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McGillivray A, Dutta A. The influence of laser-activated irrigation on post-operative pain following root canal treatment: A systematic review. J Dent 2024; 144:104928. [PMID: 38484867 DOI: 10.1016/j.jdent.2024.104928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES Synthesise evidence on post-endodontic pain (PEP) in adult teeth undergoing primary root canal treatment with the adjunctive use of laser-activated irrigation (LAI) as compared with conventional needle irrigation (CNI) during the first post-operative week. DATA An electronic search was performed; no language constraints or restriction on the year of publication were applied. SOURCES Medline, Scopus, Cochrane and PubMed on 04 June 2023 STUDY SELECTION: Randomised clinical trials (RaCTs) that evaluated PEP after LAI of endodontic irrgants were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. PEP was analysed at various time intervals until 1 week after treatment, related to the type of LAI used and the need for analgesia. REULTS Of the 793 articles identified through the electronic database search, 6 RaCTs were included. Qualitative review was favoured over meta-analysis due to substantial methodological heterogeneity between studies. Five studies were at high risk for bias determined by the Cochrane Risk-of-Bias 2 tool. Diode LAI demonstrated superior efficacy to needle irrigation in reducing pain 6-48 h post-treatment. The impact of LAI by photon-induced photoacoustic streaming (PIPS) was unclear and no difference was observed between PIPS and needle irrigation. However, PIPS mitigated PEP better than manual dynamic activation, sonic and ultrasonic activation. There was no difference in analgesia intake between LAI and needle irrigation groups. CONCLUSIONS LAI may help reduce PEP in the first 48 h. Methodological standardisation of future RaCTs on LAI would be beneficial in allowing a more accurate review with the possibility of quantitative synthesis. CLINICAL SIGNIFICANCE This unique synthesis used stringent criteria to reduce confounding factors and provided valuable evidence regarding PEP with different types of LAI. It helps clinicians choose an appropriate LAI technique as compared with CNI and predicts a time frame for reducing PEP.
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Affiliation(s)
- Alex McGillivray
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom
| | - Arindam Dutta
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom.
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Fakhri E, Samadi Kafil H, Naghizadeh M, Eslami H, Sefidan FY. Antimicrobial effect of grape seed extract as a potential intracanal medicament combined with Nd:YAG laser. AUST ENDOD J 2023; 49 Suppl 1:209-216. [PMID: 36479792 DOI: 10.1111/aej.12718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/23/2022] [Accepted: 11/06/2022] [Indexed: 12/12/2022]
Abstract
This study evaluated the antimicrobial efficacy of grape seed extract medicament combined with Nd:YAG laser, against Enterococcus faecalis, Staphylococcus aureus and Candida albicans biofilms. Root canals infected with 4-week-old biofilms were divided into five groups (n = 11): calcium hydroxide, 6.5% GSE, Nd:YAG laser (1064 nm, 1.5 w, 15 Hz and 100 mj) and 6.5% GSE followed by Nd:YAG laser and normal saline (control). Dentin chips were collected using Gates-Glidden and cultured to obtain colony-forming units. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test. GSE showed higher antibacterial activity against all species investigated compared to Ca(OH)2 . However, the lowest microbial count was obtained using a combination of GSE and Nd:YAG laser (p < 0.001). No significant difference in the susceptibility of tested pathogens to each of the protocols was observed (p > 0.05). Application of Nd:YAG laser following GSE medicament is efficient against endodontic biofilms; also, GSE can be considered as an alternative to Ca(OH)2 dressing.
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Affiliation(s)
- Elaheh Fakhri
- Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Naghizadeh
- Students' Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosein Eslami
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Bago I, Lucić R, Budimir A, Rajić V, Balić M, Anić I. Sealing Ability of Bioactive Root-End Filling Materials in Retro Cavities Prepared with Er,Cr:YSGG Laser and Ultrasonic Techniques. Bioengineering (Basel) 2022; 9:bioengineering9070314. [PMID: 35877365 PMCID: PMC9312248 DOI: 10.3390/bioengineering9070314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 12/03/2022] Open
Abstract
The aim of this in vitro study was to compare the apical sealing ability of total fill bioceramic root repair material (BC-RRM) and mineral trioxide aggregate (MTA), regarding the retrograde preparation technique used: ultrasonic or erbium, chromium: yttrium, scandium, gallium, or garnet (Er,Cr:YSGG) laser. The study sample consisted of 48 human single-rooted teeth. After root-end resection, the samples were divided into two groups, according to the retrograde preparation technique used: Group 1: ultrasonic; Group 2: Er,Cr:YSGG laser. In each group, half of the retrograde cavities were filled with BC-RRM, and the other half were filled with MTA. The specimens were mounted in tubes and sterilized in plasma. The root canals were inoculated with Enterococcus faecalis, and the tubes were filled with fetal bovine serum, leaving the apical part of the root in the serum. After 30 days, the canals were sampled and cultured, and the colony forming units (CFUs) were counted with the additional polymerase chain reaction (PCR analysis). There was no significant difference between ultrasonic groups and the Er,Cr:YSGG-MTA group, regarding the number of CFUs (p > 0.05). The Er,Cr:YSGG-BC-RRM group showed the highest number of remaining viable bacteria (p < 0.001). Both filling materials filled in ultrasonic preparations presented similar sealing abilities. The BC-RRM showed more leakage when used in retro cavities prepared with the Er,Cr:YSGG laser.
