Histopathological and Clinical Examination of an Immediate Canal Filling after Vital Pulp Extirpation in Combination with the Pulsed Nd: YAG Laser
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概要
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The purpose of this study was to evaluate histopathologically and clinically, the effects of the pulsed Nd: YAG laser irradiation on the apical seat of root canals after vital pulp extirpation, using dogs and human teeth. First of all, the histopathological examina tion was conducted to estimate the clinical effects and safety of laser irradiation. 192 vital teeth of 18 dogs were instrumented up to #40 by the conventional method and divided into lased and control groups. In the lased group, the fiber of pulsed Nd: YAG laser (d-Lase 3 0 0; American Dental Laser Co., USA) was introduced to the apical seat and the laser was ir radiated under the condition of 1, 2 and 3W, 15 and 20PPS and 0.5, 1, 2, 3 and 4sec. Then, the access cavity of both groups was sealed with guttapercha and amalgam. Histopathological study of the two groups was carried out after 1, 2 and 4 weeks. The following results were obtained;<BR>1. Debris in the apical seat could be removed depending on the condition of the laser irra diation.<BR>2. Irradiation of higher energy output in case of 2 W-2 sec and 3 W-2 sec often produced carbonized dentin and periapical chronic inflammation including root resorption.<BR>3. Irradiation under the condition of 1 W-2 sec, 2 W-1 sec and 3 W-0.5 sec was acceptable to the apical seat and periapical tissues.<BR>Sixty human pulp extirpated teeth were divided into lased and control groups and immedi ately root canal filling were carried out. Under the consideration of the safety to the perio dontal ligament, the condition of lased group in the clinical study was determined as 1 W (1 5 PPS)-1 sec irradiation at the apical seat. Clinical examination up to 3 weeks revealed that significant reduction of post-treatment discomfort or pain in lased group was comfirmed with the 5% level according to the Chi-Square analysis. Irradiation under the condition of 1 W-1 sec at the apical seat was safe and useful in case of an immediate canal filling after vital pulp extirpation. The mechanism of laser effects was considered hemostasis and removal debris and remunant pulp at the lased potion.
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