Search Results (10)

Endodontic infections are characterized by complex polymicrobial communities residing within the intricate root canal system. Traditional chemomechanical methods frequently fail to achieve complete microbial eradication, especially in cases involving biofilm-forming and resistant species. This systematic review synthesizes current evidence on the molecular basis and antimicrobial efficacy of the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser in root canal disinfection, particularly against polymicrobial infections. A comprehensive literature search was conducted in the PubMed, Embase, Scopus, and Cochrane databases in accordance with PRISMA 2020 guidelines. Experimental and preclinical studies evaluating the bactericidal properties of Nd:YAG laser therapy were included. The Nd:YAG laser demonstrated significant reductions in total microbial load through photothermal effects, including denaturation of proteins, disruption of cell membranes, and degradation of mixed-species biofilms. Although complete sterilization was not consistently achieved, its ability to penetrate dentinal tubules and target microbial consortia offers substantial adjunctive value. Standardization of laser parameters and further clinical studies are needed to validate these findings and establish Nd:YAG laser use in routine endodontic disinfection protocols. Full article

Background and Objectives: Periapical healing and bone regeneration are key indicators of endodontic success. This study evaluated the effectiveness of laser-assisted disinfection compared to conventional chemical irrigation in promoting periapical healing across various bone densities (D1–D5), using cone-beam computed tomography (CBCT) over multiple follow-up intervals. Materials and Methods: A total of 120 patients with radiographically confirmed periapical lesions were enrolled and allocated into two groups: an experimental group (n = 60, chemical irrigation + Er,Cr:YSGG laser disinfection) and a control group (n = 60, chemical irrigation only). CBCT scans were obtained at 6 months, 1 year, 2 years, and 2.5 years post-treatment to assess lesion size and CBCT-PAI scores. Lesions were classified radiographically as either well-defined radiolucent lesions or undefined periapical radiolucencies. Paired t-tests and ANOVA were used for statistical comparisons. Results: The experimental group demonstrated significantly greater reductions in lesion size and improvements in CBCT-PAI scores at all time points. Healing was especially enhanced in low-density bone (D4–D5). Complete healing rates were higher in the laser group for well-defined radiolucent (89.5% vs. 68.4%) and undefined lesions (81.8% vs. 59.1%). Post hoc power analysis confirmed statistical reliability (Cohen’s d = 3.48; power > 0.99). Conclusions: Laser-assisted endodontic disinfection significantly accelerates periapical healing and promotes bone regeneration, particularly in low-density bone. CBCT imaging supports its clinical superiority over conventional irrigation methods. Full article

Background: The quest for minimally invasive disinfection in endodontics has led to using Erbium:Yttrium-Aluminum-Garnet (Er:YAG) lasers. Conventional approaches may leave bacterial reservoirs in complex canal anatomies. Er:YAG’s strong water absorption generates photoacoustic streaming, improving smear layer removal with lower thermal risk than other laser systems. Methods: This systematic review followed PRISMA 2020 guidelines. Database searches (PubMed/MEDLINE, Embase, Scopus, Cochrane Library) identified studies (2015–2025) on Er:YAG laser-assisted root canal disinfection. Fifteen articles met the inclusion criteria: antibacterial efficacy, biofilm disruption, or smear layer removal. Data on laser settings, irrigants, and outcomes were extracted. The risk of bias was assessed using a ten-item checklist, based on guidelines from the Cochrane Handbook for Systematic Reviews of Interventions. Results: All studies found Er:YAG laser activation significantly improved root canal disinfection over conventional or ultrasonic methods. Photon-induced photoacoustic streaming (PIPS) and shock wave–enhanced emission photoacoustic streaming (SWEEPS) yielded superior bacterial reduction, especially apically, and enabled lower sodium hypochlorite concentrations without sacrificing efficacy. Some research indicated reduced post-operative discomfort. However, protocols, laser parameters, and outcome measures varied, limiting direct comparisons and emphasizing the need for more standardized, long-term clinical trials. Conclusions: Er:YAG laser-assisted irrigation appears highly effective in biofilm disruption and smear layer removal, supporting deeper irrigant penetration. While findings are promising, further standardized research is needed to solidify guidelines and confirm Er:YAG lasers’ long-term clinical benefits. Full article

