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Genc Sen O, Erdemir A. The Effectiveness of Three Different Irrigant Activation Methods in the Elimination of Enterococcus faecalis from Root Canals. Photobiomodul Photomed Laser Surg 2024. [PMID: 39007181 DOI: 10.1089/pho.2023.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background and Objective: Eliminating intracanal Enterococcus faecalis (E. faecalis) is challenging because of its ability to penetrate deep dentinal tubules and its high resistance to many chemicals. This study evaluated the effectiveness of conventional needle irrigation and three different irrigant activation methods in reducing E. faecalis. Methods: The root canals of extracted teeth were shaped, contaminated with E. faecalis, and incubated for three weeks. They were randomly allocated to four experimental groups of 15 teeth each according to the final irrigation method: group 1, conventional needle irrigation; group 2, passive ultrasonic (PU) irrigation; group 3, XP-endo Finisher (XPF); and group 4, laser-activated (LA) irrigation. Bacterial samples were taken and cultured before and after these final irrigation procedures. The colony-forming units were counted, and the bacterial reduction percentages of each group were calculated. The Kruskal-Wallis and Dunnet tests were used for statistical analysis. Results: All irrigant activation methods were significantly more effective than conventional needle irrigation. Although the LA group generated more negative samples than PU, there was no statistically significant difference between the LA and PU groups. LA was significantly more effective than the XPF, whereas PU and XPF were statistically similar. Conclusions: Within the limitations of this study, the final irrigation with LA and PU showed the best reductive effect on E. faecalis colonies. Considering that the LA group had more negative samples, it may be chosen as an alternative to enhance root canal disinfection, especially in difficult cases.
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Affiliation(s)
- Ozgur Genc Sen
- Dentistry Faculty, Department of Endodontics, Van Yuzuncu Yil University, Van, Turkey
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2
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Meire M, De Moor RJG. Principle and antimicrobial efficacy of laser-activated irrigation: A narrative review. Int Endod J 2024; 57:841-860. [PMID: 38340037 DOI: 10.1111/iej.14042] [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: 11/01/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
In the last two decades, the activation of root canal irrigants with pulsed lasers as an adjunct in root canal treatment has become increasingly popular. This narrative review explains the physical basics and the working mechanism of laser-activated irrigation (LAI), explores the parameters influencing LAI efficacy, considers historical evolutions in the field and summarizes laboratory and clinical evidence with emphasis on the antimicrobial action of LAI. Cavitation is the driving force behind LAI, with growing and imploding vapour bubbles around the laser tip causing various secondary phenomena in the irrigant, leading to intense liquid dynamics throughout the underlying root canal. High-speed imaging research has shown that laser wavelength, pulse energy, pulse length and fibre tip geometry are parameters that influence this cavitation process. Nevertheless, this has not resulted in standardized settings for LAI. Consequently, there is significant variability in studies assessing LAI efficacy, complicating the synthesis of results. Laboratory studies in extracted teeth suggest that, with regard to canal disinfection, LAI is superior to conventional irrigation and there is a trend of higher antimicrobial efficacy of LAI compared to ultrasonic activation. Clinical evidence is limited to trials demonstrating similar postoperative pain levels after LAI versus no activation or ultrasonic activation. Clinical evidence concerning the effect of LAI on healing of apical periodontitis as yet is scarce.
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Affiliation(s)
- Maarten Meire
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Roeland J G De Moor
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
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3
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Ghane HK, Samiei N, Razavi P, Khaled Y, Fekrazad R. High-Power Laser Application for Immediate Implant Placement in Infected Sites: A Systematic Review. Photobiomodul Photomed Laser Surg 2023; 41:663-673. [PMID: 38085186 DOI: 10.1089/photob.2023.0010] [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] [Indexed: 12/18/2023] Open
Abstract
Objective: The purpose of this study was to review the literatures regarding the treatment outcomes of applying laser to the infected sites in immediate implant placement. The review tended to primarily target a question: does applying high-power laser have any positive effect on infected sites in immediate implant placement? Background: Although immediate placement of dental implants has been referred to as a predictable and successful procedure, it is prone to the presence of infection that interferes with the healing process, and triggers the failure of implants. Materials and methods: A thorough electronic database search was conducted on PubMed/Medline, Embase, Web of Science, Google Scholar, and the Cochrane library in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two writers worked separately on screening the eligible studies, assessing whether there was a risk of bias, and extracting the required data. Results: Five out of the 60 studies nominated by the database search matched the inclusion criteria. The studies were carried out on a total of 192 patients with 296 implants in all. Ultimately, the study focused on 245 implants whose infected bed had been already decontaminated and prepared with the help of the high-intensity laser, used either alone or in combination with other approaches before implantation. With only nine failures, the implants inserted in infected and irradiated areas had a 96.3% overall survival rate. Conclusions: Taking the limitations of the review into account, the authors arrived at the conclusion that high-power laser irradiation can be beneficial for immediate implant placement in infected sites.
