Effectiveness of therapy of complicated forms of dental caries using an Er,Cr:YSGG laser with a wavelength of 2780 nm

BACKGROUND: The use of laser technologies in the treatment of complicated forms of dental caries is promising in dentistry. However, the available literature does not fully cover the use of the Er,Cr:YSGG laser (wavelength: 2780 nm) in the treatment of purulent pulpitis and pulp necrosis.

AIM: To determine the effectiveness of therapy for complicated forms of dental caries using an erbium–chromium laser with a wavelength of 2780 nm for biomechanical treatment of root canals.

MATERIALS AND METHODS: Overall, 106 patients were examined and divided into three groups: group 1 (control), 15 patients whose treatment was performed using a generally accepted method; group 2, 50 patients who were treated with erbium–chromium laser radiation at the second visit, immediately before root canal obturation; and group 3, 41 patients who were treated in one visit and divided into two subgroups. In group 3-A (n=18), the root canal was irradiated with a laser with factory settings, and in group 3-B (n=23), the frequency and power of the laser were increased from 20 to 40 Hz and from 1.25 to 1.5 Watts, respectively.

RESULTS: In group 1, 59 microorganisms from all 17 strains were seeded before the treatment of the root canal system of teeth with chlorine-containing disinfectants. Moreover, the proportion of seeded microorganisms in each strain was 6.6%–40% (average value: 23.1%). After treatment, the seeding rate of Streptococcus mitis decreased from 40% to 13%, Streptococcus intermedius from 20% to 6.6%, Enterococcus spp. from 33.3% to 13.3%, and Candida spp. from 33.3% to 20%. In group 2, after complex biomechanical treatment of root canals and the use of a hydrokinetic laser, none of the 17 strains sown before treatment were observed. The Candida spp. (5.5%) were not neutralized due to the use of a hydrokinetic laser with a wavelength of 2780 nm in the factory settings in group 3-A (power, 1.25 W; pulse frequency, 20 Hz; air, 10%; water, off). The combined use of the traditional protocol and hydrokinetic Er,Cr:YSGG laser in group 3B enabled complete elimination of microorganisms from those sown before treatment (p <0.001).

CONCLUSION: Treatment of purulent pulpitis and pulp necrosis in one visit using a hydrokinetic Er,Cr:YSGG laser with a wavelength of 2780 nm with increased parameters (i.e., power, 1.5 W; frequency, 40 Hz; air, 35%; water, 25%) is recommended.