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Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (V.R.); (I.A.)
- Correspondence: ; Tel.: +385-1-4802-128; Fax: +385-1-4802-116
| | - Ružica Lucić
- Health Centre Orašje, Orašje, Bosnia and Herzegovina, 76270 Orasje, Bosnia and Herzegovina;
| | - Ana Budimir
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia;
| | - Valentina Rajić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (V.R.); (I.A.)
| | - Merima Balić
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia; (V.R.); (I.A.)
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Influence of Laser Irradiation Settings, during Diode-Assisted Endodontics, on the Intraradicular Adhesion of Self-Etch and Self-Curing Luting Cement during Restoration-An Ex Vivo Study. MATERIALS 2022; 15:ma15072531. [PMID: 35407862 PMCID: PMC8999595 DOI: 10.3390/ma15072531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 12/30/2022]
Abstract
Background: Diode-assisted endodontics is nowadays utilized for pulp space disinfection, but little is known on the bonding potential of this lased root dentin when the tooth is restored with an intracanal polymer post. Objectives: to investigate the influence of diode laser irradiation settings, in laser-assisted endodontics, on the intraradicular bonding of composite materials. Methods: Sixteen two-rooted, maxillary first premolars were collected, prepared up to F4 (Protaper Universal. Dentsply-Maillefer, Ballaigues, Switzerland), and randomly assigned in two groups: group A (chopped mode or short pulse), diode irradiated according to protocol, pulse 25 ms, power 2.5 W, and group B (microchopped mode or ultrashort pulse), pulse 25 μs, peak power 12 W (both groups GentleRay. KaVo Dental, Biberach an der Riss, Germany). Buccal canals were irradiated, palatal ones served as controls. Canals were then obturated, post space was created in all canals, and quartz-fiber posts (ICE light Danville. Danville Materials, San Ramon, CA, USA) were cemented by self-etch self-curing cement (Max Cem Elite. Kerr, West Collins Orange, CA, USA) (Max Cem Elite. Kerr, Brea, CA, USA). A week later, teeth were sectioned horizontally in 1 mm increments. Push-out test was conducted in a Zwick testing machine (Zwick Roell, Ulm, Germany) at 1 mm/min speed, and the force required to dislodge the post from each specimen (F-max) was recorded. Weibull regression models were applied for statistical analyses. Results: Differences in F-max by group (control vs. chopped mode vs. microchopped mode) and height (meaning the apical-to-coronal position of each specimen along the root) were statistically significant (p < 0.05 in all cases). Conclusions: Short pulses (or chopped mode) had a profound positive effect on the quality of intraradicular bonding, while Ultrashort pulses (or microchopped mode) affected it negatively. In addition, apically positioned bonding proved weaker compared with more coronally located specimens.
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Avcı F, Etöz M, Üstün Y, Arslan T. Evaluation of ultrasonography as a diagnostic tool in the management of periapical cysts and granulomas: A clinical study. Imaging Sci Dent 2022; 52:209-217. [PMID: 35799971 PMCID: PMC9226231 DOI: 10.5624/isd.20210239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/08/2021] [Accepted: 12/27/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study was, firstly, to determine the concordance of ultrasonographic and histopathological diagnoses in patients in whom apical resection was already indicated. Secondly, this study aimed to determine whether lesions were periapical granulomas or cysts, and to compare them after root canal treatment using ultrasonography and periapical radiographs. Materials and Methods In the first stage of the study, ultrasonographic and histopathologic diagnoses of 10 lesions were compared. Secondly, the periapical radiographs and ultrasonographic images of 44 lesions were measured. The presence of internal vascularity was determined by ultrasonographic color and power Doppler modes. Follow-up examinations of healing after root canal treatment were performed using ultrasonography and periapical radiographs, and these modalities were compared. Results In the periapical granuloma and cyst groups, the measurement values decreased for all variables. There was no significant difference in the dimensional changes of lesions between the 2 groups, and ultrasonography and periapical radiographs were compatible. The pre-diagnoses were compared with histopathological diagnoses and were found to be compatible. Conclusion The ultrasonographic color and power Doppler techniques could be an effective method for diagnosing periapical lesions as cysts or granulomas. After root canal treatment of granulomas and cysts, the dimensional shrinkage and healing patterns appear to be similar. Ultrasonography and periapical radiographs were consistent in terms of dimensional comparisons, and ultrasonography may be an alternative method for follow-up of the healing of periapical lesions.
