Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-09-12, 09:26:18 | version 1.38.0
lasers in endodontics industry report | seconds, the laser will have cleaned the access cavity (Figs. 5 & 6). Any denticles will be detached from the soft tissue surrounding them and rinsed out, any soft- and hard-tissue will be removed from occult ca- nal entrances, making them visible and penetrable. 2. Opening root canals, obtaining patency Using Morita’s AdvErL Evo will prove its worth particularly in very narrow canals, which involve a high risk of iatrogenic blockage. Morita’s AdvErL Evo will rinse out the canals. Whereas the P400FL tip (25 pps, 50 mJ) is used before the initial opening, the R300T tip (25 pps, 50 mJ) is used for 20 seconds re- spectively after the coronal preparation of root ca- nals. In this way, it will be significantly easier and foreseeable to open up root canals completely with thin manual instruments or mechanical glide-path instruments up to the foramen apicale within the meaning of the ‘patency’ concept. If the irrigation solution exhibits slightly red colouring, this indi- cates that there may be a patency. If there is stronger bleeding, even if it stops on its own just a short time after the laser instrument is used, the energy param- eter should be reduced from 50 to 30 mJ. In the same way, periapical sensations of pain, which may occur sporadically to a minor degree, can be considered a sign that patency has been achieved and the energy parameter should be reduced to 30 mJ. 3. Removal of blockages 4. Cleaning the root canals, removing the smear layer Following the initial opening of the root canals and the use of mechanical nickel-titanium instru- ments to complete the root canal preparation, if necessary also intermittently during the prepara- tion, Morita’s AdvErL Evo laser is used to remove the smear layer analogous to conventional irrigation of the root canals with irrigation solutions, ultrasound or sound-activated irrigation. Then the R300T tip with 25 pps and 50 mJ is used. The cloudiness of the irrigation solution after acti- vation and the removal by rinsing of suspended particles clearly demonstrates the efficiency of the measures taken. This is particularly impressive if the conventional irrigating methods mentioned above were applied for the recommended duration in the root canal and, nonetheless, the laser still removes a smear layer from the root canal when it is applied afterwards. The cloudiness of the irrigation solution is a good indication for determining the duration of irrigation, which can be ended when the irrigation solution that is transported out of the root canal seems to be clear. As a rule, this should be the case after about 15–20 seconds. In the event of bacterial infections, 3 % NaOCI is used for the LAI; in the case of vital extirpation, 17 % EDTA should be used. If there are any blockages, as can frequently be the case in revisions of the root canal filling, the P400FL and R300T tips are used at 25 pps and 70 mJ and, if necessary, with several irrigation cycles of 20 sec- onds respectively. 5. Removing calcium-hydroxide, removing any foreign bodies As helpful as calcium hydroxide may be when it is used as an agent for disinfecting bacterially infected root canals, it is also difficult to completely remove Figs. 5 & 6: The endodontic access cavity can be cleaned efficiently with Morita’s AdvErL Evo. Fig. 5 Fig. 6 roots 3 2017 43