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| industry report lasers in endodontics Fig. 7 Fig. 8 Fig. 9 Figs. 7–9: Side canals and ramifications that became visible in radiographs demonstrate how effectively root canals and even very fine structures can be cleaned within the course of a root canal treatment. this pasty material from root canals. Within the scope of endodontic treatments, I insert calcium-hydroxide in the root canals as a medicinal filling after the me- chanical preparation has been completed but before the root canal filling is inserted. It remains there for several days; in the case of large apical bright spots, it may stay 12 to 16 weeks so that we can verify by means of X-rays that reossification, a visible sign of healing, has started before we fill the root canal. Before filling the root canal (Figs. 7–9), the calcium- hydroxide has to be removed from the root canals. To this end, the mechanical apical master file is used to proceed up to 1 mm before reaching the working length to be able to remove as much of the pasty cal- cium-hydroxide as possible by using the instru- ment’s spiral-shaped teeth like a screw conveyor. This is followed by a sound-activated irrigation using an EDDY attachment (VDW). Each root canal is rinsed for one minute with EDTA irrigation solution and sound activation. Afterwards, an XP-endo shaper instrument (FKG Dentaire) is used up to 1 mm before reaching the working length; however, the instrument is used less for preparation than for cleaning the walls of the canals mechanically. It seems reasonable to expect that there would be no more calcium hydroxide after such a time- and ma- terial-intensive manner of proceeding. So, it is highly impressive when Morita’s AdvErL Evo laser trans- ports a surprisingly large quantity of remaining calcium hydroxide out of the root canals. It is equally impressive to see that irrigating with Morita’s AdvErL Evo laser may, in certain cases, even bring to light fractured foreign bodies such as fragments of instruments or irrigation tips as well as old filling material hidden in the depths of the root canals. Summary and evaluation Progress in endodontics can be measured by the circumstance whether procedures are simplified or more cost-effective than previously. Or whether one can do something better. The Morita AdvErL Evo laser helps us improve our treatment in the different stages of a root canal procedure described above. Although I still take a negative standpoint towards many state- ments made about the use of lasers, I have a positive opinion about using an Er:YAG laser for LAI. Critical aspects are the purchase price and the op- erating costs. The Morita AdvErL Evo laser is equipped with comparably fracture-proof attachments; al- though this property is desired for the product, it is not necessarily a matter of course in view of the al- ternatives that are available. Nonetheless, it must be borne in mind that the laser attachments, being the tools that they are, are subject to wear and, hence, have a limited service life. For this reason, the pur- chase price, operating costs and time involved, need to be taken into consideration when putting to- gether a viable economic concept. Unfortunately, private health insurance schemes frequently refuse to pay for LAI treatments, even though German leg- islation added such innovative measures to the Schedule of Fees for Dentists. Of course, this is noth- ing new. For years, private health insurance compa- nies refused to assume the material costs for dispos- able mechanical NiTi instruments or the costs for using a dental microscope within the scope of endo- dontic treatments. We can only hope that legislation will support the use of LAI in the near future. Irre- spective of that, the practical benefits provided by Morita’s AdvErL Evo laser are evident. For this reason, using the Morita AdvErL Evo laser for LAI has proven its worth as a meaningful and, hence, indispensable treatment measure in all different phases of root canal treatments and my endodontic work._ contact Dr Hans-Willi Herrmann Specialist for endodontics of the German Society of Endodontics Specialist for endodontics of the German Society of Conservative Dentistry Certified Member of the European Society of Endodontology 44 roots 3 2017