Long-term clinical evaluation of endodontically treated teeth by 15 F CO₂ laser microprobe, three years clinical follow-up of 1512 root-canals-in vivo study

The purpose of this study was to determine the efficiency of 15 F CO₂ laser microprobe in cases of periapical lesions, by eliminating the pathological reaction caused by certain species of bacteria, reduction of reinfection and stimulation of osteogenesis in the periapical region. Till now, no suitable delivery fiber existed for CO₂ laser endodontic radiation in the apical region where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, Sharplan lasers designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal, thus favorably increasing the thermal effects. The study was conducted on 900 teeth (corresponds to 1512 root canals), divided in two groups. 468 were new cases, carefully selected according to strict parameters such as: wide periapical translucency over 1mm, supported by digital X-ray, with a lesion of 3mm and more. All root canals were mechanically prepared in the conventional method up to size 35, Physiological saline solution served as rinsing solution and were treated by 15 F CO₂ laser microprobe for 60 pulses repeatedly. The temperature at the surrounding tissue of the root did not exceed 38°C filling of the canal was possible at the same appointment, without antibiotical treatment. 432 of the cases, which were referred to us by other dentists, after an unsuccessful treatment according to the classical therapy, were treated by the same laser therapy. Follow up was performed by clinical examination, and digital X-ray taken, during and after treatment as well as after 3, 6, 9, 12, month. The results demonstrate 98% success rate in both study groups, according to objective criteria for a successful treatment such as: reduction of apical translucency after 2-6 month, freedom from clinical complains, and no need for periapical surgery.