Lasers in Endodontics Scientific Background and Clinical Applications 1st edition by Giovanni Olivi,Roeland de Moor,Enrico Divito 3319193279 9783319193274

Part I: Endodontic Background

1: Endodontic Morphology and Anatomy of Human Teeth

1.1 Deciduous Teeth Anatomy

1.2 Permanent Teeth

1.2.1 Macroscopic Anatomy

1.3 Upper Incisors

1.3.1 Central Upper Incisor

1.3.2 Lateral Upper Incisor

1.4 Lower Incisors

1.4.1 Lower Central Incisors

1.4.2 Lower Lateral Incisor

1.5 Cuspids

1.5.1 Upper Canine (Cuspid)

1.5.2 Lower Canine (Cuspid)

1.6 Upper Premolars (or Bicuspid)

1.6.1 Upper First Premolar

1.6.2 Upper Second Premolar

1.7 Lower Premolars (or Bicuspid)

1.7.1 Lower First Premolar

1.7.2 Lower Second Premolar

1.8 Upper Molars

1.8.1 First Upper Molar

1.8.2 Second Upper Molar

1.8.3 Third Upper Molar

1.9 Lower Molars

1.9.1 First Lower Molar

1.9.2 Second Lower Molar

1.9.3 Third Lower Molar

1.10 Apical Anatomy

1.11 Microscopical Anatomy of Permanent Teeth

1.12 Dentin

1.12.1 Predentin and Calcospherules

1.12.2 Dentinal Tubules

1.12.3 Peritubular and Intertubular Dentin

1.13 Types of Dentin

References

2: Root Canal Catheterization

2.1 Access Cavity Preparation

2.2 The Shaping Concept

2.2.1 Hand Instrumentation

2.2.2 Rotary Instrumentation

2.2.2.1 File Design Features and Functions

2.2.2.2 ProTaper Universal

2.2.2.3 Twisted Files (TF)

2.3 Root Canal Obturation

2.3.1 Lateral Compaction

2.3.2 Warm Vertical Compaction

2.3.3 Carrier-Based Obturation

2.4 Endodontic Instruments

References

3: The Role of Irrigation in Endodontics

3.1 Introduction

3.2 Irrigation Systems

3.3 Operational Characteristics of the Irrigation Systems

3.3.1 Syringe Irrigation

3.3.2 Negative Pressure Irrigation

3.3.3 Laser Activation

3.3.4 Sonic Activation

3.3.5 Ultrasonic Activation

3.4 Clinical Procedures of Irrigant Activation Techniques

3.4.1 Irrigation Activation Protocols

3.4.2 Sonic Activation

3.4.3 Ultrasonic Activation

3.4.4 Laser Activation

3.5 Flow Characteristics for Different Irrigation Systems

3.5.1 Syringe Irrigation

3.5.2 Negative Pressure Irrigation

3.5.3 Intermezzo: Flow into Lateral Canals and Tubules

3.5.4 Sonic and Ultrasonic Activation

3.5.4.1 Acoustic Streaming

3.5.4.2 Cavitation

3.5.5 Laser-Activated Irrigation

3.6 Chemical Effects Enhanced by the Irrigation Systems

3.7 Effect of Irrigation on Root Canal Disinfection

3.7.1 Interaction Between a Biofilm and the Flow Created by Sonic, Ultrasonic, or Laser Activati

3.7.2 Interaction with Cavitation Bubbles Created by Ultrasonic or Laser Activation

3.8 Effect of Irrigation on Endodontic Outcome

References

Part II: Basic Science of Laser Dentistry

4: The Physics of Lasers

4.1 History of Lasers

4.2 Electromagnetic Spectrum of Light

4.2.1 Visible Spectrum of Light

4.2.2 Invisible Spectrum of Light

4.3 Classification of Dental Lasers in the Electromagnetic Spectrum of Light [3]

4.4 Properties of Laser Light [3]

4.5 Basic Components of Lasers [3]

4.5.1 Optical Cavity

4.5.2 Active Medium

4.5.3 Energy Source (or Pumping Source)

4.5.4 Controller Subsystem and Cooler

4.5.5 Delivery System

4.5.6 Handpieces and Tips

4.6 Laser Parameters [3]

4.6.1 Laser Energy

4.6.2 Laser Emission Mode

4.6.2.1 Continuous Wave and Gated Mode

4.6.2.2 Free-Running Pulsed Mode

4.6.3 Pulse Duration and Pulse Repetition Rate

4.6.4 Laser Power

4.6.5 Operator Modality

