Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-08-02, 15:09:01 | version 1.38.0
Confidence in your hands... TF Adaptive is the endodontics file system that adapts its movement to give you more control during your procedure. The Adaptive Motion Technology and the motor’s exclusive algorithm allow the instrument to switch between reciprocation and rotation, depending on the amount of pressure placed on the file. Reducing the risks of file breakage and apical extrusion, and improving your patients’ comfort. To give you more confidence during your canal preparations. www.KerrDental.ae C M Y CM MY CY CMY K A5_EN_MEA_TF Adaptive ADV.pdf 1 25.07.16 14:30 Dental Tribune Middle East & Africa Edition | 4/2016 ENDO TRIBUNE 2 Laser Endodontic debridement and canal disinfection By Gregori M. Kurtzman, DDS, MAGD,DICOI The canal system within teeth is a complex array of accessory and lat- eral canals, fins and other anatomi- cal areas inaccessible to endodontic files. (Figure 1) The principle that only one thing can occupy a space at a time is key to endodontic success. This is dependant on disinfection and debridement of the canal sys- tem as well as how well the system is sealed during obturation. Irrigation has been long accepted as a key part oftreatmenttoachievethosegoals. Yet, complete clearing of residual bacteria especially in the apical por- tion of the canal system has been difficult to achieve with traditional methods using even sodium hy- pochlorite(NaOCL)solutions.(Figure 2) Studies have demonstrated that addition of a Er:YAG laser to activate the irrigation solution greatly in- creases not only the efficiency of the irrigation solutions advocated (NaO- CL and EDTA) but also improves dis- infectionofthecanalsystem.(Figure 3) Laserenhancedirrigation The Er:YAG laser (LiteTouch™, dis- tributed in USA by AMD LASERS, Indianapolis, IN) creates hydrody- namic pressure following cavitation bubbleexpansionandcollapsewhen the irrigation solution is activated in the chamber. The LiteTouch™ Er: YAG laser energy is set at a sub- ablative power level which allows its use without structural changes to the hard tissue within the tooth, eliminating the risks of ledging and perforationofthepulpalfloor.When activated a heat pulse is generated Figure 1:Anatomy of the canal system demonstrating accessory canals, fins and lateral canalswhicharenot accessiblewithendodonticfilesasshownincleared teeth. bylaserradiationdeliveredviaasap- phire tip into an absorbing liquid (ir- rigant). This results in tensile stress and cavitation being induced in frontofthetipatadistancefarbelow the optical penetration depth of the laser radiation. Bubble expansion and collapse cause the surrounding fluid to flow at a speed of up to 12 m/s traveling throughout the canal system. This causes rapid displace- ment of intra-canal fluid via radial and longitudinal pressures suffi- cient to drive irrigant into the canal anatomy and clean dentinal walls significantly. The photomechanical Figure 2: SEM showing bacteria and pulpal debris in the apical 1/3 that was not able to be removed fully using standard irrigation protocol. (Courtesy Prof. Georgi Tomov, Plodiv,Bulgaria) Figure3:SEMshowingcompleteremovalofbacteriaandpulpaltissueintheapical1/3 afterirrigationusingtheLT-IPI™protocol.(CourtesyProf.GeorgiTomov,Plodiv,Bulgaria) ÿPage 3 A5_EN_MEA_TF Adaptive ADV.pdf 125.07.1614:30