Efficiency and Temperature Rise of File Ablation by Neodymium:Yttrium-Aluminum-Perovskite Laser In Vitro

Abstract

IntroductionRetrieving a separated file in the root canal system requires a skilled clinician. A metal file can be removed by ablation via the neodymium:yttrium-aluminum-perovskite (Nd:YAP) laser; however, the efficiency and potential hazards of the ablation procedure are still unclear. The aim of this study was 2-fold: to investigate the efficiency of file ablation using the Nd:YAP laser and to evaluate the rise in temperature of the root surface in vitro. MethodsIn part 1 of this study, #10 and #15 C-files (VDW GmbH, Munich, Germany) and ProTaper Next X1 and X2 files (Dentsply Maillefer, Ballaigues, Switzerland) were selected. Under 8.5×, the Nd:YAP laser was used to ablate the files starting at the tip of the file. The length of the file was recorded after each 5-pulse ablation. In part 2 of this study, 3 files each of the #15 C-file and the ProTaper Next X2 were separated in 6 distal roots of mandibular second molars with single canals. Two-pulse and 5-pulse modes were used to ablate the separated files, and the rise in root surface temperature was recorded with an infrared camera. Another 3 unaltered distal roots served as the negative control. For scanning electron microscopic evaluation, the teeth were split with bone scissors and observed under a scanning electron microscope to evaluate the surface change of the file and the root canal wall. ResultsThe average length of the ablated files after each 5-pulse interval was 0.113–0.158 mm with no statistical difference between the different files.The temperature rise of the negative control group (mean ± standard deviation = 1.86° ± 0.11°C and 5.81° ± 0.35°C for the 2- and 5-pulse group) was significantly lower than the roots with separated files (mean ± standard deviation = 3.74° ± 0.20°C and 4.02° ± 0.11°C for 2-pulse C-file and ProTaper Next X2; 8.47° ± 0.19°C and 9.04° ± 0.20°C for 5-pulse C-file and ProTaper Next X2). The temperature rise of all groups was lower than 10°C. The 2-pulse group showed a lower temperature rise than the 5-pulse group. The diameter or the type of alloy had no effect on the temperature rise. ConclusionsSeparated files (stainless steel or nickel-titanium alloy) can be ablated by the Nd:YAP laser. When the number of pulses is less than 5, the temperature rise of the root surface is considered safe to the surrounding periodontium.