Theoretical simulations of temperature elevations in root dentin are performed to evaluate, how heating protocols affect the efficacy of using erbium, chromium; yttrium, scandium, gallium, garnet (Er,Cr;YSGG) pulsed lasers for bacterial disinfection during root canal treatments. The theoretical models are generated based on microcomputer tomography (microCT) scans of extracted human teeth. Heat transfer simulations are performed using the Pennes bioheat equation to determine temperature distributions in tooth roots and surrounding tissue during 500 mW pulsed Er,Cr;YSGG laser irradiation on the root canal for eradicating bacteria. The study not only determines the heat penetration within the deep dentin but also assesses potential thermal damage to the surrounding tissues. Thermal damage is assumed to occur when the tissue is subject to a temperature above at least 47 °C for a minimum duration of 10 s. Treatment protocols are identified for three representative tooth root sizes that are capable of maintaining elevated temperatures in deep dentin necessary to eradicate bacteria, while minimizing potential for collateral thermal tissue damage at the outer root surfaces. We believe that the study not only provides realistic laser heating protocols for various tooth root geometries but also demonstrates utility of theoretical simulations for designing individualized treatments in the future.
Issue Section:
Research Papers
Topics:
Biological tissues,
Canals,
Design,
Elevations (Drawings),
Heat transfer,
Heating,
Lasers,
Modeling,
Simulation,
Temperature,
Heat,
Imaging,
Human teeth,
Bacteria,
Damage
References
1.
American Dental Association Survey Center, 2007, “
Survey of Dental Services Rendered for Years 2005–2006
,” American Dental Association, Chicago.2.
Card
, S. J.
, Sigurdsson
, A.
, Orstavik
, D.
, and Trope
, M.
, 2002, “The Effectiveness of Increased Apical Enlargement in Reducing Intracanal Bacteria
,” J. Endod.
, 28
, pp. 779
–783
.3.
Jha
, D.
, Guerrero
, A.
, Ngo
, T.
, Helfer
, A.
, and Hasselgren
, G.
, 2006, “Inability of Laser and Rotary Instrumentation to Eliminate Root Canal Infection
,” J. Am. Dent. Assoc.
, 137
, pp. 67
–70
.4.
Perez
, F.
, Rochd
, T.
, Lodter
, J. P.
, Calas
, P.
, and Michel
, G.
, 2000, “In Vitro Study of the Penetration of Three Bacterial Strains Into Root Dentine
,” Oral Surg., Oral Med., Oral Pathol.
, 76
(1
), pp. 97
–103
.5.
Sjogren
, U.
, Figdor
, D.
, Persson
, S.
, and Sundqvist
, G.
, 1997, “Influence of Infection at the Time of Root Filling on the Outcome of Endodontic Treatment of Teeth With Apical Periodontitis
,” Int. Endod. J.
, 30
, pp. 297
–306
.6.
Alley
, B.
, Kitchens
, G.
, Alley
, L.
, and Eleazer
, P.
, 2004, “A Comparison of Survival of Teeth Following Endodontic Treatment Performed by General Dentists or by Specialists
,” Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.
98
(1
), pp. 327
–332
.7.
Blicher
, B.
, Baker
, D.
, and Lin
, J.
, 2008, “Endosseous Implants Versus Nonsurgical Root Canal Therapy: A Systematic Review of the Literature
,” Gen. Dent.
, 56
(6
), pp. 576
–580
.8.
De Chevigny
, C.
, Dao
, T. T.
, Basrani
, B. R.
, Marquis
, V.
, Farzaneh
, M.
, Abitbol
, S.
, and Friedman
, S.
, 2008, “Treatment Outcome in Endodontics: The Toronto Study—Phase 4: Initial Treatment
,” J. Endod.
, 34
(3
), pp. 258
–263
.9.
Ng
, Y. L.
, Mann
, V.
, and Gulabivala
, K.
, 2011, “A Prospective Study of the Factors Affecting Outcomes of Nonsurgical Root Canal Treatment: Part 1: Periapical Health
,” Int. Endod. J.
, 44
(7
), pp. 583
–609
.10.
Penesis
, V. A.
, Fitzgerald
, P. I.
, Fayad
, M. I.
, Wenckus
, C. S.
, BeGole
, E. A.
, and Johnson
, B. R.
, 2008, “Outcome of One-Visit and Two-Visit Endodontic Treatment of Necrotic Teeth With Apical Periodontitis: A Randomized Controlled Trial With One-Year Evaluation
,” J. Endod.
, 34
(3
), pp. 251
–257
.11.
Shovelton
, D. H.
, 1964, “The Presence and Distribution of Micro-Organisms Within Non-Vital Teeth
,” Br. Dent. J.
, 117
, pp. 101
–107
.12.
Siqueira
, J. F.
, Jr., De Uzeda
, M.
, and Fonseca
, M. E.
