Just bought the Lares Research Er:YAG/Nd:YAG laser called the PowerLase AT in August 2010 and am really amazed at what it can do in the field of Endodontics. I’ve been doing endo in my practice since the mid 1980’s and started off with vertical condensation and then moved from hand files to the oscillating EndoGripper invented by Jim Roane (Univ. of Oklahoma, Go Sooners!) to save my hands, and then finally to rotary. I had good success with all the different techniques, but still had to send certain teeth out because of highly curved roots, “double dog-legs” and “S” shaped canals that were sure to separate a file. Then I came across the PIPS endo and it changed my endo technique so much that I find myself looking for the really tough endo cases just to see how many extra canals and accessary canals I can pick up with the technique.
This is a good example of a tough case made simple with PIPS. Could not negotiate the mesial roots with a #6 file because of large internal resorbtive lesion. Used PIPS technique and Ultradent EndoRez/GP/sealer and filled this tooth without ever instrumenting the apical half of the mesial roots. Just amazing.
Sorry about the beat-up phosphorus plates. I think its time to order some new ones!
This case was obturated as a matter of routine endo by my associate only 3 months out of dental school with the PIPS endo technique.
NOTE: Final Fill photos of PIPS cases found at the end of the blog “New service to our patients: Laser Root Canals!”.
References:
1. Journal of Endodontics Volume 26, Issue 8, Pages 454-458, August 2000. Canal Enlargement by Er:YAG Laser Using a Cone-Shaped Irradiation Tip. Shigeru Shoji, DDS, PhD, Hiromi Hariu, DDS, Hiroshi Horiuchi, DDS, DDSc
2. Journal of Endodontics Volume 33, Issue 7, Pages 830-832, July 2007. Evaluation of the Bactericidal Effect of Er,Cr:YSGG, and Nd:YAG Lasers in Experimentally Infected Root Canals. Qian-qian Wang, DDS, Cheng-fei Zhang, DDS, PhD,Xing-zhe Yin, DDS
3. Journal of Endodontics Volume 30, Issue 8, Pages 585-588, August 2004. Q-switched Versus Free-running Er:YAG Laser Efficacy on the Root Canal Walls of Human Teeth: A SEM Study Marouan G. Khabbaz, Mersini I. Makropoulou, Alexandros A. Serafetinides, Dimitris Papadopoulos, Eirini Papagiakoumou
4. Journal of Endodontics Volume 28, Issue 2, Pages 76-78, February 2002. Root Surface Temperature Increase during Er:YAG LaserIrradiation of Root Canals. Yuichi Kimura, DDS, PhD, Kazuo Yonaga, DDS, PhD, Keiko Yokoyama, DDS, PhD, Jun-ichiro Kinoshita, DDS, Yoshiko Ogata, DDS, Koukichi Matsumoto, DDS, PhD
5. Journal of Endodontics Volume 26, Issue 2, Pages 95-99, February 2000. A Histopathological and Immunohistochemical Study of Dental Pulp and Pulpal Nerve Fibers in Rats After the Cavity Preparation Using Er:YAG Laser. Kazunori Takamori, DDS
6. Journal of Endodontics Volume 34, Issue 5, Supplement , Pages e33-e36, May 2008.Lasers in Endodontics: An Online Study Guide
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