ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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 (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22970886Bago/2013120 extracted, single straight-canal teeth.In vitro study
Key resultsLaser 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.
#2) 23763481Sahar-Helft/201360 recently extracted human molarsIn vitro study
Key resultsLaser 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/Discipline (Endodontics) (General Dentistry)
Keywords Dental lasers, root canals, irrigation
ID# 2666
Date of submission: 03/12/2014spacer
E-mail rayr3@livemail.uthscsa.edu
Author Ramon Ray
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Adriana V. Green, DDS, MPH
Faculty mentor/Co-author e-mail Greenav@uthscsa.edu
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?)
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