Healing of Apical Periodontitis after Minimally Invasive Endodontics therapy using Er,Cr:YSGG laser: A Prospective Clinical Study

Abstract

Ali A. Shaheed, Hussien A. Jawad, Basima M.A. Hussain, Ahmed M. Said

The aim of the present study was to clarify the healing percentages for a 6-months duration after clinical endodontic treatment, in cases treated by Er,Cr:YSGG laser (Waterlase MD; Biolase Technology, Inc, San Clement, CA) and filled by two obturation techniques.
The study group were composed of 40 patients, who were referred for endodontic treatment and diagnosed having apical periodontitis they received well-performed minmaly invasive nonsurgical root canal treatment with ProTaper Next instruments (Dentsply Maillefer, Ballagues, Switzerland) and copiously irrigation with 2 mL 5% NaOCl . After instrumentation, laser irradiation was performed for smear layer removal with Er,Cr:YSGG laser 2,780 nm wavelength with a redial firing tips RFT2 and RFT3 [diameter 200 μm for apical and middle third and 320 μm for coronal third respectivly]. After laser irradiation, a final irrigation was done with 5ml of Saline solution. Then, dissinfection for the root canal was done with the same laser device. The subjects were divided into 2 groups; the first one was obturated with carrier-based technique(GuttaCore, Dentsply Maillefer, Ballagues, Switzerland) and the other with cold lateral compaction technique , AH Plus sealer (Dentsply Tulsa Dental Specialties, Tulsa, OK)was used in both groups.
Healing of the different apical periodontitis cases was evaluated clinically and radiographically employing Periapical index (PAI) scoring. According to this evaluation, three conditions could be distinguished : healed, healing, or diseased. Successed cases includes healed or healing conditions which accompanied the success of root canal treatment. Statistical analysis was done by using independent t-test, Univariate (ONE WAY ANOVA) test, and Pearson coefficient.Differences between variables were setting as significant at 5% (P≤0.05) and highly significant at 1% (P≤0.01).
The prognosis of healing rates was compared temporally. Forty patients were folowed up at three recall periods at 1-month, 3-month, and 6-month after treatment. The success of root canal treatment for these periods was 67.5%, 82.5%, and 97.5%, respectively.
In conclusion, the teeth of different apical diagnosis can be treated with the Er,Cr:YSGG laser.It showed a tremendous degree of success of root canal treatment in aperiod of 6 months after treatment. The Er,Cr:YSGG laser permit for rapid rate of healing with a predictable outcome.