engleski

Antimicrobial efficacy of erbium laser in the endodontic treatment of infected root canals

Introduction: Chemo-mechanical irrigation for cleaning the infected root canals does not ensure complete removal of microorganisms. Objectives: The aim of this study was to estimate efficacy of Er:YAG laser compared to conventional methods for the treatment of infected root canals. Methods: The study included 400 freshly extracted premolar single-rooted teeth. Crowns were cut off obtaining 15 mm long samples of the root canal. The apical part was drilled through. Teeth were divided into four groups inoculated with different microbial strains (Enterococcus faecalis, Streptococcus sanguinis, Fusobacterium nucleatum and Candida albicans). Three different methods for removal of microorganisms were applied, i.e.: Er:YAG laser radiation, irrigation with 5.20% NaOCl and Qmix. Microbial viability was analyzed by flow cytometry. Results: All treatment methods effectively eliminated the majority of microbial cells. Statistically significant differences were observed in mean percentage of dead cells between tested organisms (p<0.05) for Er:YAG laser (30 and 90 seconds) and 5.20% NaOCl irrigations, but not for Qmix (p=0.052). There were significant differences in rates of dead microorganisms when comparing treatment methods (p<0.001). The percent of dead cells was significantly higher for C. albicans and S. sanguinis, than for E. faecalis or F. nucleatum. Longer duration laser radiation was significantly more efficient compared to 30 seconds radiation (p<0.001). Synergic disinfectant efficacy of irradiation in combination with irrigant was over 90% with NaOCl and over 95% with Qmix. Conclusion: Er:YAG radiation is sufficiently efficient as standard disinfection method in endodontics, and can also serve as adjuvant therapy to standard mechanical and irrigational treatments.

root canals, disinfection, Er:YAG, laser, endodontic procedures

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