(TC26) The Use of Erbium Lasers for “Coronal Conditioning” in Endodontics

The use of erbium lasers for “Coronal Conditioning” in Endodontics
Dr. Thomas Maher
The use of erbium lasers in endodontics, for ‘Laser Assisted Irrigation’ (LAI) has gained in popularity over the past several years because of the beneficial effects of cavitation, shock waves, shear forces and acoustic streaming created by that wavelength. These lasers have also been found to be effective for ablating soft and hard tissues, opening dentinal tubules, disrupting biofilm and removing the smear layer, more efficiently than syringe and needle irrigation and passive ultrasonic activation.
Clinically, we employ the erbium laser once the access preparation is completed and before any endodontic instrument is taken into the canals. This step is called “Coronal Conditioning” or “Access Debridement”, and the disruption and removal of pulp tissue and some pulp stones are observed in this phase of top-down debridement. Isthmuses on the floor of the pulp chamber are cleared, all while allowing for better visibility of canal orifices, including calcified ones. Additionally, we have also observed that this step facilitates canal negotiation due to the disruption of tissue in the coronal portion of the canals.
The purpose of this table clinic is to demonstrate the benefits of “Coronal Conditioning” by presenting intraoperative photos before and after the access debridement process.