Evaluation of Temperature Elevation During Root Canal Treatment with Dual Wavelength Laser: 2780 nm Er,Cr:YSGG and 940 nm Diode.

OBJECTIVE: The purpose of this study was to evaluate the effects of dual wavelength (2780 nm Er,Cr:YSGG and 940 nm diode) laser with radial firing tip (RFT) on the external root surface and sub-surfaces, in terms of temperature changes during laser-assisted root canal treatment. BACKGROUND DATA: A significant factor that may limit the use of lasers in endodontics is the possible thermal injury to tooth supporting structures. MATERIALS AND METHODS: A total of 50 sound single-rooted extracted teeth were divided randomly into two groups (n = 25). Group A, irradiated with Er,Cr:YSGG laser at 1.06 W, 50 Hz, and 50 µs was a control group, and group B was irradiated with dual wavelength of Er,Cr:YSGG laser with the same settings as group A and a diode laser of 0.51 W at 4 ms and 10 ms pulse duration. K-type thermocouples were used to record temperature changes at the cervical, middle, and apical root thirds, on root surfaces and sub-surfaces, arising from delivery of laser energy through RFT. RESULTS: Temperature elevation in group B was significantly higher in the middle and apical thirds of the prepared samples than in group A (p < 0.0001). Group B presented a mean temperature elevation of 5.07°C on the apical surface region corresponding to a 1.48 mm dentin thickness, whereas a mean temperature increase of 7.72°C was recorded corresponding to dentin thickness of 0.95 mm. CONCLUSIONS: Within the studied parameters, the dual wavelength laser did not result in adverse thermal changes on the external root surface in vitro.

Intrapulpal temperature changes during root surface irradiation with dual-wavelength laser (2780 and 940 nm): in vitro study.

This work reports that the ablation volume and rate of porcine skin changed significantly with the change of skin water content. Under the same laser irradiation conditions (532 nm Nd:YAG laser, pulse width = 11.5 ns, pulse energy = 1.54 J, beam radius = 0.54 mm), the ablation volume dropped by a factor of 4 as the skin water content decreased from 40 wt. % (native) to 19 wt. % with a change in the ablation rate below and above around 25 wt. %. Based on the ablation characteristics observed by in situ shadowgraph images and the calculated tissue temperatures, it is considered that an explosive rupture by rapid volumetric vaporization of water is responsible for the ablation of the high water content of skin, whereas thermal disintegration of directly irradiated surface layer is responsible for the low water content of skin.

Decontamination of deep dentin by means of erbium, chromium:yttrium-scandium-gallium-garnet laser irradiation.

The aim of this in vitro study was to evaluate the depth of effectiveness of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation on microorganism reduction. From human roots, dentin slices of 100 microm to 1,000 microm thickness were prepared. These specimens were sterilized and then inoculated with 1 microl of Enterococcus faecalis suspension. The backs of the specimens were then irradiated with Er,Cr:YSGG radiation at a pulse energy of 3.13 mJ, delivered at an incidence angle of 5 degrees to the dentin slice surface. A control group was left without irradiation. The remaining bacteria were collected in 1 ml sterilized NaCl solution, serially diluted and seeded in Columbia-Agar plates. Despite the low pulse energy of 3.13 mJ, the Er,Cr:YSGG laser irradiation resulted in significant bacterial reduction up to a dentin thickness of 500 microm (P < 0.05). Scanning electron microscopy (SEM) micrographs of the contaminated and irradiated surfaces showed the absence of a smear layer and opened dentinal tubules.

Visualising the procedures in the influence of water on the ablation of dental hard tissue with erbium:yttrium-aluminium-garnet and erbium, chromium:yttrium-scandium-gallium-garnet laser pulses.

The exact mechanism of the ablation of tooth hard tissue with most common wavelengths, which are 2,940 nm and 2,780 nm, is not yet clear. There are several different theories, but none of them has yet been established. Concepts and methods of looking at these mechanisms have been based on heat formation and transformation, and mathematical calculations evaluating the outcome of ablation, such as looking at the shape of cuts. This study provides a new concept, which is the monitoring of the direct interactions between laser light, water and enamel, with a high-speed camera. For this purpose, both the above-mentioned wavelengths were examined. Bovine anterior teeth were prepared as thin slices. Each imaged slice had a thickness close to that of the beam diameter so that the ablation effect could be shown in two dimensional pictures. The single images were extracted from the video-clips and then were animated. The following steps, explaining the ablation procedures during each pulse, were seen and reported: (1) low-output energy intensity in the first pulses that did not lead to an ablative effect; (2) bubble formation with higher output energy density; (3) the tooth surface during the pulse was covered with the plume of vapour (comparable with a cloud), and the margins of ablation on the tooth were not clear; (4) when the vapour bubble (cloud) was collapsing, an additional ablative process at the surface could be seen.

Temperature evolution on human teeth root surface after diode laser assisted endodontic treatment.

The thermal rise threshold of an 810-nm semi-conductor diode laser on the root surface when used in root canals in vitro for laser assisted root canal treatment is investigated in this study. A total of 50 human single-rooted extracted teeth were included. For this study, the canals were enlarged up to an apical size of ISO#50 file. Laser irradiation was performed with six different settings. Specimens were irradiated at 0.6-1 W output power at the distal end of the fiber and about 1-1.5 W output power in the continuous mode (CW) as two groups. In the third group, 0.6-1 W output power, 10 ms pulse length (PL) and 10 ms interval duration (ID) were selected. In three other groups 1-1.5 W output power were used with different PL and ID as following: PL 10 and ID 10 ms, PL 10 and ID 20 ms and PL 20 and ID 20 ms. The total irradiation time was from 5 to 20 s per canal with a 200 mum in diameter and 25 mm long tip. After laser treatment, the temperature changes at the outer root surface were registered by means of NiCr-Ni measuring sensors and a T 202 thermometer. The safe temperature threshold for applying this diode laser in root canal is considered as 7 degrees C increase. To avoid increasing the temperature changes at the outer root surface related to this threshold, following total irradiation times were found: 0.6-1 W output power (10 ms PL/10 ms ID): 20 s (s), 1-1.5 W output power (10 ms/10 ms and 20 ms/20 ms): 15 s, 0.6-1 W output power CW and 1-1.5 W output power (20 ms PL/10 ms ID): 10 s and 1-1.5 W output power CW: 5 s. In the first three groups, 5 s irradiation and 5 s rest period avoided a temperature increase above the threshold of 7 degrees C).