, 1996, “A Scanning Electron Microscopic Evaluation of In Vitro Dentinal Tubules Penetration by Selected Anaerobic Bacteria
,” J. Endod.
, 22
, pp. 308
–310
.13.
Drake
, D. R.
, Wiemann
, A. H.
, Rivera
, E. M.
, and Walton
, R. E.
, 1994, “Bacterial Retention in Canal Walls In Vitro: Effect of Smear Layer
,” J. Endod.
, 20
, pp. 78
–82
.14.
Haapasalo
, M.
, and Orstavik
, D.
, 1987, “In Vitro Infection and Disinfection of Dentinal Tubules
,” J. Dent. Res.
, 66
(8
), pp. 1375
–1379
.15.
Love
, R. M.
, “Enterococcus Faecalis—A Mechanism for Its Role in Endodontic Failure
,” Int. Endod. J.
, 34
, pp. 399
–405
.16.
Ng
, Y.
, Mann
, V.
, Rahbaran
, S.
, Lewsey
, J.
, and Gulabivala
, K.
, 2007, “Outcome of Primary Root Canal Treatment: A Systematic Review of the Literature—Part 1. Effects of Study Characteristics on Probability of Success
,” Int. Endod. J.
, 40
, pp. 921
–939
.17.
Ng
, Y.
, Mann
, V.
, and Gulabivala
, K.
, 2008, “Outcome of Secondary Root Canal Treatment: A Systematic Review of the Literature
,” Int. Endod. J.
, 41
, pp. 1026
–1046
.18.
Fahey
, M.
, Onyejekwe
, O.
, Mason
, H. L.
, and Mitra
, K.
, 2008, “Precise Dental Ablation Using Ultra-Short-Pulsed 1552 nm Laser
,” Int. J. Heat Mass Transfer
, 51
, pp. 5732
–5739
.19.
Gordon
, W.
, Atabakhsh
, V. A.
, Meza
, F.
, Doms
, A.
, Nissan
, R.
, Rizoiu
, I.
, and Stevens
, R. H.
, 2007, “The Antimicrobial Efficacy of the Erbium, Chromium, Yttrium-Scandium-Gallium-Garnet Laser With Radial Emitting Tips on Root Canal Dentin Walls Infected With Enterococcus Faecalis
,” J. Am. Dent. Assoc.
, 138
(7
), pp. 992
–1002
.20.
Moritz
, A.
, Jakolitsch
, S.
, Goharkhay
, K.
, and Schoop
, U.
, 2000, “Morphologic Changes Correlating to Different Sensitivities of Escherichia Coli and Enterococcus Faecalis to Nd:YAG Laser Irradiation Through Dentin
,” Lasers Surg. Med.
, 26
, pp. 250
–261
.21.
Ishizaki
, N.
, Matsumoto
, K.
, Kimura
, Y.
, Wang
, X.
, Kinoshita
, J.
, Okano
, S.
, and Jayawardena
, J.
, 2004, “Thermographical and Morphological Studies of Er,Cr:YSGG Laser Irradiation on Root Canal Walls
,” Photomed. Laser Surg.
, 22
(4
), pp. 291
–297
.22.
Matsuoka
, E.
, Jayawardena
, J. A.
, and Matsumoto
, K.
, 2005, “Morphological Study of the Er,Cr:YSGG Laser for Root Canal Preparation in Mandibular Incisors With Curved Root Canals
,” Photomed. Laser Surg.
, 23
(5
), pp. 480
–484
.23.
Radatti
, D. A.
, Baumgartner
, J. C.
, and Marshall
, J. G.
, 2006, “A Comparison of the Efficacy of Er,Cr:YSGG Laser and Rotary Instrumentation in Root Canal Debridement
,” J. Am. Dent. Assoc.
, 137
(9
), pp. 1261
–1266
.24.
Yamazaki
, R.
, Goya
, C.
, Yu
, D.
, Kimura
, Y.
, and Matsumoto
, K.
, 2001, “Effects of Erbium, Chromium:YSGG Laser Irradiation on Root Canal Walls: A Scanning Electron Microscopic and Thermographic Study
,” J. Endod.
, 27
(1
), pp. 9
–12
.25.
Zhu
, L.
, Tolba
, M.
, Arola
, D.
, Salloum
, M.
, and Meza
, F.
, 2009, “Evaluation of Effectiveness of ER,CR:YSGG Laser for Root Canal Disinfection: Theoretical Simulation of Temperature Elevations in Root Dentin
,” ASME J. Biomech. Eng.
, 131
(7
), p. 071004
.26.
Aoki
, A.
, Mizutani
, K.
, Takasaki
, A. A.
, Sasaki
, K. M.
, Nagai
, S.
, Schwarz
, F.
, Yoshida
, I.
, Eguro
, T.
, Zeredo
, J. L.
, and Izumi
, Y.
