Korkut Emre, Torlak Emrah, Gezgin Onur, Özer Hazal, Şener Yağmur
1 Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University , Konya, Turkey .
2 Department of Molecular Biology and Genetics, Faculty of Science, Necmettin Erbakan University , Konya, Turkey .
Photomed Laser Surg. 2018 Sep;36(9):480-486. doi: 10.1089/pho.2017.4369. Epub 2018 Jun 15.
The objective of this study was to compare antibacterial and smear layer removal efficacy of the erbium:yttrium-aluminium-garnet (Er:YAG) laser irradiation by photon-induced photoacoustic streaming (PIPS), neodymium:yttrium-aluminium-garnet (Nd:YAG), and diode lasers and conventional irrigation agent in primary molar root canals.
The selection, application, and activation of the irrigant are important factors affecting the success of the endodontic treatment.
Distal root canals of human primary mandibular molar teeth used for antimicrobial efficacy evaluation were first inoculated with Enterococcus faecalis (n = 25). Smear layer removal efficacy was evaluated on the noninoculated specimens (n = 20). The root canals in the first treatment groups were irrigated with a conventional technique using 5% sodium hypochlorite (NaOCl). In the laser groups, the root canals were irradiated with either Nd:YAG (1064 nm) or diode lasers (940 nm) followed by NaOCl irrigation agent. In the fourth groups, the NaOCl irrigation agent was activated with an Er:YAG laser (2940 nm) by PIPS tip using nonablative settings. Antibacterial efficacy was determined by viable counts of E. faecalis after treatments. The treated root canals were examined by scanning electron microscopy to determine the smear layer removal efficacy of treatments.
Statistically significant (p < 0.05) reductions in the number of E. faecalis were achieved in Nd:YAG and diode laser groups and Er:YAG laser by PIPS-activated irrigation groups compared to the NaOCl group. Er:YAG laser by PIPS-activated irrigation resulted in more cleaning of the root canal walls and a higher quantity of open tubules.
These findings suggest that Er:YAG laser by PIPS-activated irrigation can be considered as an effective irrigant agitation technique in pediatric endodontics.
本研究的目的是比较铒：钇铝石榴石（Er：YAG）激光通过光子诱导光声流（PIPS）、钕：钇铝石榴石（Nd：YAG）、二极管激光以及传统冲洗剂对乳磨牙根管的抗菌和去除玷污层的效果。
冲洗剂的选择、应用和激活是影响根管治疗成功的重要因素。
用于抗菌效果评估的人类下颌乳磨牙远中根管首先接种粪肠球菌（n = 25）。在未接种的标本（n = 20）上评估玷污层去除效果。第一治疗组的根管采用传统技术用5%次氯酸钠（NaOCl）冲洗。在激光组中，根管先用Nd：YAG（1064 nm）或二极管激光（940 nm）照射，然后用NaOCl冲洗剂冲洗。在第四组中，NaOCl冲洗剂通过PIPS尖端用非消融设置的Er：YAG激光（2940 nm）激活。治疗后通过粪肠球菌活菌计数确定抗菌效果。通过扫描电子显微镜检查处理后的根管，以确定治疗的玷污层去除效果。
与NaOCl组相比，Nd：YAG组、二极管激光组以及PIPS激活冲洗的Er：YAG激光组粪肠球菌数量有统计学意义的显著减少（p < 0.05）。PIPS激活冲洗的Er：YAG激光使根管壁清洁更彻底，开放的小管数量更多。
这些发现表明，PIPS激活冲洗的Er：YAG激光可被视为儿童牙髓病学中一种有效的冲洗剂搅拌技术。
