Comparative Evaluation of the Antibacterial Efficacy of Four Different Disinfection Techniques in Minimally Instrumented Experimentally Infected Root Canals: An in vitro Study
Anoop Samuel, Premila Suganthan, R Jonathan, Joan Mathew, Bejoy John
Citation Information :
Samuel A, Suganthan P, Jonathan R, Mathew J, John B. Comparative Evaluation of the Antibacterial Efficacy of Four Different Disinfection Techniques in Minimally Instrumented Experimentally Infected Root Canals: An in vitro Study. Int J Laser Dent 2013; 3 (2):49-54.
Aim: This study was set out to evaluate the antibacterial efficacy of four disinfection techniques namely needle irrigation, diode laser, Photon-induced Photoacoustic Streaming (PIPS) with Er,Cr:YSGG and EndoActivator in minimally instrumented, experimentally infected root canals.
Materials and methods: Eighty single-rooted teeth were selected, prepared to an apical size # 20, taper 0.7; the specimens were sterilized and were inoculated with Enterococcus faecalis for 2 weeks. Disinfection was performed with needle irrigation, 940 nm diode laser, PIPS with 2,740 nm Er,Cr:YSGG laser. After disinfection, aerobic sampling was performed and bacterial counts (colony-forming units) and the incidence of positive samples after 24 hours and 7 days were determined.
Results: After the two time periods, all four disinfection protocols reduced the bacterial load when compared to the pretreatment load. None of the techniques predictably generated negative samples, but diode laser and PIPS with Er,Cr:YSGG was superior, when compared to needle irrigation and EndoActivator in this aspect. No statistically significant difference was found between needle irrigation and EndoActivator.
Conclusion: Diode laser disinfection demonstrated significant elimination of E. faecalis in minimally instrumented canals. PIPS with Er,Cr:YSGG and EndoActivator reduced the bacterial load when compared with needle irrigation.
Meire MA, Coenye T, Nelis HJ, De Moor RJ. Evaluation of Nd:YAG and Er:YAG irradiation, antibacterial photodynamic therapy and sodium hypochlorite treatment on Enterococcus faecalis. Int Endod J 2012 May;45(5):481-491.
Pasqualini D, Cuffini AM, Scotti N, Mandras N, Scalas D, Pera F, Berutti E. Comparative evaluation of the antimicrobial efficacy of a 5% sodium hypochlorite subsonic activated solution. J Endod 2010 Aug;36(8):1358-1360.
Preethee T, Kandaswamy D, Arathi G, Hannah R. Bactericidal effect of the 908 nm diode laser on Enterococcus faecalis in infected canals. J Conserv Dent 2012 Jan;15(1):46-50.
Pedullà E, Genovese C, Campagna E, Tempera G, Rapisarda E. Decontamination efficacy of photon initiated photoacoustic streaming (PIPS) of irrigants using low-energy laser settings: an ex vivo study. Int Endod J 2012 Sep;45(9):865-870.
Saini HR, Tewari S, Sangwan P, Duhan J, Gupta A. Effect of different apical preparation sizes on outcome of primary endodontic treatment: a randomized control trial. J Endod 2012 Oct;38(10):1309-1315.
Khademi A, Yazdizadeh M, Feizianfard M. Determination of minimum instrumentation size for penetration of irrigants to the apical third of root canal systems. J Endod 2006 May;32(5):417- 420.
Ramachandran Nair PN. Light and electron microscopic studies of root canal flora and periapical lesions. J Endod 1987 Jan;13(1):29-39.
Chandra, Suresh B.; Krishna, Gopi V. Grossman's endodontic practice. 12th ed. 2010, Wolters Kluwer (India) Pvt. Ltd., New Delhi.
Clark D, Khademi J. Modern molar endodontic access and directed dentin conservation. Dent Clin North Am 2010 Apr;54(2):249-273.
Peters OA, Bardsley S, Fong J, Pandher G, Divito E. Disinfection of root canals with photon initiated photoacoustic streaming. J Endod 2011 Jul;37(7):1008-1012.
Pirnat S, Lukac M, Ihan A. Study of the direct bactericidal effect of Nd:YAG and diode laser parameters on pigmented and nonpigmented bacteria. Lasers Med Sci 2011 Nov;26(6): 755-761.
