PubMed · 9260415
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V T Cammarato. 1997. Endodontic therapy.. https://doi.org/10.14219/jada.archive.1997.0348
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This pilot study examined teeth subjected to extreme heat under laboratory conditions, and the subsequent effect of decalcification and histologic processing. Physical and microscopic findings were evaluated in relation to temperature and duration of thermal insult. Microscopic examination following decalcification and histologic processing revealed changes including severe tissue fragmentation, vapor bubbles within dentinal tubules, altered histologic staining, charring and tissue shrinkage. Dentin appeared to be the most reliable microscopic identifier of incinerated dental tissues. Temperatures above 600 degrees C strongly predicted tooth disintegration following decalcification. This finding has implications in incineration cases where histologic evidence must be maintained and examined intact.
Use of Er:YAG laser has been proposed for the removal of microbial deposits and calculus present on teeth affected by periodontal disease. However, the influence of Er:YAG laser irradiation on root surfaces has not yet been fully investigated. The aim of the present study was to evaluate the effects of Er:YAG laser irradiation on root cementum by scanning electron microscopy (SEM). Specimens were obtained from extracted human periodontally-diseased teeth using a water-cooled high-speed bur. An Er:YAG laser beam was then applied at various powers ranging from 25 to 100 mJ/ pulse/sec. The laser irradiation was performed under water irrigation, with the tip held perpendicular to the root surface in the contact mode. Following laser exposure, specimens were fixed, dehydrated, and dried at critical-point in liquid CO2. After mounting on SEM plates and sputter-coating with gold, the cementum surface was examined by SEM. Observations of the root surface showed a relatively flat surface in control specimens. In Er:YAG exposed specimens, the laser beam created a circular, notched-edge, crater-like defect on the root. The bottom of the lesion showed an irregular and sharp-pointed surface. Subsequently, the specimens were fractured with a sharp scalpel perpendicularly to the surface. SEM observations of these specimens showed a 15 microm layer of damaged tissue within the laser-irradiated cementum. The tissue presented an amorphous appearance and the Sharpey's and matrix fiber bundles were not clearly distinguishable. These observations indicate that cementum tissue could be damaged by Er:YAG laser irradiation.
Scaling and root planing (S&RP) are regarded as the main modalities for treating periodontal disease. The goal of these treatments is to arrest the disease process, maintain a healthy periodontium and preserve the dentition. As prevention becomes a larger component of everyday dental practice, dentists are performing S&RP more often as part of their periodontal maintenance programs. Therefore, it is essential for dentists to know the latest S&RP techniques and methods. This paper reviews the current knowledge and experiences related to mechanical non-surgical periodontal therapy and focuses on the types of S&RP instruments that are available, their advantages and disadvantages, their efficacy in debridement, and their effects on the hard tissues of the oral cavity.