Postoperative pain and antibacterial effect of 980 nm diode laser versus conventional endodontic treatment in necrotic teeth with chronic periapical lesions: A randomized control trial

Dina A Morsy, Maged Negm, Alaa Diab, Geraldine Ahmed, Dina A Morsy, Maged Negm, Alaa Diab, Geraldine Ahmed

Abstract

Background: Many challenges encounter the endodontist, especially when dealing with necrotic teeth with chronic periapical lesions. Postoperative pain may be induced following conventional endodontic therapy and total eradication of the bacteria is almost unachievable even with recently available techniques. In recent years, diode laser usage in the endodontic field has gained acceptance. Thus, this study aimed to investigate the ability of the diode laser (DL) to decrease postoperative pain and achieve root canal sterility. Methods: 56 patients with anterior teeth with chronic periapical lesions in upper anterior teeth were randomly divided into two groups (n = 28). All patients were treated with two visits of conventional root canal treatment with ProTaper Universal. The DL group: root canals were irradiated with 200 µm fiber optic at both visits; the control group (Endo): the DL fiber was placed in root canal with no activation. Bacterial samples were collected from all the cases at each step of the treatment. Pain levels were evaluated using a numerical rating scale preoperatively, and after 6, 12, 24, 48 hours and 7 days. Bacterial count was used to detect both aerobic and anaerobic bacterial load. Results: The qualitative pain scores revealed statistically significant lower pain levels in the DL group compared with the Endo group at all time intervals (P<0.001), except preoperatively where there was no significant difference. There was a statistically significant lower bacterial count for both aerobic and anaerobic bacteria in the DL group compared with the Endo group in both S3 samples (after laser application) and S4 samples (bacterial colonization) (P<0.001). Conclusion: The 980 nm diode laser may be a successful adjunct to conventional endodontic treatment of necrotic cases with chronic periapical lesions in terms of postoperative pain and root canal disinfection. Trail registration: PACTR201511001275414 (date: 23 rd September 2015).

Keywords: Diode laser; endodontic; intracanal irradiation; necrotic pulp; periapical lesion.

Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.. Intracanal application of diode laser.
Figure 1.. Intracanal application of diode laser.
Figure 2.. Column chart showing qualitative score…
Figure 2.. Column chart showing qualitative score of pain in patients enrolled in both groups.
Means with different small letters in the same column indicate statistically significance difference, means with different capital letters in the same row indicate statistically significance difference. *; significant (p0.05).
Figure 3.
Figure 3.
Line chart showing bacterial count (a) aerobic and (b) anaerobic. Means with different small letters in the same column indicate statistically significance difference, means with different capital letters in the same row indicate statistically significance difference. *; significant (p<0.05), ns; non-significant (p>0.05).

