Bactericidal efficacy of Er,Cr:YSGG laser irradiation against Enterococcus faecalis compared with NaOCl irrigation: an ex vivo pilot study.

AIM To compare the efficacy of a standard NaOCl irrigation procedure with that of Er,Cr:YSGG laser irradiation in contaminated root canals having small and large apical foramina. METHODOLOGY Forty root canals of extracted central incisor teeth with straight roots were chosen so that their apical foramina just permitted the tip of a size 20-K file to pass through. The canals were then enlarged with files to size 60 and randomly divided into four groups of 10 teeth each. The apical foramina of one group were widened further so that the tip of a size 45-K file could just pass through. After sterilization, all roots were inoculated with Enterococcus faecalis for 48 h at 37 degrees C. The first group was used as a control, the second group was irrigated with 3% NaOCl solution for 15 min, and the last two groups having different sizes of apical foramina were irradiated with the Er,Cr:YSGG laser at output power from 0.5 W, with 20% air and water levels. The disinfecting efficacy of the groups was tested by collecting dentine chips from the inner canal walls of the specimens and counting viable E. faecalis on Mueller-Hinton agar plates. RESULTS The differences in the mean number of viable colonies between the control and laser groups were statistically significant (P < 0.05). The control specimens had the highest number of microorganisms (153 x 10(3) +/- 39 x 10(3)). Complete sterilization was achieved in the 3% NaOCl group. The mean colony forming units (CFU) values obtained after Er,Cr:YSGG laser irradiation were 6.6 x 10(3) CFU and 6.5 x 10(3) CFU in root canals having large and small apical foramina respectively. CONCLUSION In teeth with straight roots the Er,Cr:YSGG laser reduced the viable microbial population in root canals with small and large apical foramina but did not eradicate all bacteria. Three percent NaOCl inhibited the growth of E. faecalis and effectively sterilized all root canals.

[1]  N. Gutknecht,et al.  Antibacterial effects of Nd:YAG laser irradiation within root canal dentin. , 1997, Journal of clinical laser medicine & surgery.

[2]  Mitsunobu Miyagi,et al.  Endodontic treatment with application of Er:YAG laser waveguide radiation disinfection. , 2002, Journal of clinical laser medicine & surgery.

[3]  A. Moritz,et al.  Bactericidal effect of the Nd:YAG laser in in vitro root canals. , 1996, Journal of clinical laser medicine & surgery.

[4]  A. Moritz,et al.  The bactericidal effect of Nd:YAG, Ho:YAG, and Er:YAG laser irradiation in the root canal: an in vitro comparison. , 1999, Journal of clinical laser medicine & surgery.

[5]  Andreas Moritz,et al.  Bactericidal effect of different laser systems in the deep layers of dentin , 2004, Lasers in surgery and medicine.

[6]  J. Figueiredo,et al.  Internal apical resorption and its correlation with the type of apical lesion. , 2004, International endodontic journal.

[7]  K. Matsumoto,et al.  Effects of erbium,chromium:YSGG laser irradiation on root canal walls: a scanning electron microscopic and thermographic study. , 2001, Journal of endodontics.

[8]  A. Moritz,et al.  Morphologic changes correlating to different sensitivities of Escherichia coli and Enterococcus faecalis to Nd:YAG laser irradiation through dentin , 2000, Lasers in surgery and medicine.

[9]  M. Abadie,et al.  An evaluation of the bactericidal effect of the Nd:YAP laser. , 1997, Journal of endodontics.

[10]  J. T. ten Bosch,et al.  Propagation of light through human dental enamel and dentine. , 1995, Caries research.

[11]  M Torabinejad,et al.  Effects of the XeCl excimer laser on Streptococcus mutans. , 1993, Journal of endodontics.

[12]  C. Estrela,et al.  Antimicrobial evaluation of calcium hydroxide in infected dentinal tubules. , 1999, Journal of endodontics.

[13]  G. Levy,et al.  Cleaning and shaping the root canal with a Nd:YAG laser beam: a comparative study. , 1992, Journal of endodontics.

[14]  R. White,et al.  A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants. , 1994, Journal of endodontics.

[15]  J. Siqueira,et al.  Intracanal medicaments: evaluation of the antibacterial effects of chlorhexidine, metronidazole, and calcium hydroxide associated with three vehicles. , 1997, Journal of endodontics.

[16]  N. Gutknecht,et al.  Diode laser radiation and its bactericidal effect in root canal wall dentin. , 2000, Journal of clinical laser medicine & surgery.

[17]  F. Prountzos,et al.  A method of adapting gutta-percha master cones for obturation of open apex cases using heat. , 1999, International endodontic journal.

[18]  K L Zakariasen,et al.  Bactericidal action of carbon dioxide laser radiation in experimental dental root canals. , 1986, Canadian journal of microbiology.

