradicular tissues in dogs. Journal of Endodontics, 1992. 18(2): p. 47-51.
21. Takeda, F., et al., Effect of Er: YAG laser treatment on the root canal walls of human teeth: an SEM study. Dental Traumatology, 1998. 14(6): p. 270-273.
22. Meire, M., et al., Effectiveness of different laser systems to kill Enterococcus faecalis in aqueous suspension and in an infected tooth model. International Endodontic Journal, 2009. 42(4): p. 351-359.
23. Picoli, F., et al., Effect of Er: YAG laser and EDTAC on the adhesiveness to dentine of different sealers containing calcium hydroxide. International Endodontic Journal, 2003. 36(7): p. 472-475.
24. Yamazaki, R., et al., Effects of erbium, chromium: YSGG laser irradiation on root canal walls: a scanning electron microscopic and thermographic study. Journal of endodontics, 2001. 27(1): p. 9-12.
25. Iandolo, A., et al., Intracanal heating of sodium hypochlorite: Scanning electron microscope evaluation of root canal walls. Journal of Conservative Dentistry: JCD, 2018. 21(5): p. 569.
26. Pini, R., et al., Laser dentistry: a new application of excimer laser in root canal therapy. Lasers in surgery and medicine, 1989. 9(4): p. 352-357.
27. Asnaashari, M. and N. Safavi, Application of low level lasers in dentistry (endodontic). Journal of lasers in medical sciences, 2013. 4(2): p. 57.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Mousa Yahia Karyri
Senior Registrar Prosthodontist, King Saud Medical City, Dental Hospital, Saudi Arabia.
Abdulaziz Marzouq Alghawazi
BDS, Adv.Cer.Pros, MDSc Prostho, PRODE, H.Dip Imp, Prince Mohammad Bin Abdulaziz Hospital, Saudi Arabia.
Sarra Mohsen Al-Otaibi
Consultant of Restorative Dentistry, Riyadh East Dental Center, Saudi Arabia.
Ahad Alhumaidi Almutairi
Dental Hygienist, East Riyadh Dental Center, Saudi Arabia.
Mohammed Ahmed Algarni
Dental Hygienist, General Directorate of Health Affairs in Riyadh Region, Saudi arabia
Turki Farhan Omish Alharbi
DentalHygienist,EastRiyadhDentalCenter,SaudiArabia
Rami Amin Gashgary
General Dental Practitioner, East Riyadh Dental Center, Saudi Arabia.
Ali Mohammed A Aldossari
General Dental Practitioner, East Riyadh Dental Center, Saudi Arabia.