Laser-Assisted Disinfection in Root Canal Therapy

Introduction

Post endodontic pain (PEP) after treatment can last from 24 to 72 h. Laser technology in endodontics offers significant advantages, including antimicrobial efficacy, anti-inflammatory effects, and smear layer removal. Each laser wavelength targets specific tissue chromophores (e.g., melanin, hemoglobin, water) and provides distinct therapeutic effects.

Study Design and Pain Measurement

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This systematic review analyzed 12 randomized controlled trials (RCTs) that examined the effects of various intracanal laser-assisted disinfection techniques on post-endodontic pain (PEP).

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These studies compared laser interventions (Nd, Er, diode lasers, and photodynamic therapy) with conventional endodontic treatments with pain measured using Visual Analog Scale (VAS) or Numeric Rating Scale (NRS) at intervals ranging from 6 hours to one week.

Treatment Protocols

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Treatments ranged from single-visit procedures to multi-visit protocols with calcium hydroxide dressing between sessions.

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Irrigants such as sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) were activated by lasers in most cases.

Effectiveness of Laser Systems

Nd:YAG Laser: Used in three studies with wavelengths of 1064 nm and 1440 nm. Findings showed significant pain reduction, especially in necrotic pulp cases.

Diode Laser: Studied at wavelengths of 940 nm and 980 nm in four studies. This laser demonstrated consistent pain reduction across various postoperative intervals, attributed to its deeper tissue penetration.

Er:YAG Laser: Analyzed in three studies. Short-term pain relief (6 to 24 hours post-treatment) was its most notable benefit.

Ketorol_Photodynamic Therapy (PDT) icon image

Photodynamic Therapy (PDT): Investigated in three studies. Results were inconsistent, with only one study showing significant pain reduction.

Pain Reduction Timeframes:
•	The use of diode lasers resulted in significant pain reduction across all postoperative intervals up to one week.
•	Er:YAG lasers were most effective in the very early postoperative period (6-24 hours).
•	PDT and Nd:YAG laser efficacy varied based on baseline patient conditions and the presence of radiographic pathology.
The review identified intracanal laser-assisted disinfection as a valuable adjunct to conventional root canal therapy for reducing post-endodontic pain (PEP). Diode lasers were the most effective, offering consistent pain relief across all postoperative intervals.

GGI-CO-A1-AQS-300023454-ELC-L24-0149
For the use of a Registered Medical Practitioner, Hospital or Laboratory only.
Reference:
Elafifi-Ebeid H, Betancourt P, Parada-Avendaño I, Arnabat-Domínguez J. Post-endodontic pain evaluation after different intracanal laser assisted disinfection techniques. A Systematic Review. J Clin Exp Dent. 2023;15(2):e149-e159. Published 2023 Feb 1. doi:10.4317/jced.59941 Click here to view the original article

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Laser-Assisted Disinfection in Root Canal Therapy

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