Objective: Esthetic dentistry is an important factor in increasing patients’ quality of life. This study aimed to investigate the impact of laser use on bleaching procedures for natural teeth and dental restorative materials. Methods: In January 2024, an electronic search was conducted using PubMed, Web of Science (WoS), and Scopus databases with the keywords (tooth) AND (laser) AND (bleaching), following PRISMA guidelines and the PICO framework. The initial search yielded 852 articles, of which 441 were screened. After applying inclusion criteria, 376 articles were excluded as they did not focus on the use of lasers in bleaching natural teeth and restorative materials. Consequently, 40 articles were included in the final review. Results: Of the 40 qualified publications, 29 utilized a diode laser, of which 10 authors concluded that it increases the whitening effect comparing classical methods. Three of included publications investigated the whitening of dental materials, while another three focused on endodontically treated teeth. Whitening procedures on ceramics effectively removed discoloration, but the resulting color did not significantly differ from the initial shade. Conversely, composite materials not only failed to bleach but also exhibited altered physical properties, thereby increasing their susceptibility to further discoloration. The KTP laser demonstrated promising outcomes on specific stains. The Er,Cr:YSGG and Er:YAG lasers also showed beneficial effects, although there were variations in their efficacy and required activation times. Conclusions: The findings partially indicate that laser-assisted bleaching improves the whitening of natural teeth. Further research on the effect of laser bleaching on the physical parameters of restorative materials is necessary. Full article

Accumulated hard tissue debris (AHTD) is an inevitable by-product during endodontic treatment and is difficult to remove completely using traditional syringe and needle irrigation (SNI). Adjunctive irrigation is proposed to assist the clean-up of AHTD. This systematic review and meta-analysis aimed to evaluate the AHTD removal efficacy of different root canal irrigation devices using micro-computed tomography (Micro-CT). A literature search was carried out within the main scientific databases until 20 June 2022. All results were screened with detailed eligibility criteria. Eleven studies were included for analysis. SNI, passive ultrasonic irrigation (PUI), negative pressure systems, sonically activated irrigation (SAI), mechanical-activated system and laser-activated irrigation (LAI) were assessed. PUI is superior to SNI for debris removal and LAI has better AHTD removal performance than PUI. The negative pressure system and mechanical-activated system were proved to be less effective. Registration: PROSPERO (CRD42021273892). Full article

Revascularization has been incorporated into endodontic practice and become a viable treatment alternative for immature teeth with pulp necrosis. Thorough disinfection of the root canal is a key factor for successful revascularization. An erbium: yttrium–aluminium–garnet (Er: YAG) laser has been proved advantageous for efficient root canal disinfection. This article reports one case of periapical periodontitis caused by a fractured occlusal tubercle. Revascularization assisted by Er: YAG laser irrigation was carried out with long-term follow up. During the process of treatment, we opened drainage to relieve the acute symptoms first. The necrotic pulp was removed, and then the root canal was rinsed with 0.5% sodium hypochlorite (NaOCl) solution assisted by Er: YAG laser irrigation, dried, and filled with a triple-antibiotic paste. After two weeks, the intracanal medication was removed, and 9 mL of whole vein blood was taken from the patient to prepare concentrated growth factor (CGF) after failing to induce enough blood into the canal system by over-instrumenting. The newly prepared CGF was transferred into the root canal. A 3 mm mineral trioxide aggregate (MTA) was placed directly on the thrombus of the CGF and then restored with glass-ionomer cement (GIC). The case was followed up for more than four years to record the clinical symptoms and imaging manifestations. Er: YAG irrigation is an efficient root canal disinfection protocol with the advantages of easy operation and minimal risk, which might be applicable to the revascularization of necrotic immature permanent teeth. Full article