Dewsnup N, Pileggi R, Haddix J, Nair U, Walker C, Varella CH. Comparison of bacterial reduction in straight and curved canals using erbium,chromium:yttrium-scandium-galliumgarnet laser treatment versus a traditional irrigation technique with sodium hypochlorite. J Endod 2010 Apr;36(4):725-728.
Walmsley AD, Lumley PJ, Laird WR. Oscillatory pattern of sonically powered endodontic files. Int Endod J 1989 May;22(3):125-132.
Giovani O, DiVito E. Photoacoustic endodontics using PIPS: experimental background and clinical protocol. J Laser Health Acad 2012 May;1:22-25.
Moritz A, Beer F, Goharkhay K, Schoop U. Laser supported root canal sterilization. Oral laser application. 1st ed. Chicago, IL: Quintessence; 2006. p 254-277.
Siquera JF Jr, Rocas IN, Alves FR, Santos KR. Selected endodontic pathogens in the in the apical third of infected root canals: a molecular investigation. J Endod 2004 Sep;30(9): 638-643.
Park DS, Lee HJ, Yoo HM, Oh TS. Effect of Nd:YAG laser irradiation on the apical leakage of obturated root canals: an electrochemical study. Int Endod J 2001 Jun;34(4):318-321.
Koba K, Kimura Y, Matsumoto K, Watanabe H, Shinoki T, Kojy R, Ito M. Post-operative symptoms and healing after endodontic treatment of infected teeth using pulsed Nd:YAG laser. Endod Dent Traumatol 1999 Apr;15(2):68-72.
Moritz A, Jakolitsch S, Goharkhay K, Schoop U, Kluger W, Mallinger R, et al. Morphologic changes correlating to different sensitivities of Escherichia coli and Enterococcus faecalis to Nd:YAG laser irradiation through dentin. Lasers Surg Med 2000;26(3):250-261.
Gaspirc B, Skaleric U. Morphology, chemical structure and diffusion processes of root surface after Er:YAG and Nd:YAG laser irradiation. J Clin Periodontol 2001 Jun;28(6):508-516.
Viduciæ D, Jukiæ S, Karloviæ Z, Boziæ Z, Miletiæ I, Aniæ I. Removal of gutta-percha from root canals using an Nd:YAG laser. Int Endod J 2003 Oct;36(10):670-673.
Aniƒ I, Tachibana H, Masumoto K, Qi P. Permeability, morphologic and temperature changes of canal dentine walls induced by Nd:YAG, CO2 and argon lasers. Int Endod J 1996 Jan;29(1):13-22.
Kivanç BH, Ulusoy OI, Görgül G. Effects of Er:YAG laser and Nd:YAG laser treatment on the root canal dentin of human teeth: a SEM study. Lasers Med Sci 2008 Jul;23(3):247-252.
Hulsmann M, Rummelin C, Schafers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: a comparative SEM investigation. J Endod 1997 May;23(5):301-306.
Adigüzel O, Yiðit-Özer S, Kaya S, Uysal Ý, Ganidaðli-Ayaz S, Akkuþ Z. Effectiveness of ethylenediaminetetraacetic acid (EDTA) and MTAD on debris and smear layer removal using a self-adjusting file. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011 Dec;112:803-808.
Gurbuz T, Ozdemir Y, Kara N, Zehir C, Kurudirek M. Evaluation of root canal dentin after Nd:YAG laser irradiation and treatment with five different irrigation solutions: a preliminary study. J Endod 2008 Mar;34(3):318-321.
Piccolomini R, D’Arcangelo C, D’Ercole S, Catamo G, Schiaffino G, De Fazio P. Bacteriologic evaluation of the effect of Nd:YAG laser irradiation in experimental infected root canals. J Endod 2002 Apr;28(4):276-278.
Rahimi S, Shahi S, Gholizadeh S, Shakouie S, Rikhtegaran S, Soroush Barhaghi MH, et al. Bactericidal effects of Nd:YAG laser irradiation and sodium hypochlorite solution on Enterococcus faecalis biofilm. Photomed Laser Surg 2012 Nov;30(11):637-641.
Usman N, Baumgartner JC, Marshall JG. Influence of instrument size on root canal debridement. J Endod 2004 Feb;30(2): 110-112.
Teixeira FB, Gomes BP, Ferraz CC, Souza-Fiho FJ, Zaia AA. Radiographic analysis of the development of periapical lesions in normal rats, sialoadenectomized rats and sialoadenectomizedimmunosuppressed rats. Endod Dent Traumatol 2000 Aug;16(4):154-157.