References

    1. Asnaashari M, Asnaashari N: Clinical application of 810nm diode laser and low-level laser therapy for treating an endodontic problem: A case presentation. Lasers Med Sci. 2011;2:82–86. 10.22037/2010.v2i2.2288
    1. Bonsor SJ, Nichol R, Reid TM, et al. : Microbiological evaluation of photo-activated disinfection in endodontics (an in vivo study). Br Dent J. 2006;200(6):337–41, discussion 329. 10.1038/sj.bdj.4813371
    1. Moritz A, Gutknecht N, Goharkhay K, et al. : In vitro irradiation of infected root canals with a diode laser: results of microbiologic, infrared spectrometric, and stain penetration examinations. Quintessence Int. 1997;28(3):205–9.
    1. Gutknecht N, Franzen R, Schippers M, et al. : Bactericidal effect of a 980-nm diode laser in the root canal wall dentin of bovine teeth. J Clin Laser Med Surg. 2004;22(1):9–13. 10.1089/104454704773660912
    1. Beer F, Buchmair A, Wernisch J, et al. : Comparison of two diode lasers on bactericidity in root canals--an in vitro study. Lasers Med Sci. 2012;27(2):361–4. 10.1007/s10103-011-0884-3
    1. Koba K, Kimura Y, Matsumoto K, et al. : Post-operative symptoms and healing after endodontic treatment of infected teeth using pulsed Nd:YAG laser. Endod Dent Traumatol. 1999;15(2):68–72. 10.1111/j.1600-9657.1999.tb00756.x
    1. Pirnat S: Versatility of an 810-nm diode laser in dentistry: An overview. Journal of the Laser and Health Academy. 2007;4:1–9.
    1. Maturo P, Perugia C, Docimo R: Versatility of an 810 Nm Diode laser in pediatric dentistry. International Journal of Clinical Dentistry. 2013;6:161–72.
    1. Gutknecht N: Lasers in endodontics. Journal of the Laser and Health Academy. 2008;4:1–5.
    1. Gutknecht N, Franzen R, Meister J, et al. : Temperature evolution on human teeth root surface after diode laser assisted endodontic treatment. Lasers Med Sci. 2005;20(2):99–103. 10.1007/s10103-005-0347-9
    1. Silva Garcez A, Núñez SC, Lage-Marques JL, et al. : Efficiency of NaOCl and laser-assisted photosensitization on the reduction of Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(4):e93–8. 10.1016/j.tripleo.2006.02.015
    1. Goharkhay K, Moritz A, Wilder-Smith P, et al. : Effects on oral soft tissue produced by a diode laser in vitro. Lasers Surg Med. 1999;25(5):401–6. 10.1002/(SICI)1096-9101(1999)25:5<401::AID-LSM6>;2-U
    1. Jamison RN, Gracely RH, Raymond SA, et al. : Comparative study of electronic vs. paper VAS ratings: a randomized, crossover trial using healthy volunteers. Pain. 2002;99(1–2):341–7. 10.1016/S0304-3959(02)00178-1
    1. Amelia W, Barbara H: Pain: A review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005;14(7):789–804. 10.1111/j.1365-2702.2005.01121.x
    1. Berk G, Ulucam U, Berk N: Clinical healing process and symptoms of two cases of chronic periapical lesions treated with Er, Cr:YSGG laser. Journal of Oral Laser Application. 2004;4:211–5.
    1. Pawar S, Pujar M, Makandar S, et al. : Postendodontic treatment pain management with low-level laser therapy. Journal of Dental Lasers. 2014;8(2):60–3.
    1. Tuner J, Hode L: The laser therapy handbook, Sweden, Prima Book AB.2007.
    1. Bjordal JM, Johnson MI, Iversen V, et al. : Low-level laser therapy in acute pain: A systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomedicine and Laser Surgery. 2006;24(2):158–68. 10.1089/pho.2006.24.158
    1. Stashenko P: Role of immune cytokines in the pathogenesis of periapical lesions. Endod Dent Traumatol. 1990;6(3):89–96. 10.1111/j.1600-9657.1990.tb00400.x
    1. Garcez AS, Nuñez SC, Hamblin MR, et al. : Antimicrobial effects of photodynamic therapy on patients with necrotic pulps and periapical lesion. J Endod. 2008;34(2):138–42. 10.1016/j.joen.2007.10.020
    1. Sjögren U, Figdor D, Perssom S, et al. : Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997;30(5):297–306. 10.1046/j.1365-2591.1997.00092.x
    1. Waltimo T, Trope M, Haapasalo M, et al. : Clinical efficacy of treatment procedures in endodontic infection control and one year follow-up of periapical healing. J Endod. 2005;31(12):863–6. 10.1097/01.don.0000164856.27920.85
    1. Vaarkamp J, Bosch JJ, Verdonschot EH: Propagation of light through human dental enamel and dentine. Caries Res. 1995;29(1):8–13. 10.1159/000262033
    1. Odor TM, Watson TF, Pitt Ford TR, et al. : Pattern of transmission of laser light in teeth. Int Endod J. 1996;29(4):228–34. 10.1111/j.1365-2591.1996.tb01374.x
    1. Ahmeduddin M, Nagesh B, Reddy KN, et al. : An assessment of bactericidal effect of two different types of lasers on enterococcus faecalis: An in vitro study. Journal of Dental Lasers. 2012;6(1):2–6. 10.4103/0976-2868.100975
    1. Preethee T, Kandaswamy D, Arathi G, et al. : Bactericidal effect of the 908 nm diode laser on Enterococcus faecalis in infected root canals. J Conserv Dent. 2012;15(1):46–50. 10.4103/0972-0707.92606
    1. Morsy DA, Negm M, Diab A, et al. : Dataset 1 in: Postoperative pain and antibacterial effect of 980 nm diode laser versus conventional endodontic treatment in necrotic teeth with chronic periapical lesions: A randomized control trial. F1000Research. 2018. 10.5256/f1000research.16794.d224351
    1. : Effect of Root Canal Disinfection with a Diode Laser on Postoperative Pain After Endodontic Retreatment. Photobiomodul Photomed Laser Surg.2019;37(2) : 10.1089/photob.2018.4539 85-90 10.1089/photob.2018.4539

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