Effect of Er:YAG laser combined with NaClO on the removal of root canal smear layer and dentin microhardness

doi:10.19439/j.sjos.2025.03.002

Abstract

Abstract: PURPOSE: To evaluate the effects of Er:YAG laser combined with NaClO on the removal of root canal taint layer, calcium hydroxide clearance and dentin microhardness. METHODS: A total of 318 single-rooted extracted teeth collected from March 2021 to January 2024 were selected, the 13 mm root was taken and mechanically prepared and randomly divided into three groups, with 106 teeth in each group. The control group was rinsed with NaClO, the experimental group 1 was rinsed with NaClO combined with ultrasonic washing, and the experimental group 2 was treated with Er:YAG laser on the basis of NaClO. The removal of the smear layer was observed under electron microscope, and the microhardness of dentin post-treatment was assessed using a microhardness tester. RESULTS: The clearance rate of calcium hydroxide in experimental group 2 was significantly higher than that in experimental group 1 and control group, and the stain layer scores of crown formula 1/3, root middle 1/3 and root tip 1/3 were significantly lower than those in the other 2 groups(P<0.05). There was no significant difference between the initial and final microhardness of the three groups(P>0.05). CONCLUSIONS: Er: YAG laser combined with NaClO can effectively enhance the removal effect of stain layer in root canal therapy, and has little effect on dentin microhardness.

Key words: Er:YAG Laser, Ultrasonic washing, Sodium hypochlorite, Root canal smear layer removal rate, Dentin microhardness

CLC Number:

R781.05

Bai Xue, Wang Xiao. Effect of Er:YAG laser combined with NaClO on the removal of root canal smear layer and dentin microhardness[J]. Shanghai Journal of Stomatology, 2025, 34(3): 233-236.

References

[1] Febvey A, Silva F, Henriques B, et al.Root canal disinfection and maintenance of the remnant tooth tissues by using grape seed and cranberry extracts[J]. Odontology, 2023, 111(3): 541-553.
[2] Brochado Martins JF, Guerreiro Viegas O, Cristescu R, et al.Outcome of selective root canal retreatment-a retrospective study[J]. Int Endod J, 2023, 56(3): 345-355.
[3] Pirani C, Camilleri J.Effectiveness of root canal filling materials and techniques for treatment of apical periodontitis: a systematic review[J]. Int Endod J, 2023, 56(Suppl 3): 436-454.
[4] 中国老年学和老年医学学会口腔保健分会. 无光纤传输技术Er:YAG激光口腔临床应用规范[J]. 中华口腔医学杂志, 2024, 59(6): 531-545.
[5] Cai C, Chen X, Li Y, et al.Advances in the role of sodium hypochlorite irrigant in chemical preparation of root canal treatment[J]. Biomed Res Int, 2023, 2023:8858283.
[6] Alkahtany MF.Efficacy of curcumin-mediated photodynamic therapy for root canal therapy procedures: a systematic review[J]. Photodiagnosis Photodyn Ther, 2023, 41: 103252.
[7] Zou X, Zheng X, Liang Y, et al.Expert consensus on irrigation and intracanal medication in root canal therapy[J]. Int J Oral Sci, 2024, 16(1): 23-32.
[8] Cosar M, Kandemir Demirci G, Çaliskan MK.The effect of two different root canal sealers on treatment outcome and post-obturation pain in single-visit root canal treatment: a prospective randomized clinical trial[J]. Int Endod J, 2023, 56(3): 318-330.
[9] Murray PE.Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth[J]. Int Endod J, 2023, 56(Suppl 2): 188-199.
[10] Castagnola R, Martini C, Colangeli M, et al.In vitro evaluation of smear layer and debris removal and antimicrobial activity of different irrigating solutions[J]. Eur Endod J, 2024, 9(1): 81-88.
[11] Li Y, Wang Z, Bao P, et al.Cleaning and disinfecting oval-shaped root canals: ex vivo evaluation of three rotary instrumentation systems with passive ultrasonic irrigation[J]. Medicina (Kaunas), 2023, 59(5): 962.
[12] Leonardo RT, Puente CG, Berbert FLCV, et al.Clinical study of antimicrobial efficacy of laser ablation therapy with indocyanine green in root canal treatment[J]. J Endod, 2023, 49(8): 990-994.
[13] 洪燕如, 江琦, 朱建宇, 等. 铒激光拆除三种全瓷高嵌体的实验研究[J]. 口腔颌面修复学杂志, 2024, 25(2): 103-108.
[14] 赵永超, 吴瑞卿, 李雅娟. Er:YAG激光辅助龈下刮治和根面平整术治疗慢性牙周炎伴2型糖尿病的临床疗效[J]. 北京口腔医学, 2023, 31(2): 105-108.
[15] Duncan HF, Kirkevang LL, Peters OA, et al.Treatment of pulpal and apical disease: the European Society of Endodontology (ESE) S3-level clinical practice guideline[J]. Int Endod J, 2023, 56(Suppl 3): 238-295.
[16] 朱维晨, 陈如婷, 张红艳. Er∶YAG激光的应用对根管玷污层清除率和牙本质显微硬度的影响[J]. 安徽医科大学学报, 2023, 58(9): 1599-1603.
[17] Shan X, Tian F, Li J, et al.Comparison of Er:YAG laser and ultrasonic in root canal disinfection under minimally invasive access cavity[J]. Lasers Med Sci, 2022, 37(8):3249-3258.
[18] Meire MA, Bronzato JD, Bomfim RA, et al.Effectiveness of adjunct therapy for the treatment of apical periodontitis: a systematic review and meta-analysis[J]. Int Endod J, 2023, 56(Suppl 3): 455-474.
[19] Asnaashari M, Sadeghian A, Hazrati P.The effect of high-power lasers on root canal disinfection: a systematic review[J]. J Lasers Med Sci, 2022, 13:e66.
[20] Kosarieh E, Bolhari B, Sanjari Pirayvatlou S, et al.Effect of Er:YAG laser irradiation using SWEEPS and PIPS technique on dye penetration depth after root canal preparation[J]. Photodiagnosis Photodyn Ther, 2021, 33:102136.
[21] Kapetanovic Petricevic G, Katic M, Brzovic Rajic V, et al.The efficacy of Er:YAG laser-activated shock wave-enhanced emission photoacoustic streaming compared to ultrasonically activated irrigation and needle irrigation in the removal of bioceramic filling remnants from oval root canals-an ex vivo study[J]. Bioengineering (Basel), 2022, 9(12):820.
[22] 周宇琨, 张方琪, 张婷婷, 等. Er∶YAG激光辅助根管荡洗对冲洗液根尖溢出影响的系统评价[J]. 中华老年口腔医学杂志, 2023, 21(1): 24-28.