Leon Vanweersch

Laser Supported Reduction of Specific Microorganisms in the Periodontal Pocket with the Aid of an Er,Cr:YSGG Laser: A Pilot Study

Objective. The aim of this study was to evaluate the effectiveness of a radial firing tip of an Er,Cr:YSGG laser as an adjunct to a nonsurgical periodontal treatment. Methods. Twelve patients with chronic or aggressive periodontitis were treated by conventional periodontal treatment using ultrasonic devices and hand instruments and, additionally, in two quadrants with an Er,Cr:YSGG laser. A new radial firing tip (RFPT 14-5, Biolase) was used with 1.5 W, 30 Hz, 11% air, 20% water, and pulse duration 140 μs. Microbiological smears were taken before treatment, one day after lasing, and three and six months after lasing. Pocket depths of all periodontal sites were measured before and six months after treatment. Results. The total bacterial load of Prevotella intermedia, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans inside the pocket was reduced significantly throughout the whole examination time. Greater pocket depth reductions were observed in all groups. There was a slight higher reduction of pocket depth in the lased group after six months. Conclusions. These results support the thesis that Er,Cr:YSGG laser supported periodontal treatment leads to a significant reduction of periopathogenes and thereby helps the maintenance of periodontal health.

Evaluation of Temperature Elevation During Root Canal Treatment with Dual Wavelength Laser: 2780 nm Er,Cr:YSGG and 940 nm Diode

OBJECTIVE The purpose of this study was to evaluate the effects of dual wavelength (2780 nm Er,Cr:YSGG and 940 nm diode) laser with radial firing tip (RFT) on the external root surface and sub-surfaces, in terms of temperature changes during laser-assisted root canal treatment. BACKGROUND DATA A significant factor that may limit the use of lasers in endodontics is the possible thermal injury to tooth supporting structures. MATERIALS AND METHODS A total of 50 sound single-rooted extracted teeth were divided randomly into two groups (n = 25). Group A, irradiated with Er,Cr:YSGG laser at 1.06 W, 50 Hz, and 50 μs was a control group, and group B was irradiated with dual wavelength of Er,Cr:YSGG laser with the same settings as group A and a diode laser of 0.51 W at 4 ms and 10 ms pulse duration. K-type thermocouples were used to record temperature changes at the cervical, middle, and apical root thirds, on root surfaces and sub-surfaces, arising from delivery of laser energy through RFT. RESULTS Temperature elevation in group B was significantly higher in the middle and apical thirds of the prepared samples than in group A (p < 0.0001). Group B presented a mean temperature elevation of 5.07°C on the apical surface region corresponding to a 1.48 mm dentin thickness, whereas a mean temperature increase of 7.72°C was recorded corresponding to dentin thickness of 0.95 mm. CONCLUSIONS Within the studied parameters, the dual wavelength laser did not result in adverse thermal changes on the external root surface in vitro.

Intrapulpal temperature changes during root surface irradiation with dual-wavelength laser (2780 and 940 nm): in vitro study

Abstract. The present study evaluated the intrapulpal thermal changes that occurred during the treatment of the root surfaces with a laser system emitting Er,Cr:YSGG 2780- and 940-nm diode laser irradiation in an alternating sequence. Thirty single-rooted human teeth were collected. The teeth were divided into three groups (n=10 each) and irradiated with Er,Cr:YSGG alone or combined with a 940-nm diode laser. To investigate the intrapulpal temperature changes, specimens were embedded in a resin block with a set of thermocouples introduced at different positions within the root canals. The first group was irradiated with only Er,Cr:YSGG (25 mJ, 50 Hz, 50  μs pulse duration, water and air spray); the second group was irradiated with Er,Cr:YSGG (same setting) and a 940-nm diode (2 W, chopped mode with 20% duty cycle); the third group was irradiated with Er,Cr:YSGG (same setting) and a diode (2 W, chopped mode with 50% duty cycle). During all irradiations, thermal changes were recorded in real time with thermocouples. While group 3 showed thermal rises on average of 1.68±0.98°C in the pulp chamber, groups 1 and 2 showed average temperature rises of <0.5°C. The combined laser emission of 2780 and 940 nm is a promising way for root surface debridement without inducing intrapulpal thermal damage when using an appropriate water/air spray. All measured temperatures were considerably below the critical value of 5.6°C.