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Affiliation(s)
- Fatma Avcı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
| | - Meryem Etöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
| | - Tuğrul Arslan
- Department of Endodontics, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
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Walling J, Kirchhoff T, Berthold M, Wenzler JS, Braun A. Impact of thermal photodynamic disinfection on root dentin temperature in vitro. Photodiagnosis Photodyn Ther 2021; 35:102476. [PMID: 34358709 DOI: 10.1016/j.pdpdt.2021.102476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/23/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Thermal photodynamic disinfection procedures have been proposed for adjunctive endodontic treatment. This study assessed photothermal disinfection relative to root dentin temperature and the thermal effects of simulated periodontal blood flow. METHODS Thirty freshly extracted human single-rooted teeth were prepared endodontically using a 45/.02 master apical file. The root surfaces were coated with wax and covered with thermoforming sheets, leaving a circumferential space of 0.25 mm after wax removal. The sheets were perforated to allow fluid circulation through the simulated periodontal space. Irradiation was performed in two groups of 30: I, 810 nm laser (1.5 W, continuous wave), 4 × 5 s; II, photothermal group: indocyanine green and 810 nm laser (200 mW, continuous wave), 20 s. Thermographic measurements were performed at different water flow rates (6, 2.6, 0 mL/min) with a baseline temperature of 37 °C. Nonparametric statistical analysis was performed (Wilcoxon). RESULTS The highest temperature change (median 7.52 °C, range 0.82-18.32 °C) was with 810 nm laser irradiation in group I, without any simulated blood flow. Fluid circulation resulted in a significant reduction in temperature changes in this group (median 2.14 °C, range 0.37-9.83 °C; p < 0.05). The lowest temperature changes were in the photothermal group with a water flow rate of 6 mL/min (median 0.79 °C, range 0.00-3.88 °C; p < 0.05). CONCLUSION Photothermal disinfection of root canals can increase root canal dentin temperatures, but periodontal fluid circulation has a cooling effect on the outer root surface, reducing the risk of potential thermal injury to periodontal tissue.
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Affiliation(s)
- Julian Walling
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstrasse 30, Aachen 52074, Germany
| | - Tabea Kirchhoff
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstrasse 30, Aachen 52074, Germany
| | - Michael Berthold
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstrasse 30, Aachen 52074, Germany
| | - Johannes-Simon Wenzler
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstrasse 30, Aachen 52074, Germany.
| | - Andreas Braun
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstrasse 30, Aachen 52074, Germany
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Root Surface Temperature Increases during Root Canal Filling In Vitro with Nd:YAG Laser-Softened Gutta-Percha. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8828272. [PMID: 32587668 PMCID: PMC7298274 DOI: 10.1155/2020/8828272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 11/29/2022]
Abstract
The aim of this in vitro study was to measure the temperature increases produced on the mesial and vestibular root surfaces of premolar teeth during a laser-softened gutta-percha obturation technique. We studied 12 extracted human premolar teeth with a single canal. After root canal cleaning and shaping, the teeth were obturated with gutta-percha that had been softened with a neodymium-doped yttrium aluminium garnet (Nd:YAG) laser (CTL 1503) at a wavelength of 1.064 nm. The laser setup parameters included a 30 Hz frequency and a 200 mJ/pulse with optical fiber tips of 0.320 mm diameter. A sectional warm gutta-percha condensation was used. Temperature changes on the whole mesial and vestibular outer surfaces of the roots were measured at approximately 2 s intervals with an infrared thermal imaging camera. A significantly higher increase in temperature was observed for the mesial root surface (7.5°C) compared to the vestibular surface (3.7°C) (p ≈ 0). The findings suggested that root canal filling with Nd:YAG laser-softened gutta-percha in premolar teeth is not likely to damage the surrounding periradicular tissues. To obtain valid temperature results, the measurement should be performed on the surface with the thinnest root wall.
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Seraj B, Moosavi Garmaroodi Z, Chiniforush N, Ghadimi S. Thermal Changes in Root Surface of Primary Teeth During Root Canal Treatment With Diode Lasers: An In Vitro Study. J Lasers Med Sci 2019; 9:237-242. [PMID: 31119017 DOI: 10.15171/jlms.2018.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Increased temperature due to the application of laser during root canal disinfection may damage periodontium, alveolar bone, and permanent dental germ. The aim of this study was to evaluate the temperature increase of the external surface of primary roots due to the application of 810 nm and 980 nm diode lasers. Methods: A total of 58 extracted human primary teeth were prepared and randomly divided into two groups: (a) 810 nm diode laser and (b) 980 nm diode laser. Then, each group was divided into 4 subgroups based on the location of the temperature measurement, including subgroup 1: external root surface of primary anterior roots (A); subgroup 2: external root surface of posterior teeth at inter-root space (IS); subgroup 3: external root surface of posterior teeth at outer-root space (OS) and subgroup 4: external surface of furcation area of posterior teeth (F). Results: The mean temperature rise in group a (7.02±2.95ºC) was less than that of group b (10.62±4.59ºC) (P<0.001). Also, a significant difference was found between the laser groups in terms of the mean temperature rise of the external root surface at IS, OS and F, with higher temperature increase occurring in all points in laser b. The comparison of irradiation points in each laser showed a higher mean temperature rise for IS than OS, but this difference was only significant in group b (P<0.001). Conclusion: Within the studied parameters, 810 nm and 980 nm diode lasers should be used cautiously in primary root canals because of their temperature rise during their application.