Yamasaki M, Kumazawa M, Khosaka T, Hiroshi N, Kameyama Y. Pulpal and periapical tissue reactions after experimental pulpal exposures in rats. J Endod 1994 Jan;20(1):13-17.
Yu SM, Stashenko P. Identification of inflammatory cells in developing rat periapical lesions. J Endod 1987 Nov;13(11):535- 540.
Gerdes J, Lelle RJ, Pickartz H, Heidenreich W, Schwarting R, Kurtsiefer L, Stauch G, Stein H. Growth fraction in breast cancers determined in situ with monoclonal antibody Ki-67. J Clin Pathol 1986 Sep;39(9):977-980.
Gracia RL, Coltrera MC, Gown AM. Analysis of proliferative grade using anti-PCNA/cyclin monoclonal antibodies in fixed embedded tissue. Am J Pathol 1989 Apr;134(4):733-739.
Onuma H, Mastui C, Morohashi M. Quantitative analysis of the proliferation of epidermal cells using a human skin organ culture system and the effect of DbcAMP using markers of proliferation (BrdU, Ki-67, PCNA). Arch Dermatol Res 2001 Mar;293(3):133-138.
Chen SC, Marino V, Gronthos S, Bartold PM. Location of putative stem cells in human periodontal ligament. J Periodont Res 2006 Dec;41(6):547-553.
Lin N-H, Menicanin D, Mrozik K, Gronthos S, Bartold PM. Putative stem cells in regenerating human periodontium. J Periodont Res 2008 Oct;43(5):514-523.
Ohta S, Yamada S, Matsuzaka K, Inoue T. The behavior of stem cells and progenitor cells in the periodontal ligament during wound healing as observed using immunohistochemical methods. J Periodont Res 2008 Dec;43(6):595-603.
Miller RJ. Lasers in oral implantology. Dental Pract 2006 Sept/ Oct;112-14.
Xu Y, Young MJ, Battaglino RA, et al. Endodontic antimicrobial photodynamic therapy: Safety assessment in mammalian cell cultures. J Endod 2009;35:1567-72.
DeRosa MC, Crutchley RJ. Photosensitized singlet oxygen and its applications. Coordination Chemistry Reviews 2002;233- 234:351-71.
Garcez AS, Nunñez SC, Hamblim MR, Suzuki H and Ribeiro MS. Photodynamic therapy associated with conventional endodontic treatment in patients with antibiotic-resistant microflora: A preliminary report. J Endod 2010 Sep;36(9): 1463-69.
Brown SB, Brown EA, Walker I. The present and future role of photodynamic therapy in cancer treatment. Lancet Oncol 2004;5:497-508.
Huang Z. A review of the progress in clinical photodynamic therapy. Technol Cancer Res Treatment 2005;4:283-93.
Zanin ICJ, Maristela ML, Rodrigues LKA, Pimenta LAF, Hofling JF, Goncalves RB. Photosensitization of in vitro Biofilms by toluidine blue O combined with a light emitting diode. Eur J Oral Sci 2006;114; 64-69.
Overman PR. Biofilm: A new view of plaque. J Contemp Dent Pract 2000;1(3):18-29.
Shibli JA, Martins MC, Nociti FH Jr, Garcia VG, Marcantonio E Jr. Treatment of ligature-induced peri-implantitis by lethal photosensitization and guided bone regeneration: A preliminary histologic study in dogs. J Periodontol 2003 Mar;74(3):338-45.
Zitzmann NU, Berglundh T, Ericsson I, Lindhe J. Spontaneous progression of experimentally induced peri-implantitis. J Clin Periodontol 2004;31:845-49.
Rinke S, Ohl S, Ziebolz D, Lange K, Eickholz P. Rinke S, et al. Prevalence of peri-implant disease in partially edentulous patients: A practice-based cross-sectional study. Clin Oral Implants Res 2011;22:826-33.
Renvert S, Persson GR. Periodontitis as a potential risk factor for peri-implantitis. J Clin Periodontol 2009;36:10:9-14.
Cho-Yan Lee J, Mattheos N, Nixon KC, Ivanovski S. Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis. Clin Oral Implants Res 2012; 23:323-33.
Ferreira SD, Silva GL, Cortelli JR, Costa JE, Costa FO. Prevalence and risk variables for peri-implant disease in Brazilian subjects. J Clin Periodontol 2006;33:929-35.