, 2008, “Current Status of Clinical Laser Applications in Periodontal Therapy
,” Gen. Dent.
, 56
(7
), pp. 674
–687
.27.
Dederich
, D. N.
, and Bushick
, R. D.
, 2004, “Lasers in Dentistry: Separating Science From Hype
,” J. Am. Dent. Assoc.
, 135
, pp. 204
–212
.28.
Pennes
, H. H.
, 1948, “Analysis of Tissue and Arterial Blood Temperatures in the Resting Human Forearm
,” J. Appl. Physiol.
, 253
, pp. H869
–H873
.29.
Craig
, R. G.
, and Peyton
, F. A.
, 1961, “Thermal Conductivity of Tooth Structure, Dental Cements, and Amalgam
,” J. Dent. Res.
, 40
(3
), pp. 411
–418
.30.
Diao
, C.
, Zhu
, L.
, and Wang
, H.
, 2003, “Cooling and Rewarming for Brain Ischemia or Injury
,” Ann. Biomed. Eng.
, 31
, pp. 346
–353
.31.
Jakubinek
, M. B.
, and Samarasekera
, C.
, 2006, “Elephant Ivory: A Low Thermal Conductivity, High Strength Nanocomposite
,” J. Mater. Res.
, 21
, pp. 287
–292
.32.
Eriksson
, A. R.
, and Albrektsson
, T.
, 1983, “Temperature Threshold Levels for Heat-Induced Bone Tissue Injury: A Vital-Microscopic Study in the Rabbit
,” J. Prosthet. Dent.
, 50
, pp. 101
–107
.33.
Floren
, J. W.
, Weller
, N.
, Pashley
, D. H.
, and Kimbrough
, W. F.
, 1999, “Changes in Root Surface Temperatures With In Vitro Use of the System B HeatSource
,” J. Endod.
, 25
, pp. 593
–595
.34.
Jung
, I. Y.
, Lee
, S. B.
, Kim
, E. S.
, Lee
, C. Y.
, and Lee
, S. J.
, 2003, “Effect of Different Temperatures and Penetration Depth of a System B Plugger in the Filling of Artificially Created Oval Canals
,” Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.
, 96
, pp. 453
–457
.35.
Lipski
, M.
, 2005, “Root Surface Temperature Rises During Root Canal Obturation, In Vitro, by the Continuous Wave of Condensation Technique Using System B HeatSource
,” Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.
, 99
, pp. 505
–510
.36.
Lipski
, M.
, 2006, “In Vitro Infrared Thermographic Assessment of Root Surface Temperatures Generated by High-Temperature Thermoplasticized Injectable Gutta-Percha Obturation Technique
,” J. Endod.
, 32
, pp. 438
–441
.37.
Lipski
, M.
, and Wozniak
, K.
, 2003, “In Vitro Infrared Thermographic Assessment of Root Temperature Rises During Thermafil Retreatment Using System B
,” J. Endod.
, 29
, pp. 413
–415
.38.
Romero
, A. D.
, Green
, D. B.
, and Wucherpfennig
, A. L.
, 2000, “Heat Transfer to the Periodontal Ligament During Root Obturation Procedures Using an In Vitro Model
,” J. Endod.
, 26
(2
), pp. 85
–87
.39.
Sweatman
, T. L.
, Baumgartner
, J. C.
, and Sakaguchi
, R. L.
, 2001, “Radicular Temperatures Associated With Thermoplasticized Gutta-Percha
,” J. Endod.
, 27
(8
), pp. 512
–515
.40.
Villegas
, J. C.
, Yoshioka
, T.
, Kobayashi
, C.
, and Suda
, H.
, 2005, “Intracanal Temperature Rise Evaluation During the Usage of the System B: Replication of Intracanal Anatomy
,” Int. Endod. J.
, 38
, pp. 218
–222
.41.
Moritz
, A. R.
, and Henriques
, F. C.
, 1947, “The Relative Importance of Time and Surface Temperature in the Causation of Cutaneous Burns
,” Am. J. Pathol.
, 23
, pp. 695
–720
.42.
Kakoli
, P.
, Nandakumar
, R.
, Romberg
, E.
, Arola
, D.
, and Fouad
, A. F.
, 2009, “The Effect of Age on Bacterial Penetration of Radicular Dentin
,” J. Endod.
, 35
(1
), pp. 78
–81
.43.
Arola
, D.
, 2007, “Fracture and Aging in Dentin
,” Dental Biomaterials: Imaging, Testing and Modeling
, R.
Curtis
and T.
Watson
, eds., Woodhead Publishing
, Cambridge, UK
.44.
Abraham
, J.
, and Sparrow
, E.
, 2007, “A Thermal Ablation Model Including Liquid-to-Vapor Phase Change, Necrosis-Dependent Perfusion, and Moisture-Dependent Properties
,” Int. J. Heat Mass Transfer
, 50
, pp. 2537
–2544
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