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Affiliation(s)
- Bahman Seraj
- Dental Research Center, Dentistry Reseach Institute, Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Moosavi Garmaroodi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghadimi
- Laser Research Center of Dentistry, Dentistry Research Institute and Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Braun A, Hagelauer FJP, Wenzler J, Heimer M, Frankenberger R, Stein S. Microcrack Analysis of Dental Hard Tissue After Root Canal Irradiation with a 970-nm Diode Laser. Photomed Laser Surg 2018; 36:621-628. [DOI: 10.1089/pho.2018.4470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Andreas Braun
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | | | - Johannes Wenzler
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | - Matthias Heimer
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | - Steffen Stein
- Department of Orthodontics, University of Marburg, Marburg, Germany
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Lopes FC, Roperto R, Akkus A, Silva Sousa YTC, Sousa-Neto MD. Evaluation of chemical and morphological changes in radicular dentin after different final surface treatments. Microsc Res Tech 2018; 81:973-979. [PMID: 30295342 DOI: 10.1002/jemt.23060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/30/2018] [Accepted: 05/07/2018] [Indexed: 11/11/2022]
Abstract
The aim of this study was to evaluate the chemical and morphological effects of different lasers as a final surface treatment for endodontic therapy through energy dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM) respectively. Twenty-five maxillary canines were selected and instrumented with K3 system. Roots were randomly distributed into five groups (n = 5) according to the surface treatment: GI (distilled water), GII (NaOCl + EDTA), GIII (NaOCl + EDTA + 980 nm diode laser), GIV (NaOCl + EDTA+ 1,064 nm Nd:YAG laser), and GV (NaOCl + EDTA+ 2,780 nm Er, Cr:YSGG laser). Lasers were applied for 20 s and samples were bisected, exposing the treated surface and then subjected to elements quantification by EDS and morphological evaluation by scanning electron microscope (SEM). EDS data were submitted to ANOVA-two way, and SEM scores were submitted to two-way Kruskal-Wallis and Dunn's tests. The EDS analysis showed no difference for the chemical elements and Ca/P ratio between groups (p > .05). Statistical analysis showed more intense results for GV and less intense results for GI (p < .05). The GIII showed an amorphous organic matrix surface, while GV provided greater removal of intertubular dentin forming craters, and GIV promoted dentin fusion. The EDS method used in this study was not able to verify any chemical changes in root canal dentin; Nd:YAG, Er, Cr:YSGG, and 980 nm diode laser were capable of modifying the dentin morphology, correlating characteristics features for each one, which are essential clinical knowledge to establish the correct indication for each case. RESEARCH HIGHLIGHTS: EDS was not able to verify any chemical changes in root canal dentin after 980 nm diode, Nd:YAG and Er;Cr:YSGG laser treatments Nd:YAG, Er, Cr:YSGG, and 980 nm diode laser modified dentin morphology, correlating characteristics features for each one.
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Affiliation(s)
- Fabiane Carneiro Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Renato Roperto
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University - CWRU, Cleveland, Ohio
| | - Anna Akkus
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University - CWRU, Cleveland, Ohio.,School of Engineering, Department of Macromolecular Science and Engineering, Case Western Reserve University - CWRU, Cleveland, Ohio
| | | | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
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Grzech-Leśniak K, Nowicka J, Pajączkowska M, Matys J, Szymonowicz M, Kuropka P, Rybak Z, Dobrzyński M, Dominiak M. Effects of Nd:YAG laser irradiation on the growth of Candida albicans and Streptococcus mutans: in vitro study. Lasers Med Sci 2018; 34:129-137. [PMID: 30145724 PMCID: PMC6343019 DOI: 10.1007/s10103-018-2622-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/15/2018] [Indexed: 01/06/2023]
Abstract
The purpose of this study was to evaluate the effects of Nd:YAG laser with flat-top handpiece on the in vitro growth of Candida albicans and Streptococcus mutans. The incidence of C. albicans (opportunistic commensal) and S. mutans (facultatively anaerobic) infections is increasing, despite available treatments. Cultures of Streptococcus mutans and Candida albicans were irradiated using Nd:YAG laser (LightWalker, Fotona) with flat-top handpiece (Genova, LightWalker, Fotona) at the following parameters: group G1: 0.25 W, 10 Hz, 15 s, 3 J and group G2: 1 W, 10 Hz, 60s, 59 J. The results were evaluated directly and 24 h after irradiation using a quantitative culture method (estimation of colony-forming units in 1 ml of suspension, cfu/ml), and microscopic analysis with Janus green stain and compared with control group in which laser was not applied. C. albicans was reduced by 20 up to 54% for G1, and for G2 by 10 up to 60% directly after the application. The cfu/ml values for S. mutans decreased by 13% (p = 0.1771) for G1 and 89% (p < 0.0001) for G2. In both test groups 24 h after the application, the number of colony-forming units decreased by 15–46% for G1 and by 15–64% for G2. The arrested cell division, increasing the surface area and increasing the number of metabolically inactive cells, were observed in morphometric analysis. Macroscopic and microscopic analyses revealed a reduction in cell number and a significant decrease of cell metabolism after laser application for both C. albicans and S. mutans.
