Removal Efficiency of Calcium Hydroxide Intracanal Medicament with Er:YAG Laser: A Scanning Electron Microscopic Study
Ourania Pantelidou, Antonis Kallis
Citation Information :
Pantelidou O, Kallis A. Removal Efficiency of Calcium Hydroxide Intracanal Medicament with Er:YAG Laser: A Scanning Electron Microscopic Study. Int J Laser Dent 2016; 6 (1):24-30.
This ex vivo study compared the efficiency of Er:YAG laser to remove calcium hydroxide from root canal walls, especially from the apical third, with manual and ultrasonic irrigation technique by using a scanning electron microscopic (SEM).
Materials and methods
Sixty-four single-rooted teeth were divided into 3 groups of 20 teeth each. The rest 4 teeth were used as control groups (2 positive and 2 negative control group). After coronal access, all teeth were instrumented by Protaper Next rotary files (Dentsply-Maillefer, Ballaigues, Switzerland) up to size F3, followed an irrigation protocol and filled with pure calcium hydroxide powder mixed with saline. Teeth were stored in an incubator for 7 days and then calcium hydroxide was removed using 3 techniques: Manually (group I), by ultrasonic irrigation (group II), by laser Er:YAG and x-pulse tip (group III). The teeth of control groups were instrumented as the experimental groups; no removal technique was applied in positive group, whereas in negative one, the root canals were left empty. Teeth were sectioned longitudinally and observed under SEM. Results were statistically analyzed with the Kruskal–Wallis test and Mann–Whitney test.
The results showed significant difference between laser and the other two groups in coronal and middle root third, but no statistic difference in apical third.
Laser improved the removal of calcium hydroxide in comparison with conventional techniques.
How to cite this article
Kourti E, Pantelidou O, Kallis A. Removal Efficiency of Calcium Hydroxide Intracanal Medicament with Er:YAG Laser: A Scanning Electron Microscopic Study. Int J Laser Dent 2016;6(1):24-30.
Investigation of pH at different dentinal sites after placement of calcium hydroxide dressing by two methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005 Apr;99(4):511-516.
Removal efficiency of calcium hydroxide intracanal medicament with two calcium chelators: volumetric analysis using spiral CT, an in vitro study. J Endod 2006 Nov;32(11):1097-1101.
Role of Calcium Hydroxide in Endodontics: a review. Global Journal of Medicine and Public Health 2012 Jan-Feb;1(1):66-70.
Effect of four vehicles on the pH of calcium hydroxide and the release of calcium ion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995 Oct;80:459-64.
Vehicle influence on calcium hydroxide pastes diffusion in human and bovine teeth. Dental Traumatol 2006 Dec;22(6):302-306.
Effect of medications for root canal treatment on bonding to root canal dentin. J Endod 2004 Feb;30(2):113-116.
Interaction of calcium hydroxide with zinc oxide-eugenol type sealers: a potential clinical problem. J Endod 1997 Jan;23(1):43-48.
Influence of calcium hydroxide intracanal medication on apical seal. Int Endod J 2002 Jul;35(7):623-628.
The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J 2007 Jan;40(1):52-57.
Dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide. J Endod 1999 Jun;25(6):431-433.
Pathways of the Pulp, 8th edn. St Louwas, MO, USA: Mosby Inc., 2002, p. 548.
Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005 Feb;99(2):231-252.
Necrotic pulp tissue dissolution by passive ultrasonic irrigation in simulated accessory canals: impact of canal location and angulation. Int Endod J 2009 Jan;42(1):59-65.
Review of contemporary irrigant agitation techniques and devices. J Endod 2009 Jun;35(6):791-804.
Lasers in endodontics. Dent Clin North Am 2000 Oct;44(4):889-906.
Comparative safety of various intracanal irrigation systems. J Endod 2009 Apr;35(4):545-549.
Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 1: a visualization study. Lasers Surg Med 2009 Sep;41(7):514-519
Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J 2009 Dec;42(12):1077-1083.
Effectiveness of the erbium:YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation. Lasers Med Sci 2012 Mar;27(2):273-280.
Long-term clinical evaluation of endodontically treated teeth byNd:YAG lasers. J Clin Laser Med Surg 1996 Feb;14(1):7-11
Effect of Er:YAG laser treatment on the root canal walls of human teeth: an SEM study. Endod Dent Traumatol 1998; 14(6):270-273.
A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971 Aug;32(2):271-275.
The effectiveness of increased apical enlargement in reducing intracanal bacteria. J Endod 2002 Nov;28(11):779-783.
One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study. J Endod 2012 Aug;38(8):1040-1052.
In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod 2005 Mar;31(3):166-170.
High-Power Lasers in Endodontics – Fiber Placement for Laser-Enhanced Endodontics: in the Canal or at the Orifice? J Laser Health Academy. 2014;(1):20-28.
Potential of an Er:YAG laser in the removal of calcium hydroxide from root canals. Photomed Laser Surg 2012 May;30(5):250-254.
Evaluation of effectiveness of various irrigating solutions on removal of calcium hydroxide mixed with 2% chlorhexidine gel and detection of orange-brown precipitate after removal. J Endod 2014 Nov;40(11):1820-1823.
Influence of lasing parameters on the cleaning efficacy of laser-activated irrigation with pulsed erbium lasers. Lasers Med Sci 2016 May;31(4):653-658.
Apical extrusion of root canal irrigants when using Er:YAG and Er, Cr:YSGG lasers with optical fibers: an in vitro dye study. J Endod 2008 Jun;34(6):706-708.
Removal efficiency of calcium hydroxide dressing from the root canal. J Endod 1999 Feb;25(2):85-88.
Removal efficacy of various calcium hydroxide/Chlorhexidine medicaments from the root canal. Int Endod J 2006 Jan;39(1):55-61.
Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals. Int Endod J 2011 Jun;44(6):505-509.
Effectiveness of four different techniques in removing intracanal medicament from the root canals: An in vitro study Contemp Clin Dent 2015 Jul-Sep;6(3):309-312.
Quantitative comparison of calcium hydroxide removal by endoactivator, ultrasonic and protaper file agitation techniques: an in vitro study. J Huazhong Univ Sci Technolog Med Sci 2013 Feb;33(1):142-145.
A comparison of different irrigation/agitation methods for the removal of calcium hydroxide medicament from the root canal walls. J Res Dent 2015;3(2):44-48.