Effect of Nd: YAG laser on the apical seal after root-end resection and MTA retrofill: a bacterial leakage study

Abstract

Laser irradiation has been investigated in terms of preventing leakage in retrofilled root canals. The aim of the present study was to evaluate the effect of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on the bacterial leakage of mineral trioxide aggregate (MTA)-retrofilled roots. In this ex vivo experimental study, 90 single-rooted incisor teeth were filled with gutta-percha and AH26 sealer. The apical 3 mm of all the roots were resected and 3-mm retrocavities were prepared by an ultrasonic device. The specimens were randomly divided into two experimental (n = 25), one positive control (n = 10), and two negative control (n = 10) groups. In the laser + MTA group, the cavity walls were irradiated by Nd: YAG laser prior to MTA placement. In the MTA group, MTA was placed without laser irradiation. The root surfaces were covered with two layers of nail varnish except for the apical 2 mm. The specimens were then embedded in a bacterial leakage test system and examined daily for 90 days. Contamination periods were recorded. Data were analyzed by Kaplan-Meier and Mann-Whitney U tests (alpha = 0.05). Five teeth with and five teeth without laser irradiation underwent scanning electron microscopic evaluation. The specimens in the laser + MTA group were contaminated earlier than those in the MTA group (p < 0.05). Comparison of survival times between the two groups showed significant differences (p < 0.05). Nd: YAG laser irradiation can decrease the sealing capacity of MTA in comparison to the apical seal achieved by MTA without laser irradiation. Further studies are recommended to provide a better seal for the MTA-retrofilled teeth after laser irradiation.