An integrative review on the tooth root canal disinfection by combining laser-assisted approaches and antimicrobial solutions

Purpose: The aim of this study was to conduct an integrative review on the synergistic effect of Er:YAG or Nd:YAG laser approaches and traditional disinfection solutions for tooth root canal disinfection. Method: A systematic bibliographic search was conducted on PubMed electronic database using a combination of the following terms: endodontic treatment, root canal, intracanal treatment, laser, Er:YAG, Nd:YAG, disinfection, faecalis, and decontamination. Results: The selected studies reported that Er:YAG or Nd:YAG laser treatment combined with NaOCl provide an ultra-high bactericidal effect by 98–99% on the eradication of E. faecalis biofilms. Additionally, Er:YAG laser promoted a 500-µm depth disinfection though smear layer down into the dentin tubules. Nevertheless, the dentin thickness and the anatomy of the teeth root canal would influence the action of the laser irradiation. Also, parameters involving intensity, time, and mode of laser irradiation should be adjusted depending on the anatomical conditions and remnant teeth structures. Conclusion: The use of laser-assisted approaches in combination with traditional antimicrobial solutions enhances considerably the eradication of bacteria in tooth root canal treatment.