Resident Albert Einstein Medical Center Philadelphia, Pennsylvania, United States
The use of lasers in endodontics has exploded in popularity over the last few years. Laser energy is a dynamic addition to our armamentarium with applications that range from intracanal cleaning, biofilm disruption, disinfection, and smear layer removal to soft and hard tissue ablation and endodontic surgery. It enhances our irrigation protocols, simplifies the root canal process, and allows us to practice more conservative endodontics with the ultimate goal of preserving our patients’ natural dentition. A benefit of lasers over alternative advanced irrigation devices is the ability to modify settings for different applications. This has led to a great deal of variation in protocols amongst clinicians but also some confusion. The most common protocols include an initial “coronal conditioning” step that involves activation of water or sodium hypochlorite in the chamber prior to instrumentation. This step has often been considered optional. This table clinic presentation proposes that coronal conditioning is no longer considered an optional step in the laser assisted endodontic protocol. It is a powerful initial step in the process that can make the rest of the procedure easier and more predictable. We have observed the following benefits after this step: enhanced color map visualization, removal of chamber calcifications, removal of vital and necrotic tissues, and subsequent ease of achieving apical patency. This table clinic will present coronal conditioning protocols with appropriate settings for each of the most popular lasers currently being used in endodontics. Clinical examples and the best available evidence will be highlighted.
