Performance assessment of novel side firing safe tips for endodontic applications

During root canal or periodontal treatment, directing laser energy onto the walls of the root canal is essential for effective disinfection. This study assessed the performance of four different fiber modifications that have increased lateral emission, including three designs with safe tips to reduce irradiation directed toward the root apex. Free-running pulsed infrared lasers (Nd:YAG, Er:YAG, and Er,Cr:YSGG) and a diode laser (980 nm) were used in combination with plain ended (forward emitting) laser fibers; conical laser fibers, side firing honeycomb pattern fibers without a safe end; honeycomb fibers with silver coated ends, conical fibers with selectively abraded tips, and selectively abraded honeycomb fibers with silver coated tips (20 fibers for each laser type). Laser emissions forward and laterally were measured, and digital photographs and thermally sensitive paper used to record the emission profiles. Thermochromic dyes painted onto the root surface of an extracted tooth were used to explore the distribution of laser energy with different tips designs. All three safe tipped ends gave reduced emissions in the forward direction (range 17-59%), but had similar lateral emission characteristics. Fiber designs with reduced forward emission may be useful for various dental laser procedures.