Title |
Laser-Activated Irrigation is More Effective Than Traditional Irrigation at Removing Endodontal Bacterial Colonies |
Clinical Question |
Is laser-activated irrigation more effective at removing endodontal bacterial colonies than traditional irrigants? |
Clinical Bottom Line |
Laser-activated irrigation is more effective than traditional irrigation at removing endodontal bacterial colonies. This is partly due to the fact that it is more successful at removal of the smear layer. This is supported by studies with numerous extracted teeth tested in vitro rather than in vivo. |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
22970886 | Bago/2013 | 120 extracted, single straight-canal teeth. | In vitro study | Key results | Laser activated irrigation (LAI) proved to be more successful at removing E. faecalis from root canal walls than saline irrigation and equally as effective as NaOCl. Conventional NaOCl irrigation reduced E. faecalis count (P<0.05) but not as well as Photo-Activated Disinfection (PAD) or EndoActivator (P>0.05), which utilize Helbo and LaserHF. Diode lasers were not significantly more effective than traditional NaOCl irrigation at removing E. faecalis but PAD and EndoActivator, which are also lasers, were. | 23763481 | Sahar-Helft/2013 | 60 recently extracted human molars | In vitro study | Key results | Laser activated irrigation (LAI) is more effective at removing bacterial colonies than irrigation alone. Chlorhexidine (2%), EDTA (17%), and saline were all more effective at removing E. faecalis colonies from canal walls when combined with laser irradiation. Bacterial colonies were viewed before and after treatment with a Scanning Electron Microscope (SEM) in order to successfully count colonies. | |
Evidence Search |
(("lasers"[MeSH Terms] OR "lasers"[All Fields] OR "laser"[All Fields]) AND activated[All Fields] AND ("therapeutic irrigation"[MeSH Terms] OR ("therapeutic"[All Fields] AND "irrigation"[All Fields]) OR "therapeutic irrigation"[All Fields] OR "irrigation"[All Fields])) AND ("dental pulp cavity"[MeSH Terms] OR ("dental"[All Fields] AND "pulp"[All Fields] AND "cavity"[All Fields]) OR "dental pulp cavity"[All Fields] OR ("root"[All Fields] AND "canal"[All Fields]) OR "root canal"[All Fields]) |
Comments on
The Evidence |
Validity: The two studies chosen are reliable due to their effective comparison of a large number of extracted teeth. However, the main drawback is that these studies were done in vitro and do not examine the potential interactions of the oral environment.
Perspective: The next step should be to have these studies done in vivo in order to truly see the effects the oral environment might have on the treatment. |
Applicability |
The main advantage to using laser-therapy over traditional irrigation (NaOCl) is that it is more effective at removing bacterial colonies in the root canal, while also eliminating the smear layer that remains in traditional irrigation. |
Specialty |
(Endodontics) (General Dentistry) (Dental Hygiene) |
Keywords |
Dental lasers, root canals, irrigation
|
ID# |
2666 |
Date of submission |
03/12/2014 |
E-mail |
rayr3@livemail.uthscsa.edu |
Author |
Ramon Ray |
Co-author(s) |
|
Co-author(s) e-mail |
|
Faculty mentor |
Adriana V. Green, DDS, MPH |
Faculty mentor e-mail |
Greenav@uthscsa.edu |
|
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
None available | |