DISINFECTION OF THE ROOT CANAL IN A PERMANENT TOOTH USING LASER DURING THE ROOT CANAL PROCEDURE/ENDODONTIC TREATMENT.

Introduction: Preventing reinfection and thoroughly cleansing the root-canal system are the primary objectives of endodontic therapy. The endodontic system is shaped, cleaned, and fully decontaminated using mechanical tools and chemical irrigation in classic endodontic procedures. It is well recognized that the root-canal system is quite complicated, and that the majority of niti (nickel-titanium) devices only operate on the central body of the canal, ignoring fins, isthmus, and cul-de-sacs. These empty areas are home to germs, tissue fragments, and their byproducts. The primary cause of endodontic failure is inadequate root canal disinfection. Using a laser makes it feasible to disinfect the whole root canal system, including the lateral and accessory canals, an otherwise difficult job. Although it may seem antiquated, laser technology was brought to the field of endodontics with the intention of enhancing the outcomes of conventional treatments by using light energy to increase cleaning capacity and enhance endodontic system decontamination. justification for laser irrigation: Compared to root canal instrumentation alone, laser irrigation enables deeper cleaning and bacterial elimination, making it a crucial component of root canal treatment. Bacteria may colonize the dentinal tubules deeply, reaching the periodontal surface (1100 µm from the canal lumen), whereas chemical reagents can only enter dentinal tubules up to 130 µm due to high surface tension. However, it has been shown that agitating the irrigants may increase their reach into the dentinal tubules by up to 800µm. Regarding laser light, experiments have shown penetration into dentinal tubules as well as a depth of up to 1000µm. Research indicates that when chemical irrigant and laser are used in tandem, the combined impact of both is much better than either one alone in terms of endodontic disinfection. Root canal preparation is a need for using a laser in permanent teeth. An iso file size of 30 corresponds to the lowest amount of canal preparation needed for a 200µm laser tip to reach the apical region. Wet canals: Any chemical irrigants, such as edta or sodium hypochlorite, may be employed sequentially or together. Laser use is completely contraindicated in cases with dry canals. working length: the measurement is 1 mm less than the actual working length. For example, if a canal’s working length is 19 mm, then 19-1 equals 18 mm. The length of the laser point that will enter the canal will be 18 mm. Settings and parameters for laser root canal disinfection: We utilized an S1 Pioon laser with a wavelength of 980 nm, and we employed a 200 µm non-initiated tip operating in continuous mode at 2 watts. Procedures for disinfecting a root canal: under rubber dam isolation, each stage is repeated until the chemomechanical preparation (CMP) is completed, with laser disinfection serving as the last step before to obturation. First, use a chemical reagent to irrigate the canals; next, use a laser. The process or method for using a laser is as follows: first, remove the tip from the canal at a rate of 2 mm per second; second, disinfect the canal starting at the apex and working your way down to the orifice; third, move the tip circumferentially without touching the walls; fourth, repeat the process; fifth, wait and irrigate; sixth, wait 10 seconds between each pass before replenishing the canal with fresh irrigant; and finally, finally, repeat the process up to three times per canal. In conclusion, lasers have been shown to adjunctively enhance the effectiveness of endodontic treatment, endodontic retreatment, and prevent any further endodontic reinfection. This is due to the complex root canal anatomy and the limited ability of chemical irrigants to clean and disinfect the entire endodontic space in three dimensions. Citations: 1. Giovanni Olivi. Laser use in endodontics: transitioning from direct laser beaming to laser-triggered irrigation. The Journal of Laser Dentistry, 21(22), pp. 58–71, 2013. 2. Giovanni Olivi, Stefano Benedicenti, Giovanni Iaria, Vasilios Kaitsas, Enrico Divito, and Rolando Crippa, Laser in Endodontics (Part I). roots: 6–9; 2011:1.

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