Pablo Betancourt; Josep Arnabat-Domínguez & Miguel Viñas
Summary
The goal of endodontics is to prevent or cure apical periodontitis. Therefore, microorganisms that have colonized the root canal system must be eliminated to promote regeneration and healing. Unfortunately, the existence of accessory canals, anastomoses, isthmus, as well as apical ramifications, form a complex three-dimensional network inside the root, which makes difficult the total elimination of bacteria and detritus. Conventional endodontic therapy has several limitations. Endodontic instruments have been shown to leave 35 % or more of the dentin surface untreated. On the other hand, the inability of generating a turbulent flow, prevents the irrigant from reaching areas that are difficult to access. This facilitates the persistence of bacterial biofilms and the survival of a significant number of viable bacteria. Laser-activated Irrigation (LAI) has been proposed as a co-adjuvant to chemo-mechanical therapy to improve cleaning and disinfection. Er, Cr: YSGG (2780nm) and Er: YAG (2940nm) lasers are the most widely used. These two wavelengths are capable of being widely absorbed by different irrigating solutions, taking into account safe use and respecting accepted clinical parameters.The deep absorption of laser energy generates steam bubbles inside the fluid, which release shear forces when imploding. This phenomenon, called cavitation, is responsible for greater cleaning and disinfection within the root canal system, even in areas difficult to access. Several studies have demonstrated the antibacterial effectiveness of LAI through microbiological methods and microscopic techniques. Recently, it has been reported that LAI would have the ability to increase the antibacterial capacity of low concentration of sodium hypochlorite (a good disinfectant but extremely toxic), which would allow working with concentrations that are safer for the patient.
KEY WORDS: laser, irrigation, endodontics, sodium hypochlorite, cavitation.
How to cite this article
BETANCOURT, P.; ARNABAT-DOMÍNGUEZ, J. & VIÑAS, M. Laser activated irrigation in endodontics. Int. J. Odontostomat., 15(3):773-781, 2021.