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Affiliation(s)
- Hadi Kaseb Ghane
- Department of Prosthodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Nazanin Samiei
- Department of Periodontics, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouyan Razavi
- Student Research Committee, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Yasser Khaled
- Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Chauhan N, Kumar G, Goswami M, Johar S, Sharma A. Antimicrobial efficacy of sodium hypochlorite, saline, and Er, Cr:YSGG laser-assisted disinfection in root canal treatment of primary molars: An in vivo study. J Indian Soc Pedod Prev Dent 2023; 41:70-75. [PMID: 37282415 DOI: 10.4103/jisppd.jisppd_98_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Aim The aim of the study was to compare the antimicrobial efficacy of sodium hypochlorite (NaOCl), Saline, and Er, Cr:YSGG laser-assisted disinfection through microbiological analysis in root canal treatment of primary molars. Materials and Methods Forty-five primary teeth were selected for this study as per the inclusion and exclusion criteria in the age group of 4-8 years and then randomly allocated to Three Groups A, B, and C. In Group A, during root canal treatment, irrigation was done using NaOCl, in Group B, laser-assisted disinfection was done using Er, Cr:YSGG laser, and in Group C, saline was used as an irrigating agent. This was followed by obtaining pre- and postirrigation samples from the canals for microbiological investigation in all the groups. Data analysis was performed using Statistical Package for the Social Science-21 (SPSS-21). Results NaOCl was more effective against aerobic bacteria while Er, Cr:YSGG laser was more effective against anaerobic bacteria when used for disinfection in root canal treatment. There was a significant difference among the three groups (P > 0.05). Conclusion The study showed that NaOCl and Er, Cr:YSGG laser have antimicrobial effects when used for disinfection in root canal treatment of primary teeth. Moreover, the study also shows that Er, Cr:YSGG laser may be used as a valuable tool for laser-assisted disinfection in root canal treatment of primary teeth.
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Affiliation(s)
- Neha Chauhan
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Gyanendra Kumar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Mridula Goswami
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Smriti Johar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Abha Sharma
- Department of Microbiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
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Srinivasan S, Kumarappan SK, Ramachandran A, Honap MN, Kadandale S, Rayar S. Comparative evaluation of pulp tissue dissolution ability of sodium hypochlorite by various activation techniques: An in vitro study. J Conserv Dent 2020; 23:304-308. [PMID: 33551605 PMCID: PMC7861078 DOI: 10.4103/jcd.jcd_425_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022] Open
Abstract
Background: The success in endodontic therapy is dependent largely on the absolute elimination of pulp tissue remnants and the maximum reduction of pathologic microbial load present within the root canal system. Aim: The aim of this in vitro study was to compare and evaluate the ability of pulp tissue dissolution with and without activation of 5.25% sodium hypochlorite (NaOCl). Materials and Methods: Pulp tissue samples collected from intact, noncarious extracted third molars were standardized to 8 mg in each group. These samples were placed in conical Eppendorf tubes of 15 ml with 10 ml 5.25% NaOCl for 4 min and were activated suitably according to the group specifications. All the procedures in this study were carried out at room temperature. The preweighed pulp tissue samples were further weighed again after the dissolution phase, and residual weight loss in each group along with its percentage was obtained. The results were then statistically analyzed using one-way analysis of variance and Tukey post hoc test. Results: The maximum amount of pulp tissue dissolution was found in the laser-assisted irrigation group, i.e., NaOCl with Er, Cr: YSGG (P < 0.05) and showed a statistically significant result in comparison with other groups. Conclusion: Within the limitations of the study, laser-assisted irrigation with a radial firing tip (NaOCl activated by Er, Cr: YSGG) was the most effective in dissolving the pulp tissue in comparison with other groups. The ultrasonic activation also showed a considerable amount of pulp tissue dissolution comparable to laser-activated irrigation in this study.
