Antibacterial effects of pulsed Nd:YAG laser radiation at different energy settings in root canals

The in vitro study aimed at the determination of the bacterial reduction in root canals used pulsed Nd:YAG laser radiation without a photosensitizing dye. In addition the temperature change in the root canals was determined during laser irradiation. The study sample was 114 root canals of extracted single-rooted human teeth that have been enlarged mechanically, sterilized, and randomly assigned to two experimental units. The source of radiation was a Nd:YAG laser device emitting pulsed infrared radiation at a wavelength of 1.064 microm, a pulse duration of 100 micros, and a pulse repetition rate of 20 pps. Samples of each experimental unit were inoculated with Escherichia coli (ATCC 25922) or Staphylococcus aureus (ATCC 25923), respectively, and divided into subgroups of 13 teeth each for irradiation for 20 s at 100 mJ or 200 mJ. One subgroup was left untreated as positive control and one subgroup was rinsed with 0.5 ml of sodium hypochloride. After laser treatment or rinsing with sodium hypochloride the number of bacteria in each root canal was determined using the surface spread plate technique. Statistical analysis of the results was performed with ANOVA and Scheffé test at a level of significance of 5% (p < 0.05). In case of E. coli the number of bacteria was reduced from 8.67 x 10(6) (+/-4.11 x 10(5)) colony-forming units (CFU)/ml to 4.39 x 10(4) (+/-1.72 x 10(4)) CFU/ml after laser radiation at 200 mJ. Regarding S. aureus the number of bacteria decreased from 1.44 x 10(6) (+/-1.59 x 10(5)) CFU/ml to 3.8 x 10(4) (+/-1.06 x 10(4)) CFU/ml at a radiation energy of 200 mJ. Rinsing with sodium hypochloride reduced the number of bacteria to 1.03 x 10(3) (+/-4.02 x 10(2)) CFU/ml regarding E. coli and to 1.84 x 10(3) (+/-7.4 x 10(2)) CFU/ml in case of S. aureus. The temperature increase at 100 mJ was 24.3 degrees C (+/-3.9) and that at 200 mJ was 61.8 degrees C (+/-4.2). The Nd:YAG laser radiation has antimicrobial effects in root canals even in the absence of photosensitizing dyes but also causes considerable temperature increase.