Conclusion

Bibliography

Suggested Texts

5: Different Lasers Used in Endodontics

5.1 History of Laser in Endodontics

5.2 Laser Wavelengths Used in Endodontics

5.2.1 Laser in the Ultraviolet Spectrum of Light: Excimer Laser

5.2.2 Lasers in the Visible Spectrum of the Light

5.2.2.1 Argon Laser

5.2.2.2 KTP Laser

5.2.2.3 Semiconductor Laser: Diode Lasers

5.2.3 Near-Infrared Lasers

5.2.3.1 Semiconductor Laser: Diode Laser

5.2.3.2 Neodymium:YAG Laser

5.2.3.3 Neodymium:YAP Laser

5.2.4 Medium-Infrared Lasers: Erbium YAG and Erbium, Chromium YSGG Laser

5.2.5 Far-Infrared Laser: CO2 Laser

5.3 Classification of Lasers in Endodontics

5.3.1 Conventional Laser Endodontics (Direct Laser Irradiation)

5.3.2 Photoactivated Disinfection (PAD)

5.3.3 Laser-Activated Irrigation and PIPS™

5.4 Laser-Tissue Interaction in Endodontics

5.5 Laser Effects in Endodontics

5.5.1 Effect of Laser Light on Bacteria

5.5.2 Effects of Laser Light on Photosensitizers

5.5.3 Effects of Laser Light on Dentinal Walls

5.5.3.1 Near-Infrared Laser

5.5.3.2 Medium-Infrared Laser

5.5.4 Effects of Laser Light on Free Water

5.6 Parameters that Influence the Laser Effects

5.6.1 Continuous Wave Mode

5.6.2 Pulsed Mode and Pulse Duration

5.6.3 Pulse Repetition Rate

5.6.4 Fluence and Power Density

5.6.5 Distance Between Target and Fiber

References

Part III: Clinical Applications of Laser in Endodontics

6: Conventional Laser Endodontics

6.1 Mechanism of Conventional Laser Endodontics

6.2 Access Cavity

6.3 Lasers for Root Canal Preparation

6.3.1 Excimer Laser

6.3.2 Nd:YAG Laser

6.3.3 Nd:YAP Laser

6.3.4 Erbium Lasers

6.4 Morphological and Cleaning Effects of Lasers on Root Dentin Surface

6.4.1 Near-Infrared Laser

6.4.1.1 Nd:YAG Laser

6.4.1.2 Nd:YAP

6.4.1.3 Diode Laser

Diode Laser 810 nm

Diode Laser 980 nm

6.4.2 Medium-Infrared Laser

6.4.3 Comparative Studies on Different Laser Wavelengths

6.4.4 Laser and Irrigation for Root Canal Cleaning

6.5 Laser Root Canal Decontamination

6.5.1 Visible and Near-Infrared Laser Decontamination

6.5.2 Irrigation and Visible and Near-Infrared Laser Irradiation for Root Canal Decontamination

6.5.3 Medium- and Far-Infrared Laser Decontamination

6.5.4 Radial Firing Tips

6.6 Discussion

References

7: Photoactivated Disinfection

7.1 Historical Background

7.2 Mechanism of Action of PAD

7.3 PAD in Endodontics

7.4 Discussion

References

8: Pulp Therapy for Primary Teeth

8.1 Introduction

8.2 Conventional Methods of Treating the Pulp in the Deciduous Dentition

8.3 Vital Pulp Therapy

8.3.1 Indirect Pulp Capping in Primary Teeth

8.3.2 Direct Pulp Capping in Primary Teeth

8.3.2.1 Laser Therapy

8.3.2.2 Laser Direct/Indirect Pulp Capping Procedure

8.3.3 Pulpotomy

8.4 Pulpectomy

8.5 Lasers in Primary Teeth Requiring Pulpal Treatments

8.5.1 Laser Pulpotomy and Pulpectomies Using the Erbium YAG Laser

8.5.2 PIPS Protocol for Pulpotomy and Pulpectomy of Primary Deciduous Teeth

8.5.3 Laser Pulpotomy Using the CO2 Laser

Conclusions

References

9: Laser Doppler Flowmetry

9.1 Introduction

9.2 Working Mechanism

9.3 Arbitrary Units

9.4 LDF: The Diagnostic Unit

9.5 Properties

9.6 LDF: A Benefit?

9.7 Restoration of Tooth Vitality (Blood Flow) and Revascularisation

9.7.1 A Complicated Trauma Case

9.7.2 Autotransplantation of Wisdom Teeth and Luxation of an Autotransplanted Second Upper Prem

