Effect of power settings versus temperature change at the root surface when using multiple fiber sizes with a holmium YAG laser while enlarging a root canal

Abstract

The aim of this study was to determine if there is an increase in temperature at the root surface as the canal is enlarged when using a Holmium:YAG laser. An increase might be expected because, as the canal is enlarged, there is less dentin between the canal walls and the outer cementum surface of the root to absorb the heat. Sixty single-rooted human teeth were randomly assigned to 1 of 3 groups according to laser power settings: 0.50, 0.75, and 1.00 W. Each tooth in each power group was subjected to lasing using fiber sizes of 140, 245, 355, and 410 microns. The dependent variables in these analyses included: (a) change in temperature, measured with T-type thermocouples placed 2 mm from the coronal and apical ends of the root; (b) depth of laser in the tooth; (c) depth that a conventional fiber could be inserted after lasing; and (d) tooth physical dimensions. ANOVA for coronal temperature showed no interaction between fibers and power settings. Repeated-measures ANOVA for apical temperature showed a significant difference between fibers, but not between power settings. No interaction between fibers and power settings was observed. For the depth of tooth during lasing (how far the fiberoptic guide penetrated into the tooth), no interaction between fibers and power settings was observed. Pairwise contrasts revealed that all fibers were different from one another, with depth decreasing as fiber size increased. Depth files could be inserted that showed the depth significantly decreased as file size increased from 50 through 70. ANOVAs illustrated that there were no significant differences between power settings for any of the five tooth physical dimensions. All temperature differences observed apically and coronally were between 0 degree to 10 degrees C, with the majority (> 98%) being between 0 degree to 5 degrees C. After lasing with the 410-micron fiber, the root canals were widened to at least 45 or 50 K-files (450 or 500 microns). However, by using a 410-micron fiber, the laser did not seem to widen the canal beyond a 500-micron diameter.