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Affiliation(s)
- Srividhya Srinivasan
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Senthil Kumar Kumarappan
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Anupama Ramachandran
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Manjiri Nagesh Honap
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Sadasiva Kadandale
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Sreeram Rayar
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India
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Laser Therapy for Infected Sites and Immediate Dental Implants in the Esthetic Zone: A Case Report and Review of Literature. Case Rep Dent 2020; 2020:2328398. [PMID: 31970001 PMCID: PMC6973183 DOI: 10.1155/2020/2328398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/21/2019] [Indexed: 12/02/2022] Open
Abstract
Placement of postextraction dental implants has become a common practice. Here, we reviewed current literature, along with clinical procedures, outcomes, and incidence of complications, associated with immediate implants in infected postextraction sites. The YSGG (yttrium, scandium, gallium, and garnet) laser can significantly reduce the bacterial concentration after extracting a compromised tooth. We treated a 40-year-old woman with a compromised tooth in the esthetic zone, presenting clinical and radiological signs of infection, particularly a periapical periodontitis. The tooth was extracted after administering local anesthesia using Optocain® (mepivacaine and adrenalin 1 : 100,000), following which the site was treated with an ErCr : YSGG (erbium, chromium-doped yttrium, scandium, gallium, and garnet) 2780 nm laser device (Biolase iPlus®). The implant (Straumann® fixture) was inserted with minimum 35 N torque, 1 mm below the most apical bone peak. Bio-Oss® and resorbable membrane were applied to improve bone healing. The use of ErCr : YSGG laser has ensured success of implant therapy performed on an infected site. There were no complications such as peri-implantitis or loss of peri-implant bone. The implant achieved good primary stability, immediate placement into an infected site did not increase complications, and the 5-year follow-up confirmed the treatment success.
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Er,Cr:YSGG Laser-Activation Enhances Antimicrobial and Antibiofilm Action of Low Concentrations of Sodium Hypochlorite in Root Canals. Antibiotics (Basel) 2019; 8:antibiotics8040232. [PMID: 31766766 PMCID: PMC6963469 DOI: 10.3390/antibiotics8040232] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 11/17/2022] Open
Abstract
The onset and persistence of endodontic infections due to residual biofilm after chemical disinfection promotes secondary bacterial infection. Alternative methods to disinfect operated root canals are a matter of great interest. The aim was to evaluate the antibacterial effectiveness of sodium hypochlorite (NaOCl) at low concentrations activated by the Er,Cr:YSGG laser-activated irrigation (LAI) against 10-day-old intracanal Enterococcusfaecalis biofilm. Biofilms were formed inside the root canals and divided into 7 groups (n13): 0.5% NaOCl + Er,Cr:YSGG; Saline + Er,Cr:YSGG; 0.5% NaOCl + syringe irrigation(SI); 2.5% NaOCl + SI; 5% NaOCl + SI; positive and negative controls. Bacterial survivors were counted and specimens visualized under scanning electron and confocal laser scanning microscopy. Treatments with 0.5% NaOCl + Er,Cr:YSGG and 2.5% NaOCl + SI gave a significant reduction in the number of CFU/mm2. Moreover, scanning electron microscopy and confocal laser scanning microscopy imaging confirmed and reinforced bacteriological data. Thus, Er,Cr:YSGG LAI proved to be able to improve the intracanal distribution of 0.5% NaOCl after 60 s of activation, reaching the same level of effectiveness than 2.5% NaOCl. This is regarded as of clinical interest, since working with lower concentrations may contribute to reduce undesired effects.
