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Namour A, El Mobadder M, Matamba P, Misoaga L, Magnin D, Arany P, Nammour S. The Safety of Removing Fractured Nickel-Titanium Files in Root Canals Using a Nd: YAP Laser. Biomedicines 2024; 12:1031. [PMID: 38790993 PMCID: PMC11117853 DOI: 10.3390/biomedicines12051031] [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: 03/30/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
The fracture of nickel-titanium (Ni-Ti) instruments during root canal instrumentation leads to compromised outcomes in endodontic treatments. Despite the significant impact of instrument facture during a root canal treatment, there is still no universally accepted method to address this complication. Several previous studies have shown the ability of a Neodymium: Yttrium-Aluminum-Perovskite (Nd: YAP) laser to cut endodontic files. This study aims to determine safe irradiation conditions for a clinical procedure involving the use of a Neodymium: Yttrium-Aluminum-Perovskite (Nd: YAP) laser for removing fractured nickel-titanium files in root canals. A total of 54 extracted permanent human teeth (n = 54) were used. This study involved nine distinct groups, each employing different irradiation conditions. Groups 1 s, 3 s, 5 s, 10 s, and 15 s simply consist of irradiation for 1, 3, 5, 10, and 15 s, respectively. After identifying the longest and safest duration time, four additional groups were proposed (labeled A, B, C, and D). Group A was composed of three series of irradiations of 5 s each separated by a rest time of 30 s (L5s + 30 s RT). Group B consisted of three series of irradiations of 5 s each separated by a rest time of 60 s (L5s + 60 s RT). Group C consisted of two series of irradiations of 5 s each separated by a rest time of 30 s (L5s + 30 s RT), and group D consisted of two series of irradiations of 5 s each separated by a rest time of 5 s (L5s + 5 s RT). In all groups, during the rest time, continuous irrigation with 2.5 mL of sodium hypochlorite (3% NaOCl) was carried out. The variation in temperature during irradiation was registered with a thermocouple during irradiation with different protocols. The mean and standard deviation of the temperature increase was noted. The calculation of the temperature was made as the Δ of the highest recorded temperature at the root surface minus (-) that recorded at baseline (37°). Additionally, scanning electron microscopy (SEM) was used after irradiation in all groups in order to assess the morphological changes in the root dentinal walls. The Nd: YAP laser irradiation parameters were a power of 3W, an energy of 300 mJ per pulse, a fiber diameter of 200 µm, a pulsed mode of irradiation with a frequency of 10 Hz, a pulse duration of 150 µs, and an energy density of 955.41 J/cm2. Our results show that the safest protocol for bypassing and/or removing broken instruments involves three series of irradiation of 5 s each with a rest time of 30 s between each series. Furthermore, our results suggest that continuous irradiation for 10 s or more may be harmful for periodontal tissue.
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Affiliation(s)
- Amaury Namour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Marwan El Mobadder
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
| | - Patrick Matamba
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Lucia Misoaga
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Delphine Magnin
- Bio- and Soft Matter Division, Institute of Condensed and Nanosciences, Université Catholique de Louvain (UCL), 1348 Louvain-la-Neuve, Belgium;
| | - Praveen Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA;
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
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Ekici Ö, Aslantaş K, Kanık Ö, Keles A. Temperature and time variations during apical resection. Acta Odontol Scand 2021; 79:156-160. [PMID: 33245674 DOI: 10.1080/00016357.2020.1850855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate temperature and time variations during root-end resection. MATERIAL AND METHODS Sixty human premolars were selected. The root canals were enlarged up to ProTaper X3 rotary instrument. A thermocouple was placed into the root canal 1 mm behind the resection line. The teeth were randomly divided into six groups according to the apical resection method: steel bur, tungsten carbide bur, Lindeman bur, diamond bur, laser and ultrasonic surgical piezo with a diamond tip. The root ends were resected 3 mm away from the root apex. The temperature of the root dentine during resection was recorded as maximum temperature, mean temperature and temperature change. The time required for apicectomy was recorded for each group. The Kruskal-Wallis method was used to analyse the differences between temperature changes during apical resections. The significance level was set at 5%. RESULTS There was no significant difference between bur groups in terms of temperature increase. The maximum temperature in piezo surgery was significantly higher than the Lindeman, tungsten and steel burs (p < .001). In addition, the maximum temperature in laser surgery was higher than the Lindeman bur (p < .05). An increase in the temperature was mostly seen in piezo surgery and the least temperature change occurred in the Lindeman bur. Mean time stayed under 1 min in each group. CONCLUSIONS Although piezo caused the highest temperature increase, the measured temperature increase was within physiological limits in all tested techniques.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Kubilay Aslantaş
- Department of Mechanical Engineering, Faculty of Technology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Özgür Kanık
- Department of Restorative Dentistry, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Kadić S, Baraba A, Miletić I, Ionescu AC, Brambilla E, Ivanišević Malčić A, Gabrić D. Influence of different laser-assisted retrograde cavity preparation techniques on bond strength of bioceramic-based material to root dentine. Lasers Med Sci 2019; 35:173-179. [PMID: 31273570 DOI: 10.1007/s10103-019-02835-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 06/25/2019] [Indexed: 11/26/2022]