Turkyilmaz I. One-year clinical outcome of dental implants placed in patients with type 2 diabetes mellitus: A case series. Implant Dent 2010;19:323-29.
Laine ML, Leonhardt A, Roos-Jansåker AM, Peña AS, van Winkelhoff AJ, Winkel EG, Renvert S. IL-1RN gene polymorphism is associated with peri-implantitis. Clin Oral Implants Res 2006;17:380-85.
Albrektsson T, Wennerberg A. Oral implant surfaces: Part 1— review focusing on topographic and chemical properties of different surfaces and in vivo responses to them. Int J Prosthodont 2004;17:536-43.
Wennerberg A, Albrektsson T. On implant surfaces: A review of current knowledge and opinions. Oral Maxillofac Implants 2010;25:63-74.
Teughels W, Van Assche N, Sliepen I, Quirynen M. Effect of material characteristics and/or surface topography on biofilm development. Clin Oral Implants Res 2006;17(Suppl 2):68-81.
Karoussis IK, Bragger U, Salvi GE, Burgin W, Lang NP. Effect of implant design on survival and success rates of titanium oral implants: A 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res 2004;15:8-17.
Renvert S, Polyzois I, Claffey N. How do implant surface characteristics influence peri-implant disease? J Clin Periodontol 2011;38(Suppl 11):214-22.
Lang NP, Tonetti M. Peri-implantitis: Etiology, pathogenesis, prevention and therapy, In: Dental implant complications etiology, prevention, and treatment: Forum SJ (Ed). Blackwell Publishing, West Sussex, United Kingdom 2010.
Esposito M, Grusovin MG, Maghaireh H, Coulthard P, Worthington HV. Interventions for replacing missing teeth: Management of soft-tissues for dental implants. Cochrane Database Syst Rev 2007;18.
Bouri A Jr, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. Int J Oral Maxillofac Implants 2008;23:323-26.
Miyata T, Kobayashi Y, Araki H, Ohto T, Shin K. The influence of controlled occlusal overload on peri-implant tissue. Part 3: A histologic study in monkeys. Int J Oral Maxillofac Implants 2000;15:425-31.
Baron M, Haas R, Baron W, Mailath-Pokorny G. Peri-implant bone loss as a function of tooth-implant distance. Int J Prosthodont 2005;18:427-33.
Dvorak G, Arnhart C, Heuberer S, Huber CD, Watzek G, Gruber R. Peri-implantitis and late implant failures in postmenopausal women: A cross-sectional study. J Clin Periodontol 2011;38: 950-55.
Shabestari GO, Shayesteh YS, Khojasteh A, Alikhasi M, Moslemi N, Aminian A, et al. Implant placement in patients with oral bisphosphonate therapy: A case series. Clin Implant Dent Relat Res 2010; 12:175-80.
Serino G, Turri A. Extent and location of bone loss at dental implants in patients with peri-implantitis. J Biomech 2011; 11:267-71.
Renvert S, Polyzois I, Maguire R. Reosseointegration on previously contaminated surfaces: A systematic review. Clin Oral Implants Res Sep 2009;20(Suppl 4):216-27.
Niemz MH. Laser-tissue interactions-fundamentals and applications. Auage, Springer Verlag, Berlin-New York, 2003;45-149.
Walsh LJ. The current status of laser applications in dentistry. Aust Dent J, 2003;48:146-55.
Welch AJ. The thermal response of laser irradiated tissue. IEEE J Quant Electron 1984;20:1471-81.
Gutknecht N, et al. Proceedings of the 1st International Workshop of Evidence Based Dentistry on Lasers in Dentistry. Quintessence Publishing Co. Ltd. 2007.
Ishii J, Fujita K, Komori T. Laser surgery as a treatment for oral leukoplakia. Oral Oncol 2003;39(8):759-69.
Katzir A. Lasers and optical fibers in medicine. Academic Press, Inc, San Diego-Boston 1993.
Nathan MI, Dumke WP, Burns G, Dill Jr FH, Lasher G. Stimulated emission of radiation from GaAs p-n junctions. Appl Phys Lett 1962;1(3):62-64.
Prahl SA. Optical absorption of hemoglobin. Oregon Medical Laser Center: http://omlc.ogi.edu/spectra/hemoglobin/ index.html
Strassl M, Kassenbacher A, Wintner E. Ultrashort laser pulses in dentistry. J Oral Laser Appl 2002;2(4):213-22.
