Removal of fractured endodontic instruments using an Nd:YAG laser.

Cvikl, Barbara; Klimscha, Johannes; Holly, Matthias; Zeitlinger, Markus; Gruber, Reinhard; Moritz, Andreas (2014). Removal of fractured endodontic instruments using an Nd:YAG laser. Quintessence international, 45(7), pp. 569-575. Quintessenz Verlags-GmbH 10.3290/j.qi.a31961

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OBJECTIVE Fractured endodontic instruments inhibit optimal cleaning and filling of dental root canals, which may result in a less favorable prognosis for the tooth. Several techniques are available to remove fractured instruments; however, healthy tooth substance often must be destroyed in the process. This study was intended to evaluate Nd:YAG laser treatment as a method to remove fractured stainless steel instruments without destroying healthy tooth substance. METHOD AND MATERIALS Stainless steel endodontic instruments were fractured in 33 unprocessed root canals of mandibular central and lateral incisors and premolars in vitro. A brass tube charged with solder was placed at the coronal end of the fractured instrument and laser energy was used to melt the solder, connecting the fractured instrument with the brass tube. The success rates of connecting and removal of fractured instruments from the root channel were recorded for each case. RESULTS Connecting was achieved in every case in which more than 1.5 mm of the fractured instrument was tangible (22 out of 22). In cases where less than 1.5 mm was tangible, the rate for successful connection decreased to 4 out of 11 (36.4%). Fractured endodontic instruments were removed successfully in 17 out of 22 cases (77.3%) in which more than 1.5 mm was tangible. If less than 1.5 mm was tangible, the removal success rate decreased to 3 out of 11 cases (27.3%). CONCLUSION Our data support Nd:YAG laser-mediated connecting of a brass tube to a fractured endodontic instrument as a feasible and tissue conserving removal approach when more than 1.5 mm of the instrument is tangible.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > School of Dental Medicine, Restorative Dentistry, Research

UniBE Contributor:

Cvikl, Barbara and Gruber, Reinhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0033-6572

Publisher:

Quintessenz Verlags-GmbH

Language:

English

Submitter:

Eveline Carmen Schuler

Date Deposited:

27 Jan 2015 17:06

Last Modified:

25 Jan 2017 12:15

Publisher DOI:

10.3290/j.qi.a31961

PubMed ID:

24847495

Uncontrolled Keywords:

endodontics, fractured instrument, instrument removal, laser

URI:

https://boris.unibe.ch/id/eprint/61510

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