October 1, 2010

Internal Resorption of Lower First Molar

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.

Internal Resorbtion, #6 file cannot negotiate

Internal Resorption

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!

Internal Resorption

Obturated Internal Resorption

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!”.


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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,email addressXing-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. KhabbazMersini I. MakropoulouAlexandros A. SerafetinidesDimitris PapadopoulosEirini 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

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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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11. Photomed Laser Surg. 2010 Aug;28 Suppl 1:S73-8. Evaluation of antifungal efficacy of erbium, chromium: yttrium-scandium-gallium-garnet laser against Candida albicans. Onay EOAlikaya CSeker E. Department of Endodontics, Baskent University, School of Dentistry, Ankara, Turkey. eonay@baskent.edu.tr

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22. Photomed Laser Surg. 2010 Apr;28(2):161-5. Thermal effects from modified endodontic laser tips used in the apical third of root canals with erbium-doped yttrium aluminium garnet and erbium, chromium-doped yttrium scandium gallium garnet lasers. George RWalsh LJ. School of Dentistry, University of Queensland, Brisbane, Australia.

23. J Endod. 2010 Jan;36(1):100-4. The synergistic antimicrobial effect by mechanical agitation and two chlorhexidine preparations on biofilm bacteria. Shen YStojicic SQian WOlsen IHaapasalo M. Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, Canada.

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31. Photomed Laser Surg. 2009 Apr;27(2):351-5. The temperature changes in the pulp chamber during cavity preparation with the Er:YAG laser using a very short pulse. Krmek SJMiletic ISimeon PMehici? GPAni? IRadisi? B. School of Dental Medicine, Department of Endodontics and Restorative Dentistry, Veterinary Faculty of the University of Zagreb, Zagreb, Croatia. jukic@sfzg.hr

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33. Am J Dent. 2009 Feb;22(1):14-8. Efficacy of calcium hydroxide, Er:YAG laser or gaseous ozone against Enterococcus faecalis in root canals. Noetzel JNonhoff JBitter KWagner JNeumann KKielbassa AM. Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Charité-Universitätsmedizin Berlin, Assmannshauser Str. 4-6, 14197 Berlin, Germany. joern.noetzel@charite.de

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40. J Endod. 2008 Apr;34(4):474-7. Impact of Er,Cr:YSGG laser therapy on the cleanliness of the root canal walls of primary teeth. Soares FVarella CHPileggi RAdewumi AGuelmann M. Department of Pediatric Dentistry, University of Florida, Gainesville, Florida 32610-0436, USA.

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48. J Am Dent Assoc. 2007 Jul;138(7):949-55. The use of the erbium, chromium:yttrium-scandium-gallium-garnet laser in endodontic treatment: the results of an in vitro study. Schoop UGoharkhay KKlimscha JZagler MWernisch JGeorgopoulos ASperr WMoritz A. Department of Conservative Dentistry, Medical University of Vienna, Austria. curd.schoop@meduniwien.ac.at

49. Braz Dent J. 2006;17(4):296-9. Er:Yag laser irradiation of the microbiological apical biofilm. Araki ATIbraki YKawakami TLage-Marques JL. Department of Endodontics, School of Dentistry, University of São Paulo, Avenida Professor Lineu Prestes 2227, 05508-000 São Paulo, SP, Brazil.

50. Int Endod J. 2007 Feb;40(2):112-9. Bactericidal efficacy of Er,Cr:YSGG laser irradiation against Enterococcus faecalis compared with NaOCl irrigation: an ex vivo pilot study. Eldeniz AUOzer FHadimli HHErganis O. Department of Endodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey. aunverdi@selcuk.edu.tr