Abstract
The purposes of the study were to evaluate the bond strength of bioceramic TotalFill root repair material (RRM) in retrograde cavities prepared using Er:YAG and Er,Cr:YSGG laser and steel bur, and to analyze failure modes. The root canals of 30 single-rooted teeth were endodontically treated, their root-ends were resected using a diamond bur, and the teeth were randomly divided into three groups (N = 10) according to the retrograde cavity preparation technique: (1) Er:YAG laser, (2) Er,Cr:YSGG laser, and (3) steel bur. All retrograde cavities were filled with the TotalFill RRM which was prepared according to the manufacturers' instructions. Push-out test was performed using universal testing machine, and failure mode was analyzed using a scanning electron microscope. The data were analyzed using one-way ANOVA, post hoc analysis with Bonferroni correction, and Fisher-Freeman-Halton exact test (p < 0.05). In the Er:YAG-, Er,Cr:YSGG-, and steel bur-prepared cavities, mean bond strengths (MPa) were 12.76, 8.44, and 6.01, respectively. The bond strength of the TotalFill RRM to dentin was significantly higher in the Er:YAG laser compared with the steel bur-prepared cavities (p = 0.004). The bond strength was not significantly different between the Er:YAG and Er,Cr:YSGG cavities (p = 0.074) and between the Er,Cr:YSGG and bur cavities (p = 0.648). In the cavities prepared by the Er,Cr:YSGG laser and bur, the failure mode of the TotalFill RRM was predominantly mixed, then adhesive and cohesive. In the Er:YAG laser-prepared cavities, the most common failure mode was adhesive, followed by mixed type and no cohesive failure. The bond strength of the TotalFill RRM to dentin was highest in the group of retrograde cavities prepared by the Er:YAG laser.
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Affiliation(s)
- Snježana Kadić
- Department of Pediatric and Preventive Dentistry, Dental Polyclinic Zagreb, Zagreb, Croatia
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, HR-10000, Zagreb, Croatia
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, HR-10000, Zagreb, Croatia
| | | | - Eugenio Brambilla
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Ana Ivanišević Malčić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, HR-10000, Zagreb, Croatia.
| | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Ayrancı F, Ayrancı LB, Özdoğan A, Özkan S, Peker MÖ, Aras MH. Resistance to vertical root fracture of apicoected teeth using different devices during two root canal irrigation procedures. Lasers Med Sci 2018; 33:1685-1691. [DOI: 10.1007/s10103-018-2517-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/18/2018] [Indexed: 11/25/2022]
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Outcome of Endodontic Surgery: A Meta-analysis of the Literature-Part 3: Comparison of Endodontic Microsurgical Techniques with 2 Different Root-end Filling Materials. J Endod 2018; 44:923-931. [PMID: 29681480 DOI: 10.1016/j.joen.2018.02.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/17/2018] [Accepted: 02/19/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate the influence of root-end preparation and filling material on endodontic surgery outcome. A systematic review and meta-analysis was conducted to determine the outcome of resin-based endodontic surgery (RES, the use of high-magnification preparation of a shallow and concave root-end cavity and bonded resin-based root-end filling material) versus endodontic microsurgery (EMS, the use of high-magnification ultrasonic root-end preparation and root-end filling with SuperEBA [Keystone Industries, Gibbstown, NJ], IRM [Dentsply Sirona, York, PA], mineral trioxide aggregate [MTA], or other calcium silicate cements). METHODS An exhaustive literature search was conducted to identify prognostic studies on the outcome of root-end surgery. Human studies conducted from 1966 to the end of December 2016 in 5 different languages (ie, English, French, German, Italian, and Spanish) were searched in 4 electronic databases (ie, Medline, Embase, PubMed, and Cochrane Library). Relevant review articles on the subject were scrutinized for cross-references. In addition, 5 dental and medical journals (Journal of Endodontics; International Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics; Journal of Oral and Maxillofacial Surgery; and International Journal of Oral and Maxillofacial Surgery) were hand checked dating back to 1975. All abstracts were screened by 3 independent reviewers (H.B., M.K., and F.S.). Strict inclusion-exclusion criteria were defined to identify relevant articles. Raw data were extracted from the full-text review of these selected articles independently by each of the 3 reviewers. In case of disagreement, an agreement was reached by discussion, and qualifying articles were assigned to group RES. For EMS, the same search strategy was performed for the time frame October 2009 to December 2016, whereas up to October 2009 the data were obtained from a previous systematic review with identical criteria and search strategy. Weighted pooled success rates and a relative risk assessment between RES and EMS were calculated. To make a comparison between groups, a random effects model was used. RESULTS Sixty-eight articles were eligible for full-text review. Of these, per strict inclusion exclusion criteria, 14 studies qualified, 3 for RES (n = 862) and 11 for EMS (n = 915). Weighted pooled success rates for RES were 82.20% (95% confidence interval [CI], 0.7965-0.8476) and 94.42% for EMS (95% CI, 0.9295-0.9590). This difference was statistically significant (P < .0005). CONCLUSIONS The probability for success for EMS proved to be significantly greater than the probability for success for RES, providing best available evidence on the influence of cavity preparation with ultrasonic tips and/or SuperEBA (Keystone Industries, Gibbstown, NJ), IRM (Dentsply Sirona, York, PA), MTA, or silicate cements as root-end filling material instead of a shallow cavity preparation and placement of a resin-based material. Additional large-scale randomized clinical trials are needed to assess other predictors of outcome.
