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ePaper created 2017-09-12, 09:26:18 | version 1.38.0
| industry report lasers in endodontics Using the AdvErL Evo laser for endodontic treatments Author: Dr Hans-Willi Herrmann, Germany Fig. 1: The Morita AdvErL Evo unit from the product group of Er:YAG lasers with an effective wavelength of 2,940 nm. Fig. 1 Introduction I used a laser in a dental treatment for the first time in 1991. I was completing my residency and my superior had ordered a Nd:YAG laser to conduct PAR therapies in his practice. But, truth be told, my very first contact with a laser had actually taken place a couple of years previously. In 1988, when I was still a student at the University of Mainz, we were shown a laser made by ADL and told that it was considered to be the future of dental medicine. I was ambivalent about that as I could not see the much praised advan- tages of using lasers because, contrary to the prom- ises made about the equipment, treatments were neither completely painless nor was the long-term quality of the treatments better. As a matter of fact, it was evident that treatments using lasers in periodontology and dental surgery took significantly longer than conventional treat- 40 roots 3 2017 ment methods. The only positive aspect I was able to discern was faster wound healing. In my opinion, this justified neither the high pur- chase price nor operating costs; and, so, I put the question of using a laser in dental medicine to rest as far as my own practice was concerned. And noth- ing caused me to change my opinion for the next 20 years. The much promoted revolution did not come about, the ever so innovative laser quickly de- scended to esoteric marketing for dental practices, whose only argument for a laser’s raison d’être was that it conveyed the image of being a modern dentist. My only points of contact with the medium were limited to reading endodontic studies within the scope of my own specialised endodontic practice. For the most part, the abstracts confirmed a reduc- tion in bacteria; however, this reduction was not better in practical terms, perhaps even worse, than that achieved with such fundamental measures as irrigating with NaOCl.1, 2 Moreover, the side effects of using a laser were men- tioned as well, e.g. those caused by an excessive ap- plication of heat.3 All in all, I had no reason to concern myself with the use of lasers in endodontics for more than two decades, not to mention investing a consid- erable amount of money in this type of equipment. Endodontics, by comparison, experienced enor- mous progress during this period of time. The use of nickel-titanium (NiTi) as a material for mechanical root canal instruments revolutionised the preparation procedure and smoothed the path for warm filling techniques. Electrical length meas- urements, dental microscopes and cone beam com- puted tomography (CBCT) became established, as did the use of ultrasound for irrigation, preparation of the primary and secondary access cavities, as well as pin/fragment removal. Nonetheless, a critical point throughout this time was the cleaning quality of our preparation methods4, which remained an unsolved problem in root canal treatments.