Disinfection of Contaminated Canals by Different Laser Wavelengths, while Performing Root Canal Therapy

Abstract

Removal of smear layer and disinfection of canals are important objectives of teeth root canal cleaning. In order to achieve this purpose, rinsing substances, intra canal drugs as well as ultrasound are used. Today, use of laser to remove smear layer and to disinfect root canals has increasingly attracted the attentions. Till now different lasers such as CO2, Nd:YAG, Er:YAG, Er,Cr:YSGG have been used for debris and smear removal from the canals. Numerous studies have shown that Er:YAG is the most appropriate laser for intra canal debris and smear removal. In addition different laser wavelengths have been used directly or as an adjunctive to disinfect canals. Laser light can penetrate areas of canals where irrigating and disinfecting solutions cannot reach, like secondary canals and deep dentinal tubules and also can eliminate microorganisms. Different studies have confirmed the penetration of Nd:YAG laser in deep dentin and reduction of microorganisms penetration. But studies on comparison of antibacterial effects of Nd:YAG laser with sodium hypochlorite showed effectiveness of both, with a better effect for sodium hypochlorite. Studies performed in relation with anti-microbial effects of Diode laser with various parameters show that this laser can be effective in reducing intra canal bacterial count and penetration in the depth of 500 microns in dentin. In studies performed on Diode laser in combination with canal irrigating solutions such as sodium hypochlorite and oxygenated water better results were obtained. Although studies on disinfection by the Erbium laser family show that use of this laser alone can be effective in disinfecting canals, studies evaluating the disinfecting effects of this laser and different concentrations of sodium hypochlorite show that the latter alone is more effective in disinfecting canals. And better results were obtained when Erbium laser was used in combination with sodium hypochlorite irrigating solution in canals. Results of the aforementioned articles indicate that this laser is effective in combination with a rinsing solution such as sodium hypochlorite. Results from studies including several types of the different Er:YAG, Ho:YAG, Nd:YAG, Er,Cr:YSGG lasers in disinfecting canals showed that all wavelengths used in disinfection for different thicknesses of dentin were efficacious without damaging thermal effect. Considering that use of different lasers in canals can be accompanied with temperature increase which can sometimes lead to damages to teeth and surrounding tissues, thus the use of photochemical phenomenon for elimination of microorganisms have attracted attention of many researchers. Studies in this field imply the efficacy of this method in reducing canal bacterial count and recommend its use as an adjunctive after biomechanical preparation of canals. Results from performed studies show removal of intra canal debris and smear layer by different lasers and particularly the Erbium laser family. Furthermore various laser wavelengths, particularly of Diode and Nd:YAG lasers can be effective in reducing intra canal microbial count. Maximum effect is obtained when laser light is used in canals in combination with sodium hypochlorite irrigating substance in appropriate concentration. Therefore use of laser energy can improve success rate of root canal treatments.

Keywords: Nd:YAG; diode laser; root canal therapies.