Endodontic Resident Albert Einstein Medical Center Lansdale, Pennsylvania, United States
Surgical intervention has proven to be highly effective when root canal therapy results in persistent post-treatment disease and retreatment appears to be challenging or impractical. Rotary burs have traditionally been used in osteotomy preparation and mechanical curettage used to remove granulation tissues. However, precision with rotary burs and maintaining visualization from excessively hemorrhaging granulation tissues are some of the challenges facing clinicians during osteotomy preparations. The available Er, Cr:YSGG, and Er:YAG lasers emit energy at the mid-infrared spectrum, and the emission is absorbed effectively by hard and soft tissue that contain water, resulting in minimal thermal damage to adjacent tissues. The development of these solid-state erbium lasers as a surgical tool may allow clinicians to more precisely and conservatively ablate bone, improve hemostasis by ablating granulation tissue, disinfect the root end, and reduce risk of causing trauma to adjacent tissues. The purpose of this table clinic is to review the indications, advantages, and procedural steps for laser-assisted osteotomy in endodontic microsurgery. With the knowledge of this approach clinicians will be able to better understand laser assisted procedures, maintain conservative osteotomies, and prepare for root end resections with optimal hemostasis.