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Crippa R, Aiuto R, Guardincerri M, Peñarrocha Diago M, Angiero F. Effect of Laser Radiation on Infected Sites for the Immediate Placement of Dental Implants. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:186-192. [PMID: 31429669 DOI: 10.1089/photob.2019.4636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The study aims to evaluate the feasibility of erbium-chromium: yttrium-scandium-gallium-garnet (ErCr:YSGG 2780 nm) laser irradiation on infected and/or inflamed post-extraction sites for the immediate placement, and when possible, immediate loading, of endosseous implants. Background: Post-extraction site infection is a serious complication. Surgical and nonsurgical options are available to treat such event, together with various decontamination methods. However, there is still no consensus on which treatment is the most effective. Materials and methods: Sixty-six patients were included in the study for a total of 94 post-extraction implants, inserted in the maxilla and mandible. All patients were eligible for implant therapy, having at least one compromised tooth requiring extraction, along with sign of inflammation and/or infection. Surgery and socket decontamination were performed using an ErCr:YSGG laser. To improve bone healing, Bio-Oss® and resorbable membrane were used in 57 patients. Eleven implants were immediately loaded, whereas 83 were loaded within 3-6 months, depending on the extraction site. Intraoral radiographs were taken at 1, 3, 6, 9, and 12 months from the implant placement to assess the alveolar bone level and treatment's outcome. Albrektsson criteria were chosen to evaluate the treatment success rate. Results: Follow-up went from 6 months to 4 years. Success rate was 94.6% (89/94): three implants failed to integrate due to poor patient compliance, being expelled during the second week, whereas two implants presented factory defects (abutment). No sockets presented signs of residual infection during follow-up. Conclusions: The combination of mechanical, chemical, and laser treatment was proven to be highly effective for the disinfection of post-extraction sites. The ErCr:YSGG laser is a useful tool, not only for his practicality as a surgical device but also as a disinfection tool, granting optimal results after implant surgery.
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Affiliation(s)
- Rolando Crippa
- Department of Oral Pathology, Italian Stomatological Institute, Milan, Italy
| | - Riccardo Aiuto
- Department of Oral Surgery, University of Valencia, València, Spain
| | - Marco Guardincerri
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy
| | | | - Francesca Angiero
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy
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Betancourt P, Merlos A, Sierra JM, Arnabat-Dominguez J, Viñas M. Er,Cr:YSGG Laser-Activated Irrigation and Passive Ultrasonic Irrigation: Comparison of Two Strategies for Root Canal Disinfection. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:91-97. [PMID: 31397611 DOI: 10.1089/photob.2019.4645] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective: To compare the antibacterial effectiveness of 0.5% sodium hypochlorite (NaOCl) activated by the Er,Cr:YSGG laser-activated irrigation (LAI) and passive ultrasonic irrigation (PUI) against a 10-day-old intracanal Enterococcus faecalis biofilm. Background: LAI and PUI are regarded as alternative methods to release the irrigant in the inner regions of the root canal system achieving enhanced cleaning ability. Nevertheless, little evidence regarding the activation of low concentrations of NaOCl has been reported. Materials and methods: Seventy-two single-rooted teeth were instrumented, inoculated (E. faecalis ATCC 29212), and incubated for 10 days to allow biofilm formation. Specimens were randomly divided into six groups (n = 12 each): (1) 0.5% NaOCl+Er,Cr:YSGG LAI, (2) saline+Er,Cr:YSGG LAI, (3) 0.5% NaOCl+PUI, (4) saline+PUI, (5) positive control (no treatment), and (6) negative control (no bacteria). The activation time was distributed as follows: 30 sec of activation, followed by a rest phase of 30 sec, and ending with 30 sec of activation. The number of bacterial survivors was determined by plate counting. Results: Both irrigation regimens LAI and PUI reduced the number of colony-forming unit. Moreover, LAI +0.5% NaOCl and the rest of groups significantly differ (p < 0.001 for all comparisons). Conclusions: Er,Cr:YSGG LAI proved to be more effective than PUI in enhancing the antimicrobial activity of 0.5% NaOCl against 10-day-old intracanal E. faecalis biofilms.
