Endodontic retreatment of curved root canals using the dual wavelength erbium, chromium:yttrium, scandium, gallium, garn
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ORIGINAL ARTICLE
Endodontic retreatment of curved root canals using the dual wavelength erbium, chromium:yttrium, scandium, gallium, garnet, and diode 940-nm lasers and the XP-Endoshaper/finisher technique Riman Nasher 1
&
Ralf-Dieter Hilgers 2 & Norbert Gutknecht 1
Received: 19 January 2020 / Accepted: 24 September 2020 # The Author(s) 2020
Abstract Purpose The aim of this quantitative study was to compare between a dual-wavelength laser (Er,Cr:YSGG, diode 940 nm) to the XP-Endoshaper/finisher combined with ethylenediaminetetraacetic acid (EDTA) 17% technique in removing secondary smear layer created during endodontic retreatment of curved canals. Methods Twenty-four human curved root canals were endodontically prepared and filled with AH-sealer and Reciproc® Gutta percha cones. The fillings were removed after 6 weeks, and the samples were randomly divided into 3 groups: A, negative control: irrigated with distilled water; B, XP-Endoshaper/finisher with EDTA 17%; and C Er,Cr:YSGG (2 W, 20 Hz, 50 μs) and diode 940 nm (2 W, 50% duty cycle). The canals were split longitudinally, and a laser scanning microscope (VK-X100K, VKX200K, Keyence, Osaka, Japan) was used to capture images with the magnification of × 1000 from the canals. The images were scored by three blinded dentists using the Hülsmann scoring system, and a statistical analysis was carried out. Results A significant difference between the apical regions of groups B and C (p = 0.0010) was observed, with group C showing a cleaner apical region. However, this difference is cancelled out when comparing all areas of the canals (t = 1.43, df 21 p = 0.1663). Conclusion Within the limitations of this study, it can be concluded that a dual laser wavelength protocol (Er,Cr:YSGG (2 W, 20 Hz, 50 μs) and diode 940 nm (2 W, 50% duty cycle) may be positive in removing the secondary smear layer formed during endodontic retreatment cases of curved root canals. Keywords Dental lasers . Er,Cr:YSGG . Diode 940 nm . Endodontic retreatment . Curved canals . Sealer removal
Introduction Studies have reported that the success rate of endodontic retreatment lies at 74% [1]. This has been associated with one or more factors, including inadequate canal debridement, inadequate obturation, and complicated canal anatomy, all in turn result in the persistence of bacterial infection inside the root canal [2–4]. Traditionally, endodontic retreatment is
* Riman Nasher [email protected] 1
Department of conservative, periodontal and preventive dentistry, University hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
2
Department of Medical Statistics, RWTH Aachen, Pauwelsstrasse 19, 52074 Aachen, Germany
performed by first removing the obturating material and sealer, followed by repeated canal preparation and irrigation with a suitable antimicrobial solution such as NaOCl, which is reported to remove bacteria and promote healing in retreatment cases [5]. Another widely used endodontic irrigant is ethylenediaminetetraacetic acid (EDTA) which is capable of removing
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