Stabholz A, Zeltzser R, Sela M, Peretz B, Moshonov J, Ziskind D. The use of lasers in dentistry: Principles of operation and clinical applications. Compend 2003;24:811-24.
Kreisler M, Daublander M, Willershausen-Zonnchen B, d‘Hoedt B. Effect of diode laser irradiation on the survival rate of gingival fibroblast cell cultures. Laser Surg Med 2001a;28(5):445-50.
Rastegar S, Jacques SL, Motamedi M, Kim BM. Theoretical analysis of equivalency of high- power diode laser and Nd:YAG laser for coagulation. Lasers in Dentistry, SPIE 1646:150-60, 1992.
Theodoro LH, Haypek P, Bachmann L, Garcia VG, Sampaio JE, Zezell DM, Eduardo C de P. Effect of Er:YAG and diode laser irradiation on the root surface: Morphological and thermal analysis. J Periodontol 2003;74(6):838-43.
White JM, Gekelman D, Shin K, Park X, Swenson T, Rouse B, Tran K, Bullard S, Scott- Beckles B, Oto MJSB, Yamamoto A. Laser interaction with dental soft tissues: What do we know from our years of applied scientific research? Lasers in Dentistry, SPIE 2002;4610:39-48.
Adams TC, Pang PK. Lasers in Aesthetic Dentistry. Dent Clin North Am 2004;48:833-60.
Bach G, Neckel C, Mall C, Krekeler G. Conventional versus laser- assisted therapy of peri-implantitis: A five year comparative study. Implant Dent 2000;9:247-51.
Clayman L, Kuo PC. Soft tissue excision techniques. In Clayman L, Kuo P. Lasers in Maxillofacial Surgery and Dentistry. Thieme Publ, Stuttgart 1997;63-83.
Convissar RA, Diamond LB, Fazekas CD. Laser treatment of orthodontically induced gingival hyperplasia. Gen Dent 1996;44(1):47-51.
Goharkay K, Moritz A, Wilder-Smith P, Schoop U, Kluger W, Jakolitsch S, Sperr W. Effects on oral soft tissue produced by a diode laser in vitro. J Oral Surg 1978;36:932-37.
Olbricht SM, Stern RS, Tang SV, Noe JM, Arndt KA. Complications of cutaneous laser surgery: A survey. Arch Dermatol 1987;123(3):345-49.
Pinheiro AL, Limeira Jr FA, Gerbi MEM, Ramalho LMP. Effect of 830 nm laser light on the repair of bone defects grafted with inorganic bovine bone and decalciûed cortical osseous membrane. J Clin Laser Med Surg 2003;21(6):383-88.
Romanos GE. Atlas der chirurgischen Laserzahnheilkunde. Urban und Fischer Verlag, München 1999.
Romanos GE, Nentwig GH. Present and future of lasers in oral soft tissue surgery: Clinical applications. J Clin Laser Med Surg 1996;14(4):179-84.
Strauss RA. Laser management of discrete lesions. In : Laser applications in oral maxillofacial surgery. (Eds) Catone G A, Alling C C, Saunders, Philadelphia, 1997
White JM, Goodis HE, Horton J, Gold S. Current status of lasers in soft tissue dental surgery. J Periodontol 1994;65(7):733-35.
Yousuf A, Hossain M, Nakamura Y, Yamada Y, Kinoshita J, Matsumoto K. Removal of gingival melanin pigmentation with the semiconductor diode laser: A case report. J Clin Laser Med Surg 2000;18:263-66.
Zeinoun T, Nammour S, Dourov N, Aftimos G, Luomanen M. Myofibroblasts in healing laser excision wounds. Lasers Surg Med 2001;28:74-79.
Al-Watban FA, Zhang XY. The comparison of effects between pulsed and CW lasers on wound healing. J Clin Laser Med Surg 2004;22(1):15-18.
Gutknecht N, Gogswaardt D, Conrads G, Apel C, Schubert C, Lampert F. Diode laser radiation and its bactericidal effect in root canal wall dentin. J Clin Las Med Surg 2000;57:57-60.
Parkins F. Lasers in pediatric and adolescent dentistry. Dent Clin N Amer 2000;44:821-30.
Santaella MR, Braun A, Matson E, Frentzen M. Effect of diode laser and fluoride varnish on initial surface demineralisation of primary dentition enamel: An in vitro study. Int J Paed Dent 2004;14:199-203.
