Laser root canal

March 15, 2014 | Posted in Endodontics, Laser | Be the first one to comment


A patient presented with discomfort on the lower left side due to pulpitis of tooth 3-5. The tooth had been previously restored with a very large and deep composite restoration. The depth of the decay and trauma associated with removing it caused an irreversibe inflammatory response in the tooth known as pulpitis. This tooth required immediate endodontic treatment to remove the inflammed pulp tissue and resolve the discomfort.

Traditionally, this treatment is completed using chemical irrigation of the canal system to ensure the organic tissue and bacteria have been removed from the system. Some chemicals can be dangerous and difficult to use. Also, there is little guarantee that the chemicals introduced into the space can completely reach the apex of the tooth without passing beyond the tooth into the periapical tissues.

At Basinview Dental Centre, Dr. Luke Haslam does not use chemical irrigation to complete root canal disinfection, but rather uses laser energy applied by the Waterlase iPlus. With this system, root canals are cleaned and shaped using traditional instrumentation (hand and rotary endodontic files; stainless steel and/ or nickel titanium). The irrigatant used is simply distilled water - zero complication if any water passes beyond the tooth apex. Once the canal has been shaped as desired, a special laser tip is inserted into the canal space. Once the canal is shaped properly, this tip can be placed into position to allow laser energy to disinfect the tooth apex. Laser energy is applied in a series of passes throughout the canal system until the desired disinfection is achieved - for some teeth, this may merely take 30 seconds!

There is no discomfort or chemical smell. The laser will remove organic debris and bacteria 1000um laterally from the main canal.  This means far greater penetration of disinfection than chemical systems into lateral canals, fins, isthmuses and apical deltas. These areas are a common cause of root canal failure - the chemical disinfection simply can not remove was it can not touch.

The root canal completed for this patient clearly shows a complex apical delta - there are at least 5 openings at the apex of this tooth. The laser disinfection allowed for these areas to be easily cleansed prior to obturation which allowed the gutta percha filling to flow into these areas. This will greatly improve the patient's chance of success with this treatment. 

The patient noted no post-operative discomfort and has been symptom free since the treatment was completed 4 months ago. The patient has scheduled to have a full coverage crown placed on this tooth to complete the treatment for this tooth.


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