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Lin T, Kawamura R, Aoki A, Ichinose S, Mizutani K, Taniguchi Y, Eguro T, Saito N, Izumi Y. Energy output reduction and surface alteration of quartz tips following Er:YAG laser contact irradiation on soft and hard tissues in vitro. Dent Mater J 2016; 35:51-62. [PMID: 26830823 DOI: 10.4012/dmj.2015-020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Though the Er:YAG laser (ErL) has been used in periodontal therapy, the irradiated tip damage has not been studied in detail. In this study, the change in the energy output, surface morphology, and temperature of quartz tips was evaluated following contact irradiation. Soft tissue, calculus on extracted human teeth, and porcine bone were irradiated by ErL for 60 min at 14.2 or 28.3 J/cm(2)/pulse and 20 Hz with or without water spray. The energy output ratio declined the most in the calculus group, followed by the bone and soft tissue groups with and/or without water spray. Carbon contamination was detected in all groups, and contamination by P, Ca, and/or other inorganic elements was observed in the calculus and bone groups. The rate of energy output reduction and the degree of surface alteration/contamination is variously influenced by the targeting tissue, temperature elevation of the tip and water spray.
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Affiliation(s)
- Taichen Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Bernardes RA, Húngaro Duarte MA, Vivan RR, Baldi JV, Vasconcelos BC, Bramante CM. Scanning electronic microscopy analysis of the apical surface after of root-end resection with different methods. SCANNING 2015; 37:126-130. [PMID: 25652816 DOI: 10.1002/sca.21188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/22/2014] [Accepted: 12/29/2014] [Indexed: 06/04/2023]
Abstract
To compare the time dispensed and the surface characteristics when a root-end resection was performed with a surgical ultrasonic device (VarioSurg, NSK, Japan) or with a Zekrya bur. Forty distal roots of freshly extracted mandibular molars were selected and divided into four different groups: (G1) stainless steel insert with ultrasound; (G2) diamond insert with ultrasound; (G3) stainless steel and diamond inserts with ultrasound, and (G4) Zekrya burs. The time required for the root-end resection was timed and the surface characteristics were evaluated via scanning electronic microscopy. The median times for the root-end resections were: 115.9 s for G1, 249.8 s for G2, 112.7 s for G3, and 7.44 s for G4, the latter presented a smoother root-end surface. There was no statistically significant difference in the comparisons between G3 group and G4 group (Zekrya burs). The other groups where the root-end resections were with ultrasonic devices proportioned a prolonged time to resection with irregular surfaces.
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Affiliation(s)
- Ricardo Affonso Bernardes
- Department of Dentistry, Endodontics and Dentistry Material, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil; Brazilian Dental Association, Taguatinga, Federal District, Brazil
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Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clin Oral Investig 2015; 19:569-82. [DOI: 10.1007/s00784-015-1398-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/02/2015] [Indexed: 01/23/2023]
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Ugurlu F, Cavus O, Kaya A, Sener CB. Evaluation of dental anxiety in patients undergoing dentoalveolar surgery with laser treatment. Photomed Laser Surg 2013; 31:169-73. [PMID: 23469870 DOI: 10.1089/pho.2012.3364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate dental anxiety in patients undergoing apicectomy procedures performed with conventional instruments or an erbium-doped yttrium aluminum garnet (Er:YAG) laser. METHODS Twenty-eight patients undergoing apicectomy were divided into two groups; roots were removed with an Er:YAG laser in group A (n=14) and with conventional instruments in group B (n=14). All patients completed preoperative State-Trait Anxiety Inventories (STAI) and postoperative questionnaires. RESULTS Although state anxiety, trait anxiety, and postoperative questionnaire scores were lower in patients undergoing Er:YAG laser treatment than in those treated with conventional instruments, the differences were not statistically significant. CONCLUSIONS Surgical instruments affect the anxiety levels of dental patients. Even with the STAI scores being lower for patients treated with Er:YAG, use of the Er:YAG laser alone cannot contribute to the resolution of dental anxiety. A patient's individual condition is the major factor influencing that patient's anxiety level.
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Affiliation(s)
- Faysal Ugurlu
- Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Marmara University Marmara Üniversitesi Nişantaşı Kampusu, Büyük Çiftlik Sk. Nişantaşı /Şişli /İstanbul, Turkey.
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Apicoectomy Using Er:YAG Laser in Association with Microscope: A Comparative Retrospective Investigation. Photomed Laser Surg 2013; 31:110-5. [DOI: 10.1089/pho.2012.3393] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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