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Affiliation(s)
- Kinga Grzech-Leśniak
- Department Oral Surgery, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
| | - Joanna Nowicka
- Department of Microbiology, Faculty of Medicine, Wroclaw Medical University, Chałubińskiego 4, 50-368, Wrocław, Poland
| | - Magdalena Pajączkowska
- Department of Microbiology, Faculty of Medicine, Wroclaw Medical University, Chałubińskiego 4, 50-368, Wrocław, Poland
| | - Jacek Matys
- Private Dental Practice, Lipowa 18, 67-400, Wschowa, Poland. .,"Sapienza" University of Rome, Rome, Italy.
| | - Maria Szymonowicz
- Department of Experimental Surgery and Biomaterials Research, Wroclaw Medical University, Bujwida 44, 50-345, Wrocław, Poland
| | - Piotr Kuropka
- Department of Histology and Embriology, Wroclaw University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland
| | - Zbigniew Rybak
- Department of Experimental Surgery and Biomaterials Research, Wroclaw Medical University, Bujwida 44, 50-345, Wrocław, Poland
| | - Maciej Dobrzyński
- Department of Conservative Dentistry and Pedodontics, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
| | - Marzena Dominiak
- Department Oral Surgery, Wroclaw Medical University, Krakowska 26, 50-425, Wrocław, Poland
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Betancourt P, Merlos A, Sierra JM, Camps-Font O, Arnabat-Dominguez J, Viñas M. Effectiveness of low concentration of sodium hypochlorite activated by Er,Cr:YSGG laser against Enterococcus faecalis biofilm. Lasers Med Sci 2018; 34:247-254. [PMID: 29980946 DOI: 10.1007/s10103-018-2578-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/27/2018] [Indexed: 12/15/2022]
Abstract
Bacteria living in biofilms exhibit altered growth phenotypes, while the biofilm provides benefits, the foremost of which is a certain protection against both immune system and killing effect by antimicrobials. Laser-activated irrigation (LAI) and passive ultrasonic irrigation (PUI) have been proposed as alternative methods for cleaning and disinfecting the root canal, as an adjuvant to conventional chemo-mechanical preparation in order to improve debridement and disinfection. Nevertheless, the potential antibacterial effect of LAI using 0.5% of sodium hypochlorite (NaOCl) has received little attention. Glass Pasteur pipettes were used to mimic single-tooth root canal and to build Enterococcus faecalis biofilm. Several irrigants and treatments were assayed for 60 s including (I) Saline, (II) NaOCl 0.5%, (III) NaOCl 5%, (IV) Er,Cr:YSGG, (V) Saline + LAI, (VI) NaOCl 0.5% + LAI, (VII) Saline + PUI, and (VIII) NaOCl 0.5% + PUI. Bacterial reduction was measured by counting the colony-forming units (CFUs). Additionally, AFM visualization and measurement of nano-roughness parameters were used to evaluate LAI effect on bacteria. NaOCl 5% unpowered and NaOCl 0.5% + LAI were capable of eliminating all bacteria, whereas non-activated saline solution and NaOCl 0.5% failed to eliminate E. faecalis. Lower efficiencies were achieved by PUI. Surface analysis by AFM revealed apparent alterations in NaOCl + LAI-treated cells. The Er,Cr:YSGG laser-activated irrigation (LAI) increased the bactericidal efficiency of 0.5% NaOCl against E. faecalis biofilm.
