Objective: The aim of this in vitro study was to investigate the antibacterial depth effect of continuous wave laser irradiation with a wavelength of 980 nm in the root canal wall dentin of bovine teeth. Background Data: The long-term success of an endodontic therapy often fails due to remaining bacteria in the root canal or dentin tubules, which cannot be sufficiently eliminated through the classical root canal preparation technique nor through rinsing solutions. Materials and Methods: A total of 102 slices of bovine root dentin of different thicknesses (100, 300 and 500 µm) were prepared. The samples were inoculated from one side with 5 µL of an enterococcus faecalis suspension of defined concentration. Four slices per slice thickness served as a control group; the rest of the 30 slices per thickness were subjected to laser irradiation-10 each of these slices were irradiated with distal outputs of 1.75, 2.3, and 2.8 Watts (W). After drying them for 30 sec, the back of the inoculated dentin slice was irradiated for 32 seconds with a 200-µm fiber optical waveguide under constant movement of the fibers. The remaining bacteria were then detached in NaCl under vibration. The eluate produced by this was-taking account of the degree of dilution-plated out on sheep blood agar plates. After 24 h of incubation, the grown bacterial colonies were able to be counted out and evaluated. By doing so, they were compared with the non-irradiated, but otherwise identically treated control group. Results: With a slice thickness of 100 µm, the 980-nm diode laser achieved a maximum bacterial reduction of 95% at 1.75 W, 96% at 2.3 W, and 97% at 2.8 W. With a slice thickness of 300 µm, a maximum of 77% of the bacteria was destroyed at 1.75 W, 87% at 2.3 W, and 89% at 2.8 W. The maximum bacterial reduction with a slice thickness of 500 µm was 57% at 1.75 W, 66% at 2.3 W, and 86% at 2.8 W. Conclusion: The results of this research show that the 980-nm diode laser can eliminate bacteria that have immigrated deep into the dentin, thus being able to increase the success rate in endodontic therapy. 9
The thermal rise threshold of an 810-nm semi-conductor diode laser on the root surface when used in root canals in vitro for laser assisted root canal treatment is investigated in this study. A total of 50 human single-rooted extracted teeth were included. For this study, the canals were enlarged up to an apical size of ISO#50 file. Laser irradiation was performed with six different settings. Specimens were irradiated at 0.6-1 W output power at the distal end of the fiber and about 1-1.5 W output power in the continuous mode (CW) as two groups. In the third group, 0.6-1 W output power, 10 ms pulse length (PL) and 10 ms interval duration (ID) were selected. In three other groups 1-1.5 W output power were used with different PL and ID as following: PL 10 and ID 10 ms, PL 10 and ID 20 ms and PL 20 and ID 20 ms. The total irradiation time was from 5 to 20 s per canal with a 200 mum in diameter and 25 mm long tip. After laser treatment, the temperature changes at the outer root surface were registered by means of NiCr-Ni measuring sensors and a T 202 thermometer. The safe temperature threshold for applying this diode laser in root canal is considered as 7 degrees C increase. To avoid increasing the temperature changes at the outer root surface related to this threshold, following total irradiation times were found: 0.6-1 W output power (10 ms PL/10 ms ID): 20 s (s), 1-1.5 W output power (10 ms/10 ms and 20 ms/20 ms): 15 s, 0.6-1 W output power CW and 1-1.5 W output power (20 ms PL/10 ms ID): 10 s and 1-1.5 W output power CW: 5 s. In the first three groups, 5 s irradiation and 5 s rest period avoided a temperature increase above the threshold of 7 degrees C).
The scientific investigation of fundamental problems plays a decisive role in understanding the mode of action and the consequences of the use of lasers on biological material. One of these fundamental aspects is the investigation of the ablation threshold of various laser wavelengths in dental enamel. Knowledge of the relationships and influencing factors in the laser ablation of hard tooth tissue constitutes the basis for use in patients and the introduction of new indications. The present paper examines the ablation threshold of an Er:YAG laser (lambda=2.94 micro m) and an Er:YSGG laser (lambda=2.79 micro m) in human dental enamel. To this end, 130 enamel samples were taken from wisdom teeth and treated with increasing energy densities of 2-40 J/cm(2). The sample material was mounted and irradiated on an automated linear micropositioner. Treatment was performed with a pulse duration of tau(P(FWHM)) approximately 150 micro s and a pulse repetition rate of 5 Hz for both wavelengths. The repetition rate of the laser and the feed rate of the micropositioner resulted in overlapping of the single pulses. The surface changes were assessed by means of reflected light and scanning electron microscopy. On the basis of the results, it was possible to identify an energy density range as the ablation threshold for both the Er:YAG and the Er:YSGG laser. With the Er:YAG laser, the transition was found in an energy density range of 9-11 J/cm(2). The range for the Er:YSGG laser was slightly higher at 10-14 J/cm(2).
The theory of the ablation of dental hard tissue with erbium lasers is based on a process of thermomechanical interaction, which is explained by the absorption of the radiation in the water component of the tissue. The abrupt evaporation of the water is the cause of tissue fragments being blasted out of the tooth structure. The aim of this study is to examine the effect of the water contained in dental hard tissues on the efficiency of ablation. 192 specimens of both bovine dental enamel and bovine dentin are irradiated with an Er:YAG and an Er,Cr:YSGG laser. Half of the specimens are dehydrated beforehand. Irradiation is carried out in subgroups: without water spray and with water spray at flow rates of 0.8 and 3 mls. The ablated volume is determined following histological preparation. Only in dentin, and then only with irradiation with the Er:YAG laser, is the water contained in the tissue found to have a significant influence (p < 0.0001) on the ablated volume. The water content has no effect on the efficiency of laser ablation in any of the other test groups. In contrast, the externally supplied water always has a significant influence on the effectiveness of the ablation process.
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