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O papel do laser ER:YAG como adjuvante na desinfecção endodontica contra E. Faecalis: revisão integrativa
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Esta revisão integrativa analisa o papel do laser Er:YAG como adjuvante na desinfeção endodôntica, com foco na sua eficácia contra Enterococcus faecalis, uma bactéria frequentemente associada ao insucesso dos tratamentos endodônticos. A literatura consultada inclui estudos in vitro e ex vivo, que demonstram que o Er:YAG, sobretudo quando combinado com irrigantes tradicionais como o hipoclorito de sódio (NaOCl), melhora significativamente a eliminação bacteriana e a remoção da smear layer. Técnicas como a PIPS (Photon-Induced Photoacoustic Streaming) amplificam o efeito do laser, facilitando a penetração em áreas inacessíveis aos irrigantes. No entanto, a eficácia varia conforme os parâmetros utilizados (energia, frequência, tempo), e o uso inadequado pode causar aumento de temperatura nos tecidos, o que reforça a necessidade de irrigação contínua e protocolos padronizados. Conclui-se que o laser Er:YAG tem potencial como complemento à desinfeção convencional, especialmente