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Affiliation(s)
- P Betancourt
- Lab. Molecular Microbiology & Antimicrobials. Dept. of Pathology & Experimental therapeutics. Faculty of Medicine, University of Barcelona, Carrer Feixa Larga s/n; 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Research Centre in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Avenida Francisco Salazar, 01145, Temuco, Chile
| | - A Merlos
- Lab. Molecular Microbiology & Antimicrobials. Dept. of Pathology & Experimental therapeutics. Faculty of Medicine, University of Barcelona, Carrer Feixa Larga s/n; 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J M Sierra
- Lab. Molecular Microbiology & Antimicrobials. Dept. of Pathology & Experimental therapeutics. Faculty of Medicine, University of Barcelona, Carrer Feixa Larga s/n; 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - O Camps-Font
- Department of Dentistry. Faculty of Medicine, University of Barcelona, Carrer Feixa Larga s/n; 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Arnabat-Dominguez
- Department of Dentistry. Faculty of Medicine, University of Barcelona, Carrer Feixa Larga s/n; 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - M Viñas
- Lab. Molecular Microbiology & Antimicrobials. Dept. of Pathology & Experimental therapeutics. Faculty of Medicine, University of Barcelona, Carrer Feixa Larga s/n; 08907, L'Hospitalet de Llobregat, Barcelona, Spain
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In vitro bond strength of an epoxy resin-based root canal sealer to root dentin irradiated with high-power lasers and adhesive interface analyses. Lasers Med Sci 2017; 33:271-277. [DOI: 10.1007/s10103-017-2362-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 10/12/2017] [Indexed: 01/04/2023]
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Schulte-Lünzum R, Gutknecht N, Conrads G, Franzen R. The Impact of a 940 nm Diode Laser with Radial Firing Tip and Bare End Fiber Tip onEnterococcus faecalisin the Root Canal Wall Dentin of Bovine Teeth: AnIn VitroStudy. Photomed Laser Surg 2017; 35:357-363. [DOI: 10.1089/pho.2016.4249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Ruth Schulte-Lünzum
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
| | - Norbert Gutknecht
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH University Hospital Aachen, Aachen, Germany
| | - Rene Franzen
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
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Sarp ASK, Gulsoy M. Determining the optimal dose of 1940-nm thulium fiber laser for assisting the endodontic treatment. Lasers Med Sci 2017; 32:1507-1516. [PMID: 28669067 DOI: 10.1007/s10103-017-2272-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 06/19/2017] [Indexed: 11/27/2022]
Abstract
Insufficient cleaning, the complex anatomy of the root canal system, inaccessible accessory canals, and inadequate penetration of irrigants through dentinal tubules minimizes the success of the conventional endodontic treatment. Laser-assisted endodontic treatment enhances the quality of conventional treatment, but each laser wavelength has its own its own limitations. The optimal parameters for the antibacterial efficiency of a new wavelength, 1940-nm Thulium Fiber Laser, were firstly investigated in this study. This paper comprises of two preliminary analyses and one main experimental study, presents data about thermal effects of 1940-nm laser application on root canal tissue, effective sterilization parameters for bacteria, Enterococcus faecalis, and finally the antibacterial effectiveness of this 1940-nm Thulium Fiber Laser irradiation in single root canal. Based on these results, the optimal parameter range for safe laser-assisted root canal treatment was investigated in the main experiments. Comparing the antibacterial effects of four laser powers on an E. faecalis bacteria culture in vitro in 96-well plates showed that the most effective group was the one irradiated with 1 W of laser power (antibacterial effect corresponding to a log kill of 3). After the optimal laser power was determined, varying irradiation durations (15, 30, and 60 s) were compared in disinfecting E. faecalis. Laser application caused significant reduction in colony-forming unit values (CFU) compared with control samples in the 17% ethylenediaminetetraacetic acid (EDTA) group. The results of bacteria counts showed that 1 W with 30 s of irradiation with a 1940-nm thulium fiber laser was the optimal dose for safely achieving maximal bactericidal effect.
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Affiliation(s)
- Ayse Sena Kabas Sarp
- Biophotonics Laboratory, Bogazici University Institute of Biomedical Engineering, Kandilli Kampus, 34684, Istanbul, Turkey.
