Evaluation of the Effectiveness of Erbium Lasers on Removing Calcium Hydroxide

Year 2021, Volume: 11 Issue: 1, 47 - 52, 31.03.2021

Emre Çulha , Cihan Yıldırım

https://doi.org/10.33808/clinexphealthsci.737154

Abstract

Objective: The purpose of this study was to compare the efficacy of Erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG), and Erbium-doped yttrium aluminum garnet laser (Er:YAG) lasers with passive ultrasonic irrigation (PUI) and conventional syringe irrigation (CSI) for the removal of calcium hydroxide [Ca(OH)2] paste from standardized canal irregularities.

Methods: Forty single-rooted human teeth were split longitudinally, forming halves, and cut a standardized groove in canal walls. After filling each groove with Ca(OH)2 paste, the teeth were reassembled and stored for 1 week. Ca(OH)2 was removed with CSI by using 10 milliliters (mL) of 5% sodium hypochlorite (NaClO) and 10 mL of 17% ethylenediaminetetraacetic acid (EDTA), respectively. The teeth were randomly divided into four groups (n=10). CSI group was irrigated with10 mL of 5% NaClO, 10 mL of 17% EDTA, and 10 mL of distilled water with CSI (control group), respectively. In Er:YAG group, 5% NaClO was activated with Er:YAG laser, and in Er,Cr:YSGG group, Er,Cr:YSGG laser equipped with Radial Firing Tip 2 (RFT 2) was used. In the PUI group, PUI was used with 2.5% NaClO. All groups received irrigation with 10 mL of distilled water as final irrigation. The root halves were examined with a stereomicroscope using a 4-grade scoring system.

Results: Residues of Ca(OH)2 in artificial grooves were observed in all groups. In Er,Cr:YSGG group, only three specimens got a score of 1 (less than half of the groove is filled). Er,Cr:YSGG group was found slightly higher yet the difference was found to be not significant with other groups.

Conclusions: Although Er,Cr:YSGG laser equipped with RFT 2 tip seems to have a superior effect on removing Ca(OH)2 from the standardized canal irregularities, there was no statistically significant difference between the applications.

Keywords

Er:YAG laser, Er Cr:YSGG laser, passive ultrasonic irrigation, calcium hydroxide, artificial groove

Supporting Institution

Gaziantep University Scientific Research Projects Governing Unit.

Project Number

DHF.15.03

References

• Peters LB, Wesselink PR. Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms. Int Endod J 2002; 35:660-7.
• Siqueira JF, Jr, Araujo MC, Garcia PF, Fraga RC, Dantas CJ. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod 1997; 23:499-502.
• Siqueira JF, Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999; 32:361-9.
• Meire M, De Moor R. Mineral trioxide aggregate repair of a perforating internal resorption in a mandibular molar. J Endod 2008; 34:220-3.
• Capar ID, Ozcan E, Arslan H, Ertas H, Aydinbelge HA. Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals. J Endod 2014; 40:451-4.
• van der Sluis LW, Wu MK, Wesselink PR. The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J 2007; 40:52-7.
• Lambrianidis T, Kosti E, Boutsioukis C, Mazinis M. Removal efficacy of various calcium hydroxide/chlorhexidine medicaments from the root canal. Int Endod J 2006; 39:55-61.
• Burleson A, Nusstein J, Reader A, Beck M. The in vivo evaluation of hand/rotary/ultrasound instrumentation in necrotic, human mandibular molars. J Endod 2007; 33:782-7.
• Lee SJ, Wu MK, Wesselink PR. The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls. Int Endod J 2004; 37:672-8.
• van der Sluis LW, Wu MK, Wesselink PR. The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from human root canals prepared using instruments of varying taper. Int Endod J 2005; 38:764-8.
• Roy RA, Ahmad M, Crum LA. Physical mechanisms governing the hydrodynamic response of an oscillating ultrasonic file. Int Endod J 1994; 27:197-207.
• Matsumoto H, Yoshimine Y, Akamine A. Visualization of irrigant flow and cavitation induced by Er:YAG laser within a root canal model. J Endod 2011; 37:839-43.
• Guidotti R, Merigo E, Fornaini C, Rocca JP, Medioni E, Vescovi P. Er:YAG 2,940-nm laser fiber in endodontic treatment: a help in removing smear layer. Lasers Med Sci 2014; 29:69-75.
• Peeters HH, Mooduto L. Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er,Cr:YSGG laser irradiation: an in vivo study. Clin Oral Investig 2013; 17:2105-12.
• Kivanc BH, Ulusoy OI, Gorgul G. Effects of Er:YAG laser and Nd:YAG laser treatment on the root canal dentin of human teeth: a SEM study. Lasers Med Sci 2008; 23:247-52.
• De Moor RJ, Meire M, Goharkhay K, Moritz A, Vanobbergen J. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod 2010; 36:1580-3.
• Rodig T, Sedghi M, Konietschke F, Lange K, Ziebolz D, Hulsmann M. Efficacy of syringe irrigation, RinsEndo and passive ultrasonic irrigation in removing debris from irregularities in root canals with different apical sizes. Int Endod J 2010; 43:581-9.
• de Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LW. Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J 2009; 42:1077-83.
• George R, Meyers IA, Walsh LJ. Laser activation of endodontic irrigants with improved conical laser fiber tips for removing smear layer in the apical third of the root canal. J Endod 2008; 34:1524-7.
• Deleu E, Meire MA, De Moor RJ. Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci 2015; 30(2):831-5.
• van der Sluis LW, Gambarini G, Wu MK, Wesselink PR. The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. Int Endod J 2006; 39:472-6.