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Affiliation(s)
- Pablo Betancourt
- Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona, Barcelona, Spain.,Dental School, Research Centre in Dental Sciences (CICO), Universidad de La Frontera, Temuco, Chile
| | - Alex Merlos
- Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona, Barcelona, Spain.,Cuerpo de Sanidad Militar, Ejército del Aire de España, Zaragoza, España
| | - Josep Maria Sierra
- Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Miguel Viñas
- Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona, Barcelona, Spain
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Tokuc M, Ozalp S, Topcuoglu N, Kulekci G. Bactericidal Effect of 2780 nm Er,Cr:YSGG Laser Combined with 940 nm Diode Laser in Enterococcus faecalis Elimination: A Comparative Study. Photobiomodul Photomed Laser Surg 2019; 37:489-494. [PMID: 31140907 DOI: 10.1089/photob.2018.4613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: This study aims to compare the bactericidal efficacy of different Er,Cr:YSGG disinfection methods, particularly combined application of Er,Cr:YSGG and Diode laser. Background: Root canal disinfection is important for long-term endodontic success. Different laser systems are proposed as alternatives to conventional techniques in bacterial elimination. Materials and methods: Ninety-five straight, single-rooted premolars with similar canal dimensions were selected. After the mechanical preparation, the samples were sterilized, and root canals were infected with Enterococcus faecalis. The samples were randomly divided into five groups (n = 15): 5% NaOCl, Er,Cr:YSGG, Er,Cr:YSGG +5% NaOCl, Er,Cr:YSGG + Diode, and control group. Results: The maximal bacterial elimination was observed in Er,Cr:YSGG + NaOCl group (p < 0.005). More bacteria were found in Er,Cr:YSGG and Er,Cr:YSGG + Diode groups compared with 5% NaOCl group (p < 0.005). Marginal significance was detected between the Er,Cr:YSGG group and the Er,Cr:YSGG + Diode group (p = 0.091). Conclusions: The most successful E. faecalis elimination was obtained from laser-activated irrigation group. As combined application of Er,Cr:YSGG and Diode laser gives suggestive results, further studies with larger sample sizes are needed to clarify the outcome.
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Affiliation(s)
- Muge Tokuc
- 1Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - Serife Ozalp
- 2Department of Pediatric Dentistry, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Nursen Topcuoglu
- 3Department of Microbiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Guven Kulekci
- 3Department of Microbiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Henninger E, Berto LA, Eick S, Lussi A, Neuhaus KW. In Vitro Effect of Er:YAG Laser on Different Single and Mixed Microorganisms Being Associated with Endodontic Infections. Photobiomodul Photomed Laser Surg 2019; 37:369-375. [PMID: 31074693 DOI: 10.1089/photob.2018.4557] [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: 01/23/2023] Open
Abstract
Objective: The purpose of this in vitro study was to evaluate the antimicrobial effect of activated irrigation with different modes of erbium-doped yttrium aluminum garnet (Er:YAG) laser application on microorganisms related to secondary endodontic infection. Background: Er:YAG laser has been recommended as an adjuvant tool for root canal disinfection during endodontic treatment. Materials and methods: Laser-activated irrigation (LAI) with 300 or 600 μm tips were tested with or without intermittent irrigation with 0.9% sodium chloride (NaCl) solution against different microorganisms (five single strains and dual species (Streptococcus gordonii combined with Actinomyces oris or Fusobacterium nucleatum) in root canals after 3 days of incubation. In a 21-day infection model, LAI was used together with intermittent rinsing with sodium hypochlorite (NaOCl) against the dual-species mixtures; here the incidence of microbial regrowth after up to 7 days was monitored. Results: In the 3-day root infection model, LAI protocols did not show any significant reduction of the microbial load when compared with manual irrigation with saline solution. In the 21-day infection, S. gordonii combined with A. oris were not detectable anymore after applying the LAI protocol with a 600 μm tip (30 mJ/10 pps) up to 7 days after treatment. Conclusions: Application of LAI with a 600 μm tip by using an Er:YAG laser might be advantageous in treatment of endodontic infections.