| | - Murat Gulsoy
- Biophotonics Laboratory, Bogazici University Institute of Biomedical Engineering, Kandilli Kampus, 34684, Istanbul, Turkey
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The Antibacterial Effect of Nd:YAG Laser Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial. J Endod 2017; 43:857-863. [PMID: 28389075 DOI: 10.1016/j.joen.2017.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/22/2016] [Accepted: 01/10/2017] [Indexed: 12/18/2022]
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Beer F, Farmakis ETR, Kopic J, Kurzmann C, Moritz A. Temperature Development on the External Root Surface During Laser-Assisted Endodontic Treatment Applying a Microchopped Mode of a 980 nm Diode Laser. Photomed Laser Surg 2017; 35:206-212. [PMID: 28092475 DOI: 10.1089/pho.2016.4189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The aim of this article was to investigate the temperature increase of the external root surface during laser-assisted endodontic treatment using a diode laser (980 nm) in a microchopped mode. METHODS Ten freshly extracted, human maxillary incisors with mature apices were collected, prepared to size F4 at working length (ProTaper; Dentsply Maillefer, Ballaigues, Switzerland), mounted to a holder, and irradiated (using spiral movements in coronal direction) with a diode laser (GENTLEray 980 Classic Plus; KaVo, Biberach, Germany) with a 200 μm fiber in four different treatment groups: Group 1 (control group) was irradiated in six cycles of 5-sec irradiation/20-sec pause with 2.5 W in the pulse mode. Groups 2 to 4 were irradiated at six cycles of 5-sec irradiation/20-sec pause in the microchopped mode (Group 2-1.6 W; Group 3-2.0 W; Group 4-2.5 W). The applied mode was 25 ms on/25 ms off. Within the on period, the laser delivered an intermittent sequence of energy complexes and the maximum output was equal to the nominated output of the device (12 W). Canals were kept moist by sterile saline irrigation in between irradiations, and temperature changes were continuously measured using a thermal imaging camera. Recordings were analyzed by a mixed model (analysis of variance [ANOVA] for repeated measurements). RESULTS The highest mean of temperature rise, 1.94°C ± 1.07°C, was measured in Group 4, followed by Group 3 (1.74°C ± 1.22°C) and Group 2 (1.58°C ± 1.18°C). The lowest increase occurred in Group 1 (1.06°C ± 1.20°C). There was a significant difference (p = 0.041) between the groups. Significant differences were found between Groups 1 and 4 (p = 0.007) and 1 and 2 (p = 0.035). In addition, a marginally significant difference between Groups 1 and 2 (p = 0.052) was noted. There was no significant difference between Groups 2, 3, and 4. Despite the low mean values reported, the highest temperature increase (+5.7°C) was measured in one of the specimens of treatment Group 2 at the middle third. CONCLUSIONS Under the conditions used and within the limitations of the study, the microchopped diode laser irradiation is a safe possible treatment option in laser-assisted endodontic treatment, concerning the temperature elevation on the external root surface.
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Affiliation(s)
| | | | - Josip Kopic
- 3 Unit-Division of Dental Student Training and Patient Care, School of Dentistry, Medical University of Vienna , Vienna, Austria
| | - Christoph Kurzmann
- 4 Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna , Vienna, Austria
| | - Andreas Moritz
- 4 Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna , Vienna, Austria
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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 2016; 2016:8421656. [PMID: 27462611 PMCID: PMC4947651 DOI: 10.1155/2016/8421656] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/18/2016] [Accepted: 05/15/2016] [Indexed: 12/03/2022]
Abstract
Objective. In endodontics, Nd:YAG laser (1064 nm) and diode laser (810 nm and 980 nm) devices are used to remove bacteria in infected teeth. A literature review was elaborated to compare and evaluate the advantages and disadvantages of using these lasers. Methods. Using combined search terms, eligible articles were retrieved from PubMed and printed journals. The initial search yielded 40 titles and 27 articles were assigned to full-text analysis. The studies were classified based upon laser source, laser energy level, duration/similarity of application, and initial and final bacterial count at a minimum of 20 prepared root canals. Part of the analysis was only reduced microorganisms and mechanically treated root canals upon preparation size of ISO 30. All studies were compared to evaluate the most favorable laser device for best results in endodontic therapy. Results. A total of 22 eligible studies were found regarding Nd:YAG laser 1064 nm. Four studies fulfilled all demanded criteria. Seven studies referring to the diode laser 980 nm were examined, although only one fulfilled all criteria. Eleven studies were found regarding the diode laser 810 nm, although only one study fulfilled all necessary criteria. Conclusions. Laser therapy is effective in endodontics, although a comparison of efficiency between the laser devices is not possible at present due to different study designs, materials, and equipment.