Tuner J, Hode L. The laser therapy handbook. Grängesberg 2004;231.
Gherlone EF, Maiorana C, Grassi RF, Ciancaglini R, Cattoni F. The use of 980 nm diode and 1064 nm Nd: YAG laser for gingival retraction in fixed prostheses. J Oral Laser Applications 2004;4:183-90.
Glauche CE, de Freitas PM, Vieira ND, Marques JL. Qualitative microanalysis of ions and ultrastructuralchanges in dentin exposed to laser irradiation. Lasers Surg Med 2005;36(4): 334-39.
Gutknecht N, Zimmermann R, Lampert F. Lasers in periodontology: State of the art. J Oral Laser Applications 2001a;1:169-79.
Kreisler M, Haj HA, d‘Hoedt B. Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planning. Lasers Surg Med 2005;37:350-55.
Mester E, Spiry T, Szende B, Tota JG. Effect of laser rays on wound healing. Am J Surg 1971;22:532-35.
Patruta S, Franz A, Beer F, Goharkhay K, Sperr W, Moritz A. In vitro stimulatory effect of diode laser on the secretion of tissue inhibitor of matrix mealloproteinases 1(TIMP-1) in human gingival fibroblast: A preliminary report. J Oral Laser Applications 2004;4(3):167-70.
Silveira LB, Silveira JB, Ribeiro MS, Garrocho AA, Novelli MD, Marigo H, Growth EB, et al. In vivo study on mast cells behavior following low intensity visible and near infrared laser radiation (abstract 304). Lasers Surg Med 2002;82.
Bach G, Koch HK, Hellerich U, Venzke T. Konventionelle Diodenlaser versus Hochpulstechnik. Laser Journal 1/2008:18-20.
Deppe H, Horch HH. Laseranwendungen in der chirurgischen Zahn-,Mund-und Kieferheilkunde. Laser Zahnheilkunde 2007;4:219-22.
Horch HH, Deppe H. Laser anwendungen im Mund-Kiefer- Gesichtsbereich. In Horch HH: Mund-Kiefer-Gesichtschirurgie. München: Elsevier 2007;797-820.
Roodenburg JL, Witjes MJ, deVeld DC; Tan IB, Nauta JM: Lasers in dentistry. Use of lasers in oral and maxillofacial surgery. Ned Tijdschr Tandheelkd 2002;109:470.
Maiorana C, Salina S. Oral soft tissue pathologies: Long-term evaluation after laser treatment. J Oral Laser Appl 2001;1:20.
Crippa R. Report on 103 cases of precancerous and other oral lesions treated with a diode laser. J Oral Laser Appl 2001;1:26.
Bach G. Er:YAG versus Diode-Zwei Wellenlängen made in Baden-Württemberg. Laser Zahnheilkunde 2007;4:283-87.
Andersen K. Laser technology- a surgical tool of the past, present and future. Aorn J 2003;78:794-802.
Eichler J, Schneeweiss-Wolter C. Wirkung von Laserstrahlung auf Gewebe. MTA 1999;14:255.
McKenzie AL. Physics of thermal processes in laser- tissue interaction. Phys Med Biol 1990;35:1175-209.
Sullins KE. Diode laser and endoscopic laser surgery. Vet Clin North Am Small Anim Pract 2002;32:639-648.
Svaasand LO, Boerslid T, Oeveraasen M. Thermal and optical properties of living tissue: Application to laser-induced hyperthermia. Lasers Surg Med 1985;5:589-602.
Welch AJ, Motamedi M, Rastegar S, LeCarpentier GL, Jansen D. Laser thermal ablation. Photochem. Photobiol 1991;53: 815-23.
Lippert BM, et al. Wound healing after laser treatment of oral and oropharyngeal cancer. Lasers Med Sci. 2003;18(1):36-42.
Grossenbacher R. Laser surgery in the oral cavity. J Clin Laser Med Surg 1992;10(1):19-21.
Guttenberg SA, Emery RW. Laser resurfacing and oral and maxillofacial surgeons. Dermatol. Surg 1999;25(6):519.
Coleton S. Laser treatment of atypical oral pigmentation. A case report. NY State Dent J 2006;72(2):22-23.
Damante CA, et al. Histomorphometric study of the healing of human oral mucosa after gingivoplasty and low-level laser therapy. Lasers Surg Med 2004;35(5):377-84.
Eichler J, Eichler HJ. Laser. Springer Verlag, Berlin- Heidelberg- New York 1991.