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Affiliation(s)
- Eva Henninger
- 1 Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Luciana Aranha Berto
- 1 Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- 2 Laboratory for Oral Microbiology, Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Adrian Lussi
- 1 Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Klaus W Neuhaus
- 1 Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,3 Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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Decontamination of Dental Implant Surfaces by the Er:YAG Laser Beam: A Comparative in Vitro Study of Various Protocols. Dent J (Basel) 2018; 6:dj6040066. [PMID: 30513706 PMCID: PMC6313799 DOI: 10.3390/dj6040066] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 12/18/2022] Open
Abstract
Oral rehabilitation with dental implants has revolutionized the field of dentistry and has been proven to be an effective procedure. However, the incidence of peri-implantitis has become an emerging concern. The efficacy of the decontamination of the implant surface, by means of lasers, is still controversial. Previous studies have revealed a reduction in osteoblast adhesion to carbon-contaminated implant surfaces. This in-vitro study aimed to evaluate the decontamination of failed implants by assessing the carbon proportion, after irradiation by low-energy erbium yttrium-aluminum-garnet laser (Er:YAG) (Fotona; 2940 nm, Ljubljana, Slovenia) for a single and for multiple passages, until getting a surface, free of organic matters; to find the appropriate procedure for dental-implant surface-decontamination. Ninety implants were used. Thirty sterile implants were kept as a negative control. Thirty failed implants were irradiated by the Er:YAG laser, for a single passage, and the other thirty, for multiple passages. The parameters used in our experiments were an irradiation energy of 50 mJ, frequency of 30 Hz, and an energy density of 3.76 J/cm2. A sapphire tip, with a length of 8 mm, was used with concomitant water spray irrigation, under air 6 and water spray 4. Super short pulse mode (SSP) was of 50 μs; irradiation speed being 2 mm/s. We used energy-dispersive X-ray spectroscopy (EDX) to evaluate the carbon proportion on the surfaces of the sterile implants, the contaminated, and the lased implants, with one (LX1) and with three passages (LX3). Statistical analysis was performed by ANOVA. Results showed mean difference between the three groups (contaminated, LX1, and LX3) with p < 0.0001, as between LX1 and Group A (p < 0.0001), while the difference between LX3 and the control group was not statistically significant. The decontamination of the implant surfaces with a low-energy Er:YAG laser with three passages, appeared to be an encouraging approach.
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Wang X, Cheng X, Liu X, Wang Z, Wang J, Guo C, Zhang Y, He W. Bactericidal Effect of Various Laser Irradiation Systems on Enterococcus faecalis Biofilms in Dentinal Tubules: A Confocal Laser Scanning Microscopy Study. Photomed Laser Surg 2018; 36:472-479. [PMID: 29717903 DOI: 10.1089/pho.2017.4430] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to compare the bactericidal effect of various laser irradiation systems on Enterococcus faecalis biofilms in dentinal tubules by using a novel dentin infection model and confocal laser scanning microscopy (CLSM). BACKGROUND DATA Laser-activated irrigations have been proposed as an adjuvant to conventional protocols of root canal treatment to enhance the smear layer removal, which is a promising protocol for root canal disinfection. MATERIALS AND METHODS E. faecalis were centrifuged into the dentinal tubules, cultured for 3 weeks, and then received 1- and 3-min treatments as follows: (A) 5.25% sodium hypochlorite (NaOCl) irrigation, (B) Nd:YAG laser irradiation, (C) diode laser irradiation, (D) Nd:YAP laser irradiation, (E) Er,Cr:YSGG laser-activated NaOCl irrigation, and (F) Er:YAG laser-activated NaOCl irrigation. Bacterial reductions were assessed by CLSM using a LIVE/DEAD® bacterial viability stain method. RESULTS For each group, the bacterial reduction increased as the treatment time increased (p < 0.05). The Er,Cr:YSGG and Er:YAG laser significantly enhanced the bactericidal effect of NaOCl (p < 0.05). Under the conditions of the same treatment time, bacterial reductions were presented in the descending order of Er:YAG + NaOCl, Er,Cr:YSGG + NaOCl > Nd:YAP > Nd:YAG, diode > NaOCl. CONCLUSIONS Under the conditions of present study, treatments of Er:YAG + NaOCl and Er,Cr:YSGG + NaOCl presented the strongest bactericidal effect among the tested protocols and are potential protocols for root canal disinfection.
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Affiliation(s)
- Xiaoli Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Xiaogang Cheng
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Xin Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Zhihua Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Juan Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Cuihong Guo
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Yaqing Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
| | - Wenxi He
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Shaanxi, P.R. China
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14
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Gwynne PJ, Gallagher MP. Light as a Broad-Spectrum Antimicrobial. Front Microbiol 2018; 9:119. [PMID: 29456527 PMCID: PMC5801316 DOI: 10.3389/fmicb.2018.00119] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/18/2018] [Indexed: 01/05/2023] Open
Abstract
Antimicrobial resistance is a significant and growing concern. To continue to treat even simple infections, there is a pressing need for new alternative and complementary approaches to antimicrobial therapy. One possible addition to the current range of treatments is the use of narrow-wavelength light as an antimicrobial, which has been shown to eliminate a range of common pathogens. Much progress has already been made with blue light but the potential of other regions of the electromagnetic spectrum is largely unexplored. In order that the approach can be fully and most effectively realized, further research is also required into the effects of energy dose, the harmful and beneficial impacts of light on eukaryotic tissues, and the role of oxygen in eliciting microbial toxicity. These and other topics are discussed within this perspective.