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Lopes FC, Roperto R, Akkus A, Akkus O, Souza-Gabriel AE, Sousa-Neto MD. Effects of different lasers on organic/inorganic ratio of radicular dentin. Lasers Med Sci 2016; 31:415-20. [DOI: 10.1007/s10103-015-1862-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
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da Frota MF, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Bagnato VS, Espir CG, Berbert FLCV. Photodynamic therapy in root canals contaminated with Enterococcus faecalis using curcumin as photosensitizer. Lasers Med Sci 2014; 30:1867-72. [PMID: 25502831 DOI: 10.1007/s10103-014-1696-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/30/2014] [Indexed: 12/27/2022]
Abstract
The aim of the study was to evaluate the photodynamic therapy (PDT) effect on root canals contaminated with Enterococcus faecalis using a light emitting diode (LED) light and a curcumin solution (CUR) as photosensitizer (PS). Eighty root canals from uniradicular human teeth were prepared with Protaper Universal rotary system and contaminated with E. faecalis for 21 days. They were divided as: GIa-PDT (CUR, pre-irradiation for 5 + 5 min of irradiation); GIb-PDT (CUR, pre-irradiation for 5 + 10 min of irradiation); GIIa-(CUR, pre-irradiation for 5 + 5 min without irradiation); GIIb-(CUR pre-irradiation for 5 + 10 min of irradiation); GIIIa-(physiological solution and irradiation for 5 min); and GIIIb-(physiological solution and irradiation for 10 min); positive and negative control groups. Collections from root canals were made at time intervals of 21 days after contamination, immediately after treatment, and 7 days after treatment, and submitted to colony forming units per milliter (CFU mL(-1)) counts. The data were submitted to ANOVA and Tukey multiple comparison tests, at a level of significance of 5 %. In the immediate post-treatment collection, group GIa showed greater bacterial reduction in comparison with GIIa, GIIb, GIIIa, GIIIb, and positive control (P < 0.05). At 7 days post-treatment, GIa showed significant bacterial reduction only in comparison with GIIIa (P < 0.05). Curcumin as sensitizer was effective by 5 min LED irradiation but not by 10 min irradiation PDT using LED light, and curcumin as PS was not effective in eliminating E. faecalis. No difference was observed for periods of irradiation.
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Aksakalli S, Ileri Z, Yavuz T, Malkoc MA, Ozturk N. Porcelain laminate veneer conditioning for orthodontic bonding: SEM-EDX analysis. Lasers Med Sci 2014; 30:1829-34. [DOI: 10.1007/s10103-014-1682-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 10/17/2014] [Indexed: 10/24/2022]
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22
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Pich O, Franzen R, Gutknecht N, Wolfart S. Laser treatment of dental ceramic/cement layers: transmitted energy, temperature effects and surface characterisation. Lasers Med Sci 2013; 30:591-7. [DOI: 10.1007/s10103-013-1340-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/24/2013] [Indexed: 11/28/2022]
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Vescovi P, Conti S, Merigo E, Ciociola T, Polonelli L, Manfredi M, Meleti M, Fornaini C, Rocca JP, Nammour SA. In vitro bactericidal effect of Nd:YAG laser on Actinomyces israelii. Lasers Med Sci 2012; 28:1131-5. [PMID: 23053244 DOI: 10.1007/s10103-012-1197-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
Abstract
A bactericidal effect has been reported by the use of near-infrared laser light on both Gram-positive and Gram-negative bacteria. The aim of this study was to evaluate the effect of Nd:YAG laser on Actinomyces israelii, filamentous bacteria causing cervicofacial actinomycosis. Experiments were realized on bacterial cells in saline suspension or streaked on Mueller-Hinton (MH) agar plates with or without India ink. Laser application was performed in Eppendorf tubes with different powers and frequencies for 40 s; bacterial suspensions were then streaked on agar plates and incubated at 35 °C in proper conditions for 5 days before colony enumeration. A reduction of colony number variable from 60.13 to 100 % for powers of 2, 4, and 6 W at 25-50 Hz of frequency was observed in comparison with growth control. For agar plates, laser application was performed with different powers at 50 Hz for 60 s. A growth inhibition was observed after 5 days of incubation on MH plates with powers of 6 W and on MH-ink plates with all applied powers. This preliminary study showed a bactericidal effect caused by Nd:YAG laser application worthy to be evaluated in further experiments in vivo.
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Affiliation(s)
- Paolo Vescovi
- Faculté de Médécine et Chirurgie de Liège, Liege, Belgium
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Determination of the effect of Nd:YAG laser irradiation through dentinal tubules on several oral pathogens. Lasers Med Sci 2012; 28:281-6. [DOI: 10.1007/s10103-012-1150-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 06/25/2012] [Indexed: 11/26/2022]
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Angiero F, Benedicenti S, Signore A, Parker S, Crippa R. Apicoectomies with the Erbium Laser: A Complementary Technique for Retrograde Endodontic Treatment. Photomed Laser Surg 2011; 29:845-9. [DOI: 10.1089/pho.2011.3046] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Francesca Angiero
- Department of Pathology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Stefano Benedicenti
- Department of Biophysical Medical and Stomatological Science and Technology, University of Genoa, Genoa, Italy
| | - Antonio Signore
- Department of Biophysical Medical and Stomatological Science and Technology, University of Genoa, Genoa, Italy
| | | | - Rolando Crippa
- Department of Oral Pathology and Laser Therapy, Stomatological Institute of Milan, Milan, Italy
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dos Santos Antonio MP, Moura-Netto C, Camargo SEA, Davidowicz H, Marques MM, Maranhão de Moura AA. Bactericidal effects of two parameters of Er:YAG laser intracanal irradiation: ex-vivo study. Lasers Med Sci 2011; 27:1165-8. [DOI: 10.1007/s10103-011-1023-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 10/24/2011] [Indexed: 10/15/2022]
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