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ePaper created 2017-06-15, 09:14:00 | version 1.38.0
In the clinical practice, the warm vertical conden- sation technique is widely used to obturate the canal, but keeping a gutta-percha cone warm enough to obtain favorable sealing in the ramifications may cause lasting discomfort because of thermal damage to periodontal tissues.27,28 On the other hand, the mechanism of sealer placement by the Nd:YAP laser is different from thermoplastic techniques. Sealer is placed in the canal with a lentulo spiral followed by application of the Nd:YAP laser to disperse the sealer into ramifications by the fleeting pressure of laser beam. Although the pressure causes slight discom- fort, the post-filled sensation is not overt and dissi- pates clinically within a few hours. In most cases, there was radiographic evidence of sealer being forced into lateral/accessory canals. Puffs of sealer from the periapical foramen are considered an evi- dence of tight seal.1 Zinc-oxide and eugenol-based sealer was chosen in this case report because working and setting time are conducive to completion of the entire obturation process before the sealer sets. The heat from laser irradiation induces fast setting and burning of epoxy resin-based sealer; these types of sealers are not recommended with this technique. Taking periapical films during obturation is recom- mended to confirm whether the sealer is placed into canal adequately. general practitioners to acquire the skill and follow this method. Further histological analysis is needed to verify the significance of laser disinfection and sealer place- ment with the use of the Nd:YAP laser. These addi- tional investigations will hopefully add to the store of knowledge relative to canal disinfection and the benefits of adequate obturation of auxiliary canals. Conclusion Obturation of lateral canals and apical ramifica- tions were observed on postoperative radiographs. This indicates enhanced canal cleanliness and sealing of these small ramifications. The Nd:YAP laser can be utilised as adjuncts to disinfection, canal irrigation and canal filling to improve the quality of obturation in the canal system. The efficiency of Nd:YAP laser- assistant endodontic treatment could simplify the procedure of root canal treatment without purchas- ing additional equipment to provide an advanced level of treatment._ Acknowledgement: The authors are grateful to Eric Jacobs, a media specialist, from University of Detroit Mercy School of Dentistry for image edition. Another advantage of using the Nd:YAP laser is that the need for analgesics/antibiotics after treatment can be decreased. The Nd:YAP laser has a strong anti- bacterial effect and an excellent potential for promot- ing tissue healing induced without a more invasive procedure29,30; therefore, using the Nd:YAP laser may be more efficient in disinfection and obturation of the root canal system resulting in a higher success rate of non-surgical root canal treatment. Based upon per- sonal experience and observation for four years in laser application, Nd:YAP laser-assistant endodontic treatment is less technique sensitive and easy for contact Dr John Palanci Clinical assistant professor Department of Oral Health and Integrated Care, University of Detroit Mercy 2700 Martin Luther King Jr. Blvd. Detroit, MI 48208, USA Tel.: +1 313 4946863 palancjg@udmercy.edu Author details Kurz & bündig Ausgehend von der Aussage Schilders (1967), dass die finale Zielvorgabe einer jeden endodontischen Behandlung die komplette, dreidimensionale Füllung der Wurzel- und Nebenkanäle sei, einschließlich der Entfernung aller organi- scher Ablagerungen, Bakterien und Bakteriengifte, erheben die Autoren dieses Artikels diese Maßgabe zum ultimativen Qualitätskriterium der endodontischen Behandlung. Im Bewusstsein, dass diese These auch heute noch von Behandlern kritisch diskutiert wird, stellen die Autoren eine lasergestützte endodontische Behandlungsalternative anhand dreier Fallbeispiele vor. Dabei kam der Nd:YAP-Laser bei der Einbringung des Sealers zum Einsatz. Auf den anschließend angefertigten Röntgenaufnahmen konnte die Aufbereitung der Nebenkanäle und apikalen Verzweigungen sichtbar ge- macht werden, sodass aus Sicht der Autoren auch diese bestmöglich gereinigt und versiegelt werden konnten. Literature Abschließend kommen sie daher zu dem Schluss, dass der Nd:YAP-Laser eine geeignete Behandlungsalternative für die Desinfektion, Spülung und Füllung der Wurzelkanäle darstelle und die Qualität der Wurzelkanalaufbereitung signifikant erhöhe. industry | laser 2 2017 29