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Affiliation(s)
- Peter J Gwynne
- School of Biology, University of Edinburgh, Edinburgh, United Kingdom
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15
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Martins MR, Lima RC, Pina-Vaz I, Carvalho MF, Gutknecht N. Endodontic Treatment of an Autogenous Transplanted Tooth Using an Er,Cr:YSGG Laser and Radial Firing Tips: Case Report. Photomed Laser Surg 2016; 34:487-493. [PMID: 27575836 DOI: 10.1089/pho.2015.4061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE AND BACKGROUND Although several surgical techniques have been reported, no study has yet reported alternative strategies for endodontic treatment of autogenous transplanted teeth. Therefore, the aim of this clinical report is to present the long-term endodontic outcome of a nonvital autogenously transplanted third molar treated with an Er,Cr:YSGG laser and radial firing tips (RFTs). CASE REPORT Autogenous tooth transplantation can be considered an alternative to restore edentulous areas and, in donor's teeth with complete root formation, root canal treatment should be performed up to 14 days following transplantation. In the present case report, the patient returned only after 6 months, with clinical and radiological signs of apical periodontitis (AP) associated with the transplanted tooth. METHODS Instead of traditional endodontic chemical irrigants or medications, the protocol for smear-layer removal and root canal disinfection was based on intracanal irradiation with an Er,Cr:YSGG laser and RFTs. RESULTS After 3-years' follow-up, the complete reestablishment of the periodontal ligament and the arrest of the resorptive process could be noticed. CONCLUSIONS This protocol has shown to be effective for the endodontic treatment of a transplanted multi-rooted tooth with AP. Further randomized clinical trials should be conducted to clearly demonstrate the effectiveness of this laser-assisted endodontic protocol.
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Affiliation(s)
- Miguel Rodrigues Martins
- 1 Department of Endodontics, Faculdade de Medicina Dentária, Universidade do Porto , Porto, Portugal
| | - Rita C Lima
- 2 Department of Oral Surgery, Faculdade de Medicina Dentária, Universidade do Porto , Porto, Portugal
| | - Irene Pina-Vaz
- 1 Department of Endodontics, Faculdade de Medicina Dentária, Universidade do Porto , Porto, Portugal
| | - Manuel Fontes Carvalho
- 1 Department of Endodontics, Faculdade de Medicina Dentária, Universidade do Porto , Porto, Portugal
| | - Norbert Gutknecht
- 3 Department of Conservative Dentistry, RWTH Aachen University , Aachen, Germany
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16
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Souza-Gabriel AE, Sousa-Neto MD, Ururahy MSL, Andrade LM, Faraoni JJ, Romeo U, Palma-Dibb RG. Analysis of adhesive interface in root canals irradiated by Er,Cr:YSGG laser after luting a fiber post. Microsc Res Tech 2016; 79:1090-1096. [PMID: 27543845 DOI: 10.1002/jemt.22749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/08/2016] [Accepted: 08/02/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Aline Evangelista Souza-Gabriel
- Department of Restorative Dentistry; School of Dentistry of Ribeirão Preto, University of São Paulo; CEP 14040-904 SP Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry; School of Dentistry of Ribeirão Preto, University of São Paulo; CEP 14040-904 SP Brazil
| | - Mirian Saavedra Lopes Ururahy
- Department of Restorative Dentistry; School of Dentistry of Ribeirão Preto, University of São Paulo; CEP 14040-904 SP Brazil
| | - Lilian Mendes Andrade
- Department of Restorative Dentistry; School of Dentistry of Ribeirão Preto, University of São Paulo; CEP 14040-904 SP Brazil
| | - Juliana Jendiroba Faraoni
- Department of Restorative Dentistry; School of Dentistry of Ribeirão Preto, University of São Paulo; CEP 14040-904 SP Brazil
| | - Umberto Romeo
- Department of Oral and Maxillofacial Science; “Sapienza” University of Rome; Rome 0016 Italy
| | - Regina Guenka Palma-Dibb
- Department of Restorative Dentistry; School of Dentistry of Ribeirão Preto, University of São Paulo; CEP 14040-904 SP Brazil
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17
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Franceschini K, Silva-Sousa YTC, Lopes FC, Pereira RD, Palma-Dibb RG, de Sousa-Neto MD. Bond strength of epoxy resin-based root canal sealer to human root dentin irradiated with Er,Cr:YSGG laser. Lasers Surg Med 2016; 48:985-994. [DOI: 10.1002/lsm.22496] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Keila de Almeida Franceschini
