Early Application of Laser-Activated Irrigation During Root Canal Debridement
Abstract
Reducing microorganisms and intracanal debris is a central goal of chemomechanical preparation. A crown-down approach to cleaning and shaping the root canal system has been recommended to extrude less debris into the periapical tissues in infected root canals. The aim of this study was to investigate the impact of a crowndown irrigation approach involving the application of an early step of laser-activated irrigation (LAI) before establishing initial patency or completing instrumentation. The impact of early LAI on time required to achieve initial patency and canal cleanliness was investigated and compared to conventional needle irrigation (CNI).
The mesiobuccal (MB) and distobuccal (DB) roots of 65 extracted human permanent maxillary molars were included in the study. One hundred twenty roots underwent the patency investigation where root canals were treated according to a LAI or CNI irrigation protocol using 3% sodium hypochlorite (NaOCl) early in chemomechanical preparation before patency was established or manual instrumentation was completed. Time required to achieve initial patency was recorded. A scanning electron microscopic (SEM) investigation was then performed using 10 root canals from each irrigation protocol and five additional control root canals. The quantity of debris remaining on the root canal walls was analyzed.
The Mann-Whitney U test found no significant difference in time required to establish initial patency between groups (p = .534). In the SEM investigation, the Kruskal-Wallis test revealed a significant difference in the debris scores among LAI CNI, and control groups (p < .001). The LAI group had significantly lower debris scores than the control and CNI groups (p < .001).
Early implementation of the laser in the chemo-mechanical preparation of root canals had no measurable impact on time required to establish initial apical patency. However, within the parameters of the study, early LAI with NaOCl resulted in a significant reduction in the amount of debris remaining on root canal walls compared to CNI and control root canals.
Description
Keywords
laser-activated irrigation, root canal therapy, Er,Cr:YSGG, SEM