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ePaper created 2016-11-22, 09:52:12 | version 1.38.0
| case report use of Er,Cr:YSGG laser in endodontics 34 roots 4 2016 Introduction Endodontic therapy is the treatment of choice for teeth with apical periodontitis and Internal Root Re- sorptions (IRR) as it aims to eliminate bacterial con- tamination, granulation tissue and blood supply of the clastic cells that are commonly reported to be in- volved with the process.1,2 Sodiumhypochlorite(NaOCl)isarguablychosenas primary endodontic disinfection solution. Neverthe- less, the ideal concentration, temperature, contact period and extent of clinical effectiveness of NaOCl remains under discussion.3–6 Moreover, several clini- cal factors (e.g. root perforations, absence of apical constrictionetc.)mayaccidentlyinduceNaOClextru- sionintoperiapicaltissueswithpotentiallysevereand hazardous consequences.7–9 In spite of this, several clinical strategies were re- ported with regards to the management of root re- sorptions,10 theirscientificevidenceislimitedtocase reports and few present alternative disinfection techniques.11–14 Lasers have long been presented as promising alternatives to conventional endodontic procedures.15 Each laser wavelength has a specific absorption coefficient for every tissue16 and erbium lasersdemonstrateahighabsorptioncoefficientfor both water/aqueous solutions and hydroxyapa- tite.17,18 Thus,therationaleforusingerbiumlasersin endodonticsmaybebrieflydescribedas:(1)theabil- ity of infrared light to interact with aqueous solu- tions and produce cavitation effects capable to removesmearlayer,dentinaldebrisandfillingmate- rials from the root canal walls19–21 and (2) the ability of infrared light to propagate into the dentinal tubules, achieving significant bactericidal effects deeper than conventional chemical solutions.22,23 Accordingly, the 2,780nm Er,Cr:YSGG laser has beenreportedasaneffectivemethodforsmearlayer and debris removal in comparison with EDTA irriga- tion,handactivationorevenultrasonicactivatedir- rigation,19,24–27 resulting in a significant clearance of canals/isthmuses prior obturation28 and less mi- croleakage of root canal filling materials.29 More- over, it has also been shown to be suitable for deep Er,Cr:YSGG laser and Internal Root Resorptions Case report of an endodontic treatment using radial firing fips Authors: Dr Miguel Rodrigues Martins, Prof. Dr Manuel Fontes Carvalho, Prof. Dr Irene Pina-Vaz, Prof. Dr Miguel André Martins & Prof. Dr Norbert Gutknecht, Portugal/Germany © Annareichel/Shutterstock.com 42016