Background: Diode-assisted endodontics is nowadays utilized for pulp space disinfection, but little is known on the bonding potential of this lased root dentin when the tooth is restored with an intracanal polymer post. Objectives: to investigate the influence of diode laser irradiation settings, in laser-assisted endodontics, on the intraradicular bonding of composite materials. Methods: Sixteen two-rooted, maxillary first premolars were collected, prepared up to F4 (Protaper Universal. Dentsply-Maillefer, Ballaigues, Switzerland), and randomly assigned in two groups: group A (chopped mode or short pulse), diode irradiated according to protocol, pulse 25 ms, power 2.5 W, and group B (microchopped mode or ultrashort pulse), pulse 25 μs, peak power 12 W (both groups GentleRay. KaVo Dental, Biberach an der Riss, Germany). Buccal canals were irradiated, palatal ones served as controls. Canals were then obturated, post space was created in all canals, and quartz-fiber posts (ICE light Danville. Danville Materials, San Ramon, CA, USA) were cemented by self-etch self-curing cement (Max Cem Elite. Kerr, West Collins Orange, CA, USA) (Max Cem Elite. Kerr, Brea, CA, USA). A week later, teeth were sectioned horizontally in 1 mm increments. Push-out test was conducted in a Zwick testing machine (Zwick Roell, Ulm, Germany) at 1 mm/min speed, and the force required to dislodge the post from each specimen (F-max) was recorded. Weibull regression models were applied for statistical analyses. Results: Differences in F-max by group (control vs. chopped mode vs. microchopped mode) and height (meaning the apical-to-coronal position of each specimen along the root) were statistically significant (p < 0.05 in all cases). Conclusions: Short pulses (or chopped mode) had a profound positive effect on the quality of intraradicular bonding, while Ultrashort pulses (or microchopped mode) affected it negatively. In addition, apically positioned bonding proved weaker compared with more coronally located specimens. Full article

Incomplete and inadequate removal of endodontic biofilm during root canal treatment often leads to the clinical failure. Over the past decade, biofilm eradication techniques, such as sonication of irrigant solutions, ultrasonic and laser devices have been investigated in laboratory settings. This review aimed to give an overview of endodontic biofilm cultivation methods described in papers which investigated sonic-, ultrasonic- and Er:Yag laser-assisted biofilm removal techniques. Furthermore, the effectiveness of these removal techniques was discussed, as well as methods used for the evaluation of the cleaning efficacy. In general, laser assisted agitation, as well as ultrasonic and sonic activation of the irrigants provide a more efficient biofilm removal compared to conventional irrigation conducted by syringe/needle. The choice of irrigant is an important factor for reducing the bacterial contamination inside the root canal, with water and saline being the least effective. Due to heterogeneity in methods among the reviewed studies, it is difficult to compare sonic-, ultrasonic- and Er:Yag laser-assisted techniques among each other and give recommendations for the most efficient method in biofilm removal. Future studies should standardize the methodology regarding biofilm cultivation and cleaning methods, root canals with complex morphology should be introduced in research, with the aim of simulating the clinical scenario more closely. Full article

(1) Background: Adjunctive instruments, such as lasers have been investigated to address the risk of failure of endodontic therapy due to the complexity of the root canal system. Lasers have been used therapeutically, in direct irradiation of the root canals or adjunct to irrigants placed into the canals, in combination with a photosensitizer (antimicrobial photodynamic therapy) and in pain management (photobiomodulation). The purpose of this systematic review was to evaluate the evidence in clinical use within these three areas of therapy. (2) Methods: PubMed, Cochrane and Scopus search engines were used to identify human clinical trials regarding the use of lasers in endodontic therapy. (3) Results: After applying the keywords and additional filters, inclusion and exclusion criteria, the initial number of 1486 articles was reduced to 17. It was revealed that almost all studies (14/17) presented a statistically significant improved outcome in laser-assisted endodontic therapy, with the remaining three not showing any adverse effects. (4) Conclusions: The use of laser photonic energy of appropriate delivered parameters can be proposed as useful adjunctive when considering optimal treatment modalities in orthograde endodontics. Additionally, a tendency of research towards pain modulation in this field is developing. Full article

In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers. Ultrasonic agitation and more recently pulsed lasers have emerged as two promising methods for activating endodontic irrigation fluids. Ultrasonic agitation with piezoelectric devices employs a moving tip, while laser agitation uses a stationary tip. Both methods cause cavitation, followed by implosions and shear forces which assist with debridement. Fluid streaming further enhances the activity of the fluids. While agitation enhances performance of irrigants, extrusion of fluids from the root canal during activation is a hazard that must be controlled. Full article