[19]  C. Reit,et al.  Microbiological status of root-filled teeth with apical periodontitis. , 1998, International endodontic journal.

[20]  L. Miserendino,et al.  Evaluation of the antibacterial effects of intracanal Nd:YAG laser irradiation. , 1994, Journal of endodontics.

[21]  O. Erganiş,et al.  An in vitro test model for investigation of disinfection of dentinal tubules infected with Enterococcus faecalis. , 1997, Brazilian dental journal.

[22]  S. Friedman,et al.  Antimicrobial substantivity of chlorhexidine-treated bovine root dentin. , 2000, Journal of endodontics.

[23]  N. Gutknecht,et al.  Bactericidal effect of a 980-nm diode laser in the root canal wall dentin of bovine teeth. , 2004, Journal of clinical laser medicine & surgery.

[24]  T. Strömberg,et al.  Thermal effects and antibacterial properties of energy levels required to sterilize stained root canals with an Nd:YAG laser. , 1997, Journal of endodontics.

[25]  Camillo D'Arcangelo,et al.  Bacteriologic evaluation of the effect of Nd:YAG laser irradiation in experimental infected root canals. , 2002, Journal of endodontics.

[26]  M. Midda,et al.  A laboratory investigation of the bactericidal effect of a NdYAG laser , 1994, British Dental Journal.

[27]  K L Zakariasen,et al.  Comparative bactericidai exposures for selected oral bacteria using carbon dioxide laser radiation , 1990, Lasers in surgery and medicine.

[28]  M. Anzai,et al.  Root canal system of the maxillary central incisor. , 1990, Journal of endodontics.

[29]  N. Gutknecht,et al.  The efficiency of root canal disinfection using a holmium:yttrium-aluminum-garnet laser in vitro. , 1997, Journal of clinical laser medicine & surgery.

[30]  A. Byström Evaluation of endodontic treatment of teeth with apical periodontitis , 1986 .

[31]  E. Berutti,et al.  Penetration ability of different irrigants into dentinal tubules. , 1997, Journal of endodontics.

[32]  G. Sundqvist,et al.  Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. , 1981, Scandinavian journal of dental research.

[33]  J Sulc,et al.  Er:YAG and alexandrite laser radiation propagation in root canal and its effect on bacteria. , 1999, Journal of clinical laser medicine & surgery.

[34]  R. Walton,et al.  Bacterial retention in canal walls in vitro: effect of smear layer. , 1994, Journal of endodontics.

[35]  A. Moritz,et al.  The Er:YAG laser in endodontics: Results of an in vitro study , 2002, Lasers in surgery and medicine.

[36]  Xiaogu Wang,et al.  Thermographical and morphological studies of Er,Cr:YSGG laser irradiation on root canal walls. , 2004, Photomedicine and laser surgery.

[37]  L. Fabricius,et al.  Influence of combinations of oral bacteria on periapical tissues of monkeys. , 1982, Scandinavian journal of dental research.

[38]  D. Ørstavik,et al.  Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. , 1990, Endodontics & dental traumatology.

[39]  H. Horch,et al.  Bactericidal action of 308 nm excimer-laser radiation: an in vitro investigation. , 1998, Journal of endodontics.

[40]  H. Steiman,et al.  Comparative evaluation of the antibacterial effects of intracanal Nd:YAG laser irradiation: an in vitro study. , 1995, Journal of endodontics.

[41]  Y. Haikel,et al.  Effectiveness of four methods for preparing root canals: a scanning electron microscopic evaluation. , 1988, Journal of endodontics.

[42]  D. Ørstavik,et al.  Inactivation of local root canal medicaments by dentine: an in vitro study. , 2000, International endodontic journal.

[43]  M. Bonnaure-Mallet,et al.  An evaluation of the CO2 laser for endodontic disinfection. , 1999, Journal of endodontics.

[44]  Albert Mehl,et al.  Bactericidal effects of 2.94 μm Er:YAG-laser radiation in dental root canals , 1999 .

[45]  R. Piccolomini,et al.  Microbiological study and scanning electron microscopic analysis of root canal wall dentin following pumped Diodium Nd:YAG laser irradiation. , 2004, The New Microbiologica.

[46]  J Moshonov,et al.  Nd:YAG laser irradiation in root canal disinfection. , 1995, Endodontics & dental traumatology.

[47]  D. Ørstavik,et al.  The susceptibility of starved, stationary phase, and growing cells of Enterococcus faecalis to endodontic medicaments. , 2005, Journal of endodontics.

[48]  I. Rotstein,et al.  Lasers in endodontics. , 2004, Dental clinics of North America.

[49]  R. Hickel,et al.  Antibacterial effects of pulsed Nd:YAG laser radiation at different energy settings in root canals. , 2002, Journal of endodontics.