:sharpen(level=0):output(format=png)/up/dt/2024/07/Utilising-R-SWEEPS-laser-assisted-irrigation-Fig-1.png "Laser Irrigation for power periapical periodontitis")
Teeth #46 used to be mushy to percussion, non-tender to palpation and had no reaction to the electrical pulp check and chilly check. Research of the dental panoramic tomogram confirmed a big mesio-occlusal amalgam recovery with recurrent caries, attaining just about the mesial pulp horn of the teeth (Fig. 1). Two roots may well be noticed and no visual root resorption. Slight periodontal ligament widening used to be obvious and a periapical lesion. She used to be recognized with irreversible pulpitis of teeth #46 and persistent periapical periodontitis.
We determined to make use of laser-assisted irrigation with a 2,940 nm Er:YAG laser and Fotona R-SWEEPS (resonant surprise wave-enhanced emission photoacoustic streaming) mode at settings appropriate for treating a mandibular molar. Within the first consultation, 4% articaine hydrochloride with 1:100,000 adrenaline (citocartin, Molteni Dental) used to be Administered to anaesthetise the world. The affected person used to be correctly draped with a water resistant robe to offer protection to her clothes. The teeth used to be remoted with a dental dam. The outdated amalgam and carious tissue had been got rid of, an get admission to hollow space used to be ready and the basis canal used to be negotiated to the apex with a #8 hand Okay-file. There used to be no spontaneous bleeding upon opening of the pulp chamber, and there used to be necrotic tissue provide. Therefore, the verdict used to be made to finish the basis canal remedy in two classes.
A complete of 4 canals had been known (Fig. 2). The remedy began with steady supply of sodium hypochlorite (NaClO) answer (3 ml) by means of syringe and simultaneous activation by means of Er:YAG laser. Laser-assisted irrigation used to be carried out with a LightWalker AT-S (Fotona) and an Er:YAG H14 handpiece with a flat SWEEPS 400/9 fibre tip located safely on the front to the pulp orifice (Desk 1). For the shaping of the basis canal machine, the ProTaper Gold rotary dossier machine (Dentsply Sirona) used to be used. Minimally invasive root canal preparation started with the nineteen/0.04 SX dossier to relocate the coronal facet of the canals. Cleansing and shaping of the canals had been due to this fact carried out with the 18/0.02 S1 dossier and 20/0.07 F1 dossier to the running period.
| Parameter | Price |
| Power (mJ) | 10 |
| Energy (W) | 0.3 |
| Frequency (Hz) | 15 |
| Water | 0 |
| Air | 0 |
The R-SWEEPS ultimate irrigation protocol used to be carried out on the finish of instrumentation and consisted of 2 cycles of 17% EDTA activated by means of R-SWEEPS for 30 seconds for each and every activation duration with 30 seconds of resting time in between, rinsing with distilled water activated by means of R-SWEEPS for 30 seconds, after which 3 cycles of five% NaClO activated by means of R-SWEEPS for 30 seconds for each and every activation duration and a resting time of a minimum of 30 seconds in between. After drying the canals (Fig. 3), Odontopaste (Australian Dental Production), a zinc oxide-based root canal paste with 5% clindamycin hydrochloride and 1% triamcinolone acetonide, used to be positioned, adopted by means of a short lived filling (Fig. 4).
Fig. 6: Ultimate recovery in situ.
There used to be no ache or discomfort all over or after the medical remedy, and thus the affected person didn’t want to take any drugs to alleviate the ache. Two weeks later at the second one appointment, the Odontopaste used to be washed out with one 30-second EDTA cycle, adopted by means of rinsing the canal with distilled water and 3 cycles of 30-second R-SWEEPS irrigation with 5% NaClO. The overall obturation used to be carried out with iRoot SP bioceramic sealant (Cutting edge BioCeramix) and thermoplastic gutta-percha Thermafil (Dentsply Sirona).
The 3-month follow-up confirmed wholesome periapical bone construction and no medical signs (Fig. 5). The teeth have been restored the use of a whole monolithic zirconia crown (Fig. 6). The gingiva used to be utterly wholesome and had a regular pocket probing intensity.
Conclusion
R-SWEEPS laser-assisted irrigation helps minimally invasive endodontics and awesome decontamination, enabling a paradigm shift within the apply of endodontics. R-SWEEPS is also utilised to extend the efficacy of laser-assisted root canal remedy.