Projects / Programmes
Optodynamic optimization of laser root canal irrigation
| Code |
Science |
Field |
Subfield |
| 3.02.00 |
Medical sciences |
Stomatology |
|
| Code |
Science |
Field |
| B730 |
Biomedical sciences |
Odontology, stomatology |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
root canal therapy, lasers, irrigation
Researchers (13)
| no. |
Code |
Name and surname |
Research area |
Role |
Period |
No. of publicationsNo. of publications |
| 1. |
11905 |
PhD Aleš Babnik |
Manufacturing technologies and systems |
Researcher |
2016 - 2019 |
0 |
| 2. |
50157 |
Katjuša Fabjan |
|
Technical associate |
2017 - 2019 |
0 |
| 3. |
30442 |
PhD Aleš Fidler |
Stomatology |
Head |
2016 - 2019 |
0 |
| 4. |
29224 |
PhD Peter Gregorčič |
Manufacturing technologies and systems |
Researcher |
2016 - 2019 |
0 |
| 5. |
50212 |
PhD Luka Hribar |
Manufacturing technologies and systems |
Junior researcher |
2017 - 2019 |
0 |
| 6. |
50517 |
Teja Jereb |
|
Technical associate |
2018 - 2019 |
0 |
| 7. |
21238 |
PhD Matija Jezeršek |
Manufacturing technologies and systems |
Researcher |
2016 - 2019 |
0 |
| 8. |
32838 |
Maša Juvan |
|
Technical associate |
2016 |
0 |
| 9. |
19091 |
PhD Rok Kosem |
Stomatology |
Researcher |
2016 - 2019 |
0 |
| 10. |
01649 |
PhD Janez Možina |
Manufacturing technologies and systems |
Researcher |
2016 |
0 |
| 11. |
27660 |
PhD Tadej Perhavec |
Manufacturing technologies and systems |
Researcher |
2016 - 2019 |
0 |
| 12. |
50158 |
Valerija Skopec |
|
Technical associate |
2017 - 2019 |
0 |
| 13. |
39060 |
Andreja Tomšič Korelc |
|
Technical associate |
2016 |
0 |
Organisations (3)
Abstract
Reason for tooth loss
One of the main reasons for tooth loss is pulp necrosis and apical periodontitis. Affected tooth should be extracted or endodontically treated. After a successful endodontic treatment the tooth can be preserved in full function for years.
Success rate of endodontic treatment is 85% to 95% and depend on numerous factors. Such high success rates were reported in studies, performed at university hospitals or specialty clinics. The success rate in overall population in Europe is drastically lower at about 50%. The main reason for such a low success rate is technical difficulty of the procedure.
Root canal treatment
Root canal therapy is based on elimination of infection and prevention of reinfection of root canal system. Root canal system is a complex three-dimensional space. Root canals are curved in multiple planes, dilacerating and joining through their course and form isthmuses and beside one major apical foramen, apical delta and lateral canals can be found. Additionally, at the ultrastructural level, dentinal tubules with diameter of 3-5 µm are projecting radially from main root canal and can be invaded by bacteria. Root canal treatment can be divided into several steps. The first step is mechanical cleaning and shaping, aiming to remove infection from the main root canal. Due to complex anatomy, mechanical cleaning and shaping cleans only 40-60% of root canal system surface, being the reason for low efficiency. Efficiency of bacteria removal must be increased by irrigation, conventionally performed with sodium hypochlorite by a syringe and needle. Irrigation mechanically removes remnants of pulp tissue, dentine debris, and bacteria and reach areas of root canal walls, previously not reached by mechanical instrumentation. Additionally, irrigant also have antibacterial and tissue dissolving effect. Small dimensions of the root canal system reduce the flow of irrigant and speed of diffusion into tubules, resulting in reduced irrigation effect. To increase irrigation efficacy, several activation methods were proposed. Beside ultrasonic and mechanical irrigant activation, laser activated irrigation (LAI) was proposed
Laser activated irrigation
It is based on laser generated vapor bubbles, creating dynamical fluid movement in whole root canal system. In present in vitro studies, LAI performed superior to other methods. However, dynamic irrigant movement in the root canal results in irrigant extrusion into periapical tissues and resulting in severe pain, bleeding, and facial tissue necrosis. Efficiency of LAI is largely affected by selection of laser parameter and shape of laser fiber tip. These parameters are of great importance for clinical application of LAI as a balance between patient safety and treatment efficiency should be found.
Research objectives
The primary objective is to construct a prototype of apical plug instrument (API), an instrument that will prevent apical extrusion and increase patient safety with LAI. This is original solution for prevention of periapical extrusion. A series of experiments will be performed to evaluate the effect of its size, taper and surface properties, which all affect dynamics of fluid and vapor bubbles. These findings will lead to construction of prototype API.
The secondary objective is to optimize the laser operating parameters and shape of laser fiber tip aiming to increase the efficacy of LAI using new instrument. Using API prototype, a series of experiments will be performed to evaluate effect of laser parameters and shape of fiber tip on irrigation efficiency and safety aiming to maximize efficiency without any harmful side effects for the patient.
Significance for science
The proposed interdisciplinary project addresses important challenges in the fields of laser induced hydrodynamics and root canal system irrigation
Relevant contributions to field root canal irrigation evaluation, resulting mainly from Activities 1-4
• increased understanding and contribution to the awareness of the potentials and pitfalls of irrigation systems, achieved through scientifically rigorous and objective validation
• promotion of further research and development of root canal irrigation evaluation methods, and facilitation of objective evaluation and comparison studies of canal irrigation,
• optimization of LAI in regards of efficiency and patient safety
Relevant contributions to the field of laser induced cavitation in confined space, resulting mainly from Activities 5-7
• advancement of understanding of laser induced vapor bubbles dynamics in confined space in other areas of application
• advancement of understanding of working parameters influence on irrigation efficiency
During implementation of the planned activities and through extensive multidisciplinary research collaborations between academia, healthcare providers, and industry, we expect that mutual exchange of knowledge, views, findings, needs and innovative solutions, will lead to novel discoveries and will reveal new and challenging research opportunities.
Significance for the country
Social impact indicator: improved patient care and quality of life
The planned results will enable the dentists to better understand and perform root canal treatment, to improve the education and training processes of general dentists and endodontists and to foster the use of new and innovative research methodologies.
For dentist and patients, needing a root canal treatment, the LAI will have a twofold immediate benefit:
• increased efficiency of irrigation, resulting in higher success rate of root canal treatment and higher number of retained teeth
• increased safety of irrigation, resulting in less complications, ranging from mild inflammation and slight pain to extensive hemorrhage, necrosis of facial tissues and strong pain
Additionally, the development and increased use of novel irrigation method have the potential to reduce both the time and cost of dental treatment.
Economic/commercial indicator: new products/services, increased employment
In the field of endodontics, there is a constant search for new and more efficient devices for root canal treatment. The activities planned within this project will result in the most innovative prototype of new instrument for increased efficiency and safety of root canal irrigation. This will strengthen the reputation, increase sales of dental lasers, produced by of one of the most high-tech companies in Slovenia, Fotona d.d. and increase employment.
Most important scientific results
Final report
Most important socioeconomically and culturally relevant results
Final report