- Department of Restorative Dentistry; Shcool of Dentistry of Ribeirão Preto, University of São Paulo; Ribeirão Preto São Paulo Brazil
| | | | - Fabiane Carneiro Lopes
- Department of Restorative Dentistry; Shcool of Dentistry of Ribeirão Preto, University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Rodrigo Dantas Pereira
- Department of Restorative Dentistry; Shcool of Dentistry of Ribeirão Preto, University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Regina Guenka Palma-Dibb
- Department of Restorative Dentistry; Shcool of Dentistry of Ribeirão Preto, University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Manoel Damião de Sousa-Neto
- Department of Restorative Dentistry; Shcool of Dentistry of Ribeirão Preto, University of São Paulo; Ribeirão Preto São Paulo Brazil
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18
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Gregorcic P, Lukac N, Možina J, Jezeršek M. In vitro study of the erbium:yttrium aluminum garnet laser cleaning of root canal by the use of shadow photography. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:15008. [PMID: 26790642 DOI: 10.1117/1.jbo.21.1.015008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/15/2015] [Indexed: 06/05/2023]
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19
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Mathew J, Emil J, Paulaian B, John B, Raja J, Mathew J. Viability and antibacterial efficacy of four root canal disinfection techniques evaluated using confocal laser scanning microscopy. J Conserv Dent 2014; 17:444-8. [PMID: 25298645 PMCID: PMC4174704 DOI: 10.4103/0972-0707.139833] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/16/2014] [Accepted: 06/29/2014] [Indexed: 11/14/2022] Open
Abstract
Background: Several disinfection techniques have been recently introduced with the main objective of improving root canal disinfection in the inaccessible areas of the root canal system. This in vitro study was done to evaluate the antimicrobial effect and viability of Enterococcus faecalis biofilms using conventional irrigation, EndoActivator (Dentsply, Tulsa Dental, USA), diode laser irradiation and photon-initiated photoacoustic streaming (PIPS). Materials and Methods: Root canals of 130 single rooted mandibular premolars, standardized to a uniform length of 20 mm were instrumented until finishing file, F1 (Universal Protaper Rotary System, Dentsply, Tulsa Dental Specialties, USA). After smear layer removal and sterilization, five teeth were randomly selected to assure sterility before bacterial inoculation. The remaining 125 samples were contaminated with E. faecalis suspension, incubated for 21 days and divided into five groups (n = 25). In Group 1; untreated group (positive control), the root canals were not subjected to any disinfection procedure. Sampling was performed within the canals and the colony-forming unit count was evaluated for 20 samples. Five samples were selected to visualize the pattern of colonization at Level 1 (4 mm from the apex) and Level 2 (1 mm from the apex) by confocal laser scanning microscopy. Samples in Groups 2-5 namely conventional needle irrigation, EndoActivator, diode laser and PIPS were subjected to their respective disinfection procedures. Postdisinfection sample evaluation criteria was followed for all groups as same as that for Group 1. Results: Diode laser displayed the highest antibacterial efficacy and least viable bacteria than the other three disinfection techniques. Conclusion: Diode laser group showed better antibacterial efficacy and least viable bacteria when compared to conventional needle irrigation, PIPS and EndoActivator groups in minimally instrumented, experimentally infected root canals.
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Affiliation(s)
- Joan Mathew
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli District, Tamil Nadu, India
| | - Jonathan Emil
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli District, Tamil Nadu, India
| | - Benin Paulaian
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli District, Tamil Nadu, India
| | - Bejoy John
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli District, Tamil Nadu, India
| | - Jacob Raja
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli District, Tamil Nadu, India
| | - Jean Mathew
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli District, Tamil Nadu, India
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