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RO0211

Fig. 3_RFT2 (yellow) and RFT3 (blue) laser tips compared to hand files. 14 I I special _ laser _Total elimination of bacteria from infected root-canal systems remains the most important objective of endodontic therapy. However, in spite ofaplethoraofnewproductsandtechniques,achiev- ing this objective continues to elude our profession. Historically, endodontic treatment focused on root- canal disinfection with “entombment” of remaining bacteria within dentinal tubules and inaccessible areas of the root-canal system. Although many factorshavebeenimplicatedintheaetiologyofendo- dontic failures, it has become evident that these “entombed”bacteriaplayapivotalroleinthepersist- ence of endodontic disease.1 Although impressive results have been obtained in vitro, laser energy alone has not been able to achieve total bacterial kill in extracted teeth. From a clinical perspective, it is apparent that a combination of different treatment modalities is required to ster- ilise root-canal systems. In addition, many clinical obstacles exist that further complicate the clinician’s ability to achieve this goal. These include, but are not limited to: restricted endodontic access, complex root-canal anatomy, limitations of irrigation and instrumentationtechniques,inabilitytoentombbac- teria,andtheinabilitytoreachandeliminatebacteria deep within the tooth structure. While the purpose of this article is to focus on the clinical use of the Er,Cr:YSGG laser with radial- firing tips, a definitive treatment protocol needs to be in place to reduce the intra-canal bacterial load prior to laser usage and to facilitate delivery of the Fig. 1_Comparison of different wavelengths used by lasers and their penetration depth in water/tissue. The higher the absorption, the greater the ability of the laser to cut or ablate tissue. Fig. 2_Laser energy is emitted as a broad cone, providing better coverage of root-canal walls. roots2_2011 The clinical use of the Er,Cr:YSGG laser in endodontic therapy Author_ Dr Justin Kolnick, USA Fig. 1 Fig. 2 Fig. 3