ENDODONTICS AND THERMOVISION-TEMPERATURE CHANGES DURING PHOTO-ACTIVATED DISINFECTION IN ROOT CANALS. THERMOVISION DIAGNOSIS IN ENDODONTIC TREATMENT.

Abstract

Introduction: The application of thermovision in endodontics is an innovative method and has a great informative value, evidence proved, thanks to the use of last generation camera Flir A310 and a software ThermaCam Reporter 8.3 Pro. In the recent years a new method of root canal disinfection is introduced – photo-activated disinfection (PAD). Temperature increase have always been a concern during dental laser treatment. Aim: The purpose of our study is to evaluate the temperature elevation on the outer root surface at extracted teeth and in periapical tissues when photodynamic therapy with 630-nm diode laser is used for root canal disinfection. Materials and methods: For the laboratory study we used 72 single-rooted freshly extracted human teeth. They were divided into six groups depending on the power of the light source (220 mW, 360 mW and 500 mW ) and the type of photosensitizer agent - Fotosan and Zn-phtalocianine. In our clinical study participated 8 patients, who came in to our clinic with complaints of spontaneous pain or were with infected root canals and were referred for endodontic treatment. PAD was performed with a diode laser with wavelength of 630 nm using an endodontic handpiece with fiberoptic connector, allowing penetration to 4 mm from the apical stop, and movements of fibreoptic (200 µm) in apicalcoronal direction . Results: The highest temperature value was detected at 500mW and 360mW. The average temperature increase recorded in our study at the external surface of the root canal did not exceed 10°C only at power setting of 220 mW during PAD with Zn-phtalocianine. Conclusion: In conclusion, photo-activated disinfection of the root canal with Zn-phtalocianine and 630-nm diode laser using 200 µm fibreoptic tips at a power setting of 220 mW for 60 seconds induces a temperature increase which isn’t sufficient to damage the neighbouring tissues. Based on this results we don’t recommend root canal preparation over 02 or 04 taper when PAD will be performed.