High speed imaging of an Er,Cr:YSGG laser in a model of a root canal

Laser systems of various wavelengths and pulse characteristics have been introduced in dentistry. At present, the range of applications for the different systems is being investigated mainly differentiating between soft and hard tissue applications. For the preparation of root canals both hard and soft tissues are involved. Ideally, one would like to use one laser system for the whole treatment. In this study, we studied the characteristics of the pulsed 2,78 Er,Cr:YSGG laser (Biolase, Waterlase Millenium), in view of root canal cleaning and desinfection. The laser energy was fiber delivered with fiber tip diameters from 400 mm down to 200 mm. Special thermal and high speed imaging techniques were applied in a transparent model of a tapered root canal and slices cut from human teeth. High speed imaging revealed the dynamics of an explosive vapor bubble at the tip of the Er laser in water and the root canal model. Typically for Erbium lasers, within a time span of several hundred ms, a longitudinal bubble expanded to maximum size of 5 mm length and 2 mm diameter at 100 mJ and imploded afterwards. In the root canal, the explosive bubble created turbulent high speed water streaming which resects soft tissue from the hard tissue. Thermal imaging showed the dynamics of all lasers heating of the canal wall up to several mm depending on the wavelength and energy settings. The mechanism of smear layer removal and sterilization in the root canal, is attributed to cavitation effects induced by the pulsed laser. The heat generation into the dentine wall was minimal.