ENDODONTICS AND THERMOVISION-TEMPERATURE CHANGES DURING PHOTO-ACTIVATED DISINFECTION IN ROOT CANALS. THERMOVISION DIAGNOSIS IN ENDODONTIC TREATMENT.

Abstract

Introduction: The application of thermovision in endodontics is an innovative method and has a great informative value, evidence proved, thanks to the use of last generation camera Flir A310 and software ThermaCam Reporter 8.3 Pro. In the recent years a new method of root canal disinfection is introduced - photo-activated disinfection (PAD). Temperature increase have always been a concern during dental laser treatment. Aim: The purpose of our study is to evaluate the temperature elevation on the outer root surface at extracted teeth and in periapical tissues when photodynamic therapy with 630-nm diode laser is used for root canal disinfection. Materials and methods: For the laboratory study we used 72 single-rooted freshly extracted human teeth. They were divided into six groups depending on the power of the light source (220 mW, 360 mW and 500 mW) and the type of photosensitizer agent - Fotosan and Zn-phtalocianine. In our clinical study participated 8 patients, who came in to our clinic with complaints of spontaneous pain or were with infected root canals and were referred for endodontic treatment. PAD was performed with a diode laser with wavelength of 630 nm using an endodontic handpiece with fiberoptic connector, allowing penetration to 4 mm from the apical stop, and movements of fibreoptic (200 μm) in apicalcoronal direction. Results: The highest temperature value was detected at 500 mW and 360 mW. The average temperature increase recorded in our study at the external surface of the root canal did not exceed 10oC only at power setting of 220 mW during PAD with Zn-phtalocianine. Conclusion: In conclusion, photo-activated disinfection of the root canal with Zn-phtalocianine and 630-nm diode laser using 200 μm fibreoptic tips at a power setting of 220 mW for 60 seconds induces a temperature increase which isn't sufficient to damage the neighbouring tissues. Based on this results we don't recommend root canal preparation over 02 or 04 taper when PAD will be performed.