External temperature during KTP-Nd:YAG laser irradiation in root canals: an in vitro study

To avoid the damage of periodontal tissues during laser irradiation of the root canal, the conditions of lasering must be carefully controlled. The aim of this study was to determine the safety parameters of the irradiation conditions during the use of a KTP-Nd:YAG laser in root canals. Root canals of 60 freshly extracted teeth were prepared (step-back technique) and filled with a photosensitiser (Acid Red 52). Different irradiation conditions [output power (P), pulse width (PW), pulse repetition rate (PRR, Hz)] were used. The laser beam was delivered by means of the KTP-Nd:YAG fibre tip with a beam spot-size diameter of 200 microm. The temperature increases were measured on the external apical third of the root surface using a thermocouple. The results showed that the temperature rise was always below 7 degrees C at the following laser settings: (1) single irradiation, P < or = 4 W, PW < or = 2.55 ms and PRR < or = 20 Hz; (2) repetitive irradiation series, five pulses of 1 s each, four resting times of 1 s each, P < or = 2.25 W, PW < or = 2.55 ms and PRR < or = 20 Hz. The use of resting times was necessary so as to avoid thermal cumulative effects. In these in vitro irradiation conditions, the use of the KTP-Nd:YAG laser in endodontics may be considered harmless for periodontal tissues.