9.7.3 Luxation of an Autotransplanted Second Upper Premolar

9.7.4 Discussion

9.8 Is There a Need for the Use of a Splint?

9.9 Reliability/Accuracy of LDF and Diurnal Variations

9.9.1 Accuracy and Reliability

9.9.2 Diurnal Variations

9.10 Does LDF Have a Future?

Conclusion

References

Part IV: New Development of Laser for Endodontic Irrigation

10: Laser-Activated Irrigation (LAI)

10.1 Introduction

10.2 Mechanism of Laser-­Activated Irrigation

10.2.1 Wavelengths and Target Chromophore

10.2.2 Laser Target Interaction: Effects on Irrigants

10.2.2.1 Photothermal Interaction: Heating of the Irrigant

10.2.2.2 Hydrodynamic Cavitation

10.3 The Power of the Bubbles: Parameters That Influence Bubble Formation

10.3.1 Effect of Energy

10.3.2 Effect of Pulse Duration

10.3.3 Effect of Pulse Frequency

10.3.4 Effect of Different Wavelengths

10.3.5 Effect of Tip Design

10.4 Other Conditions That Influence LAI Efficiency and Safety

10.4.1 Apical Preparation and Root Canal Shaping

10.4.2 Tip Position

10.4.3 Apical Extrusion

10.4.4 Temperature Variation

10.5 Laser Chemical Effects on NaOCl

10.6 Laser-Activated Irrigation: An Appraisal of the Influencing Factors

10.7 Thoughts for the Clinical Applications of LAI

10.8 Effects of Laser-Activated Irrigation on Smear Layer and Compacted Root Canal Debris

10.9 Effects of Laser-Activated Irrigation on Enterococcus faecalis

Conclusion

References

11: Advanced Laser-Activated Irrigation: PIPSTM Technique and Clinical Protocols

11.1 Introduction

11.2 PIPS in Brief

11.3 Mechanism of PIPS

11.4 Bubbles: Cavitation and Shock Wave

11.5 Fluid Dynamics Study of PIPS

11.5.1 Qualitative Observations

11.5.2 Quantitative Results

11.6 Parameters that Influence the Bubble Formation

11.6.1 Effect of Energy and PIPS Tip Diameter and Design

11.6.2 Effect of Pulse Duration

11.7 Conditions that Influence PIPS Efficiency and Safety

11.7.1 Effect of Different Wavelengths

11.7.2 Effect of Pulse Frequency

11.7.3 Effect of Continuous or Intermittent Irrigation

11.7.4 Effect of Tip Position in the Pulp Chamber

11.7.5 Apical Preparation and Root Canal Shaping Using PIPS

11.7.6 Apical Extrusion

11.7.6.1 Wide Apical Foramen

11.7.6.2 High Pressure Inside the Canal

11.7.6.3 Tip Position

11.8 Temperature Variation

11.9 PIPS Effects on Irrigants: The Activation Phase and the Resting Phase of NaOCl

11.10 Other Effects of PIPS: Vapor Lock

11.11 Undesired Effects: Fluid Splashing

11.12 Clinical Applications of PIPS

11.12.1 Effects of PIPS on Intracanal Tissue, Debris, and Smear Layer

11.12.2 Effects of PIPS on Enterococcus faecalis and Biofilm

11.13 Discussion

11.14 PIPS: New Concept in Cleaning and Shaping the Root Canal

11.15 PIPS Protocol for Primary Endodontic Treatment for Both Vital and Necrotic (Includes Acute

11.15.1 Access Opening and Glide Path

11.15.2 Anatomical and Working Length of the Canal

11.15.3 Shaping the Root Canal

11.15.4 Ensuring Apical Patency

11.15.5 PIPS Irrigation Protocol

11.15.6 Root Canal Obturation

11.16 PIPS Protocol for Endodontic Retreatment

11.17 PIPS as an Aid for Locating and Establishing Patency in Calcified Canals

11.18 PIPS as an Aid in Dislodging Fractured Instruments

11.19 Other Application of PIPS

11.19.1 PIPS Effects on Adhesion of Resin Sealer Cement to Root Canal Dentin

11.19.2 PIPS Effect on Activation of Hydrogen Peroxide Devital Tooth Bleaching