Manni J. Surgical diode lasers. J Clin Laser Med Surg 1992;10: 377-80.
Pick RM, Powel GL. Lasers in dentistry, soft tissue procedures. Dent Clin North Am 1993;37:281-97.
Scherer H, Fuhere A, Hopf J. Current status of laser surgery of benign diseases in the area of soft palate. Laryngol Rhinol Otol 1994;73:14-18.
Morita T, Okamura Y, Ookub K, et al. A new instrument for hemostatic vascular management in endoscopic surgery: Diode laser(STATLaser-SDL) and it‘s hand piece (Dual Hook). J Clin Laser Med Surg 1999;17:57-61.
Claus PN. Comparative study on CW mode versus pulsed mode in AlGaAs diode lasers. SPIE Proc 2001;4249:44-49.
Krause F, Frentzen M. Dioden- Laser in der zahnmedizinischen Anwendung. DGL Zeitschrift für Laserzahnheilkunde 2007;3/ 07:151-58.
Coluzzi DJ. Lasers and soft tissue curettage: An update. Compend Contin Educ Dent 2002;23:1104-111.
Schwarz F, Sculean A, Berakdar M, Szathmari L, Geoerg T, Becker J. In vivo and in vitro effects of an Er:YAG laser, a diode laser, and scaling and root-planning on periodontally diseased root surfaces: A comparative histologic study. Lasers Surg Med 2003;32:359-66.
Fontana CR, Kurachi C, Mendonca CR, Bagnato VS. Temperature variation at soft periodontal and rat bone tissue during a medium- power diode laser exposure. Photomed Lasres Surg 2004;22:519-22.
Borrajo JL, Varela LG, Castro LG, Rodriguez-Nunez I, Torreira MG: Diode laser (980 nm) as an adjunct to scaling and root planning. Photomed Laser Surg 2004;22:509-12.
Kreisler M, Al Haj H, Daublander M, Gotz H, Duschner H, Willershausen B, D‘Hoedt B. Effect of diode laser irradiation on root surface in vitro. J Clin Laser Med Surg 2002;20:63-69.
Meister J, Franzen R. Dentale Lasersysteme Teil II: Der Dioden- Laser. DGL Zeitschrift für Laserzahnheilkunde 2007;3/07: 185-89.
Alam T, Dawasaz AA, Thukral N, Jangam D. Surgical diode laser excision for peripheral cemento-ossifying fibroma: A case report and literature review. J Oral Laser Applications 2008;8:43- 49.
Convissar RA. An overview of laser wavelength used in dentistry. Dent Clin North Am 2000;44:753-765.
Kreisler M, Meier C, Stender E, Daubländer M, Willershausen- Zönnchen B, de Hoedt B. Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: An in vitro study. J Periodontol Oct 2001;72(10):1312-17.
Black P. Der Dentallaser in der oralen Chirurgie-Masterthese- Teil2 Laser Journal 1/2007: 16-21, 2007 146. Van Hillegersberg R: Fundamentals of Laser Surgery Eur J Surg Jan 1997;163(1): 3-12.
Haina D, Landthaler M, Braun-Falco O, Waidelich W. Comparison of the maximum coagulation depth in human skin for different types of medical lasers. Lasers Surg Med 1987;7(4): 355-62.
Sullins KE. Diode laser and endoscopic laser surgery. Vet Clin North Am Small Anim Pract May 2002;32(3):639-48.
McKenzie AL. Physics of thermal processes in laser-tissue interaction. Phys Med Biol Sep 1990;35(9):1175-209.
Reinisch L. Laser physics and tissue interaction. Otolaryngol Clin North Am Dec 1996;29(6):893-914.
Coluzzi DJ. Fundamentals of dental lasers: Science and instruments. Dent Clin North Am 2004;48:751-70.
Maiorana C, Salina S. Versatility of superpulsed diode laser in oral surgery: A clinical report. J Oral Laser Appl 2006;6: 193-99.
Kamp M Halbleiterlaser. Vorlesung WS 2006, Technische Physik, Uni Würzburg 2006.
Schäfer O. Die Entwicklung des Diodenlasers bis zur Digitalpulstechnik. Laser Journal 2/2008:6-7.
Nanami T, Shiba H, Ikeuchi S, Nagai T, Asanami S, Shibata T. Clinical applications and basic studies of laser in dentistry and oral surgery. Keio J Med Dec.1993;42(4):199-201.