Abstract
The purpose of this in vitro study was to evaluate the effect of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation on intracanal dentin surface by SEM analysis and its interference in the apical seal of filled canals. After endodontic treatment procedures, 34 maxillary human incisors were randomly assigned to 2 groups. In the negative control group (n=17), no additional treatment was performed and teeth were filled with vertically condensed gutta-percha; in the laser-treated group (n=17), the root canals were irradiated with Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) before filling as described for the control group. Two specimens of each group were prepared for SEM analysis to evaluate the presence and extent of morphological changes and removal of debris; the other specimens were immersed in 0.5% methylene blue dye (pH 7.2) for 24 h for evaluation of the linear dye leakage at the apical third. SEM analysis of the laser-treated group showed dentin fusion and resolidification without smear layer or debris. The Student's t-test showed that the laser-treated group had significantly less leakage in apical third than the control group. Within the limitations of this study, it may be concluded that the morphological changes on the apical intraradicular dentin surface caused by Nd:YAG laser resulted in less linear dye apical leakage.
Highlights
The fundamental part in endodontic therapy is the removal of inorganic and organic debris followed by the appropriate filling of the canal space in order to seal it off from the surrounding oral tissues
Teeth were randomly assigned into 2 groups: a negative control group (n=17), which received no treatment before root filling; and a laser-treated group (n=17), which was irradiated with Nd:YAG laser before root filling
Several laser systems have been investigated in Dentistry over almost 30 years and Nd:YAG laser is well established for endodontic purposes
Summary
The fundamental part in endodontic therapy is the removal of inorganic and organic debris followed by the appropriate filling of the canal space in order to seal it off from the surrounding oral tissues. Apical leakage has been proven an important reason for root canal treatment failure and its occurrence is generally associated with deficient smear layer removal [1,2,3]. A number of studies have demonstrated that the traditional method for root canal preparation produces a significant amount of smear layer that can adhere on the dentinal walls, obliterating the dentinal tubules. It reduces dentinal permeability and hinders penetration of intracanal drugs into dentin, even when chemical irrigation is used combined with mechanical instrumentation. It has been claimed that the incidence of leakage is significantly reduced in the absence of smear layer and that smear layer removal is capable of enhancing seal ability and increasing resistance to bacterial penetration [4]
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