Superior disinfection, minimally invasive access, greater efficiency, and more promising long-term results
By Roy H. Stevens, Professor and Chairman, Department of Endodontology, Temple University Kornberg School of Dentistry.
The new Endolase™ Radial Firing Tips Root Canal Therapy System enables endodontists and general dentists to perform root canal procedures faster and more effectively than with conventional treatment methods.
Endolase RFT System includes two newly designed, single-use laser tips, called endoTips™, and the procedure protocol for use with the Waterlase MD™ YSGG laser system. BIOLASE received U.S. Food and Drug Administration (FDA) 510(k) clearance of its Waterlase MD with RFT endoTips for root canal disinfection after endodontic instrumentation, making BIOLASE the first company to receive clearances allowing dentists to treat root canals with advanced laser technology.
Only two-to-three times the width of a human hair and very flexible, endoTips™ are shaped so the laser energy is emitted in a radial pattern, allowing the dentist to disinfect the root cavity while protecting and preserving tooth structure.
A research team from BIOLASE and Temple University, led by Dr. Roy Stevens, Professor and Chairman, Department of Endodontology at Temple’s Kornberg School of Dentistry, demonstrated that Er,Cr:YSGG laser light is capable of significantly reducing the level of infection in root canals and adjacent infected dentin by up to 99.7 percent. (1,2,3)
“The effectiveness of this treatment lends itself to improving the way that we perform root canal therapy,” Dr. Stevens said, adding that the results of the team’s research were of “great significance” for several reasons. “First, these bacteria are known to be highly resistant to other disinfection currently used in root canal therapy,” Dr. Stevens said. “Second, the research demonstrates that the disinfection capability of the laser is effective at a distance into the dentin surrounding the canal, overcoming some accessibility problems for conventional treatment methods. Third, a high level of disinfection can be achieved in minutes, saving both the patient and dentist considerable time during endodontic treatment.”
As the Radial Firing Tip moves along the canal wall, its radial YSGG laser energy penetrates deep into dentin and tubules to reach and destroy hidden bacteria
Why do conventional treatments fail even when all canals are located and cleaning and enlargement is successful? Research has shown that most root canal treatment failures are caused by persistent or secondary intraradicular infections, with E. faecalis, the most prevalent species.(4)
Waterlase MD™ YSGG treatment may reduce the risk of retreatment. Waterlase MD™ treatment with radial firing EndoTips™ reduces bacterial counts to levels approaching sterilization. Waterlase YSGG 2780nm laser energy penetrates deep into dentinal tubules to kill more bacteria without subjecting patients to the potential toxicity of sodium hypochlorite solutions.
The smear layer remaining after rotary or hand instrumentation contains infected tissue that can seal infection within dentinal tubules. Scanning Electron Microscopy shows how treatment with Waterlase MD™ radial firing EndoTips™ leaves canal walls free of smear layer and opens dental tubules, allowing YSGG laser energy to penetrate and destroy bacteria.
Artist’s rendering of Endolase™ Radial Firing Tip disinfecting a root canal.
The EndoTips™ System removes smear layer without chemical irrigants, in only 2-3 minutes per canal. The Hydrophotonics™ effect of Waterlase MD™ YSGG laser energy and water creates a powerful microagitation throughout the entire length of the canal, scouring tissue debris from dental walls and tubules, and flushing it from the canal. At the same time, the minimally invasive ablation of the Waterlase creates only the required widening of the canal, avoiding unnecessary coronal widening and weakening of the root.
Laser Disinfection
The Endolase™ disinfection process is simple. Using the RFT2 endoTip™, place the tip into the handpiece and select 10 percent air flow and 0 percent water settings on the Waterlase MD. Insert the tip to 1mm short of the apex and, using the tip’s depth guide, activate the laser and start moving the tip coronally at approximately 1 mm/s. Use a contact brushing technique to deliver YSGG laser energy to the surface, peri- and inner-tubular dentin. Re-insert the tip immediately and perform an additional pass over the same area. Then repeat four or more times to ensure disinfection of the apical and partial coronal two-thirds of the canal.
For more information, call Biolase at 1-800-321-6717
For more information in Canada, call 1-800-668-5558
Anterior Part No. 7200795: RFT2, 25mm Tip – 1 (EA) / RFT3, 21mm Tip – 1 (EA)
Posterior Part No. 7200801: RFT2, 21mm Tip – 1 (EA) / RFT3,
FOOTNOTES:
1. The antimicrobial efficacy of the erbium, chromium:yttrium-scandium-gallium-garnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus faecalis: Wanda Gordon, DMD, Vahid A. Atabakhsh, DDS, Fernando Meza, DMD, Aaron Doms, DDS, Roni Nissan, DMD, Ioana Rizoiu, MS and Roy H. Stevens, DDS, MS. JADA 2007; 138(7): 992-1002.
2. The impact of an erbium, chromium: yttrium-scandium-gallium-garnet laser with radial-firing tips on endodontic treatment:U. Schoop, A. Barylyak, K. Goharkhay, F. Beer, J. Wernisch, A. Georgopoulos,W. Sperr, A. Moritz. Lasers in Medical Science DOI 10.1007/s10103-007-0520-4.
3. The use of the erbium, chromium:yttrium-scandium-gallium-garnet laser in endodontic treatment. The results of an in vitro study: Ulrich Schoop, DDS, MD, Kawe Goharkhay, DMD, MD, Johannes Klimscha, DMD, MD, Manuela Zagler, DMD, Johann Wernisch, TD, PhD, Apostolos Georgopoulos, MD, PhD, Wolfgang Sperr, DDS, MD, PhD and Andreas Moritz, DMD, MD, PhD JADA.
4. Siqueira and Rocas; “Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. OO 2004 97;85-94.
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