The effect of an Nd-YAG pulsed laser on the cleaning of the root canal and the formation of a fused apical plug.

A Neodymium-yttrium aluminium garnet (Nd-YAG) pulsed laser was used in vitro to determine whether various laser energy levels from 0.75 W to 1.7 W at 15 pulses s(-1) (pps) were able to (i) remove debris from the walls of prepared root canals (ii) remove pulpal tissue from unprepared canals and (iii) create a fused apical plug from dentine chips, hydroxyapatite (HAP) or low-fusing dental porcelain. Single-rooted teeth were sectioned at the amelocemental junction and the crowns discarded. The root canals of 50 teeth were prepared chemomechanically and allocated to four groups of 10 teeth for laser treatment. One group was left unlased as a control. After lasing, the teeth were split longitudinally, stained and examined for residual debris. Results showed that there was no statistically significant difference between the groups (P<0.05). A further 20 teeth were not prepared and lased in the coronal one-third of the root canal at different energy levels; five teeth were not lased. The teeth were split and examined as previously. The results showed that lasing cleaned the coronal part of the root canal almost completely of pulpal tissue. In the final part of the study laser energy was applied to dentine chips, HAP and low-fusing porcelain in an attempt to produce a fused apical plug. The laser was unable to melt the dentine chips but some hardening of HAP occurred when combined with blue food-colouring, with or without glycerine, at energy levels of 1.0 W, at 15 pps for 30 s. Superficial hardening of low-fusing porcelain occurred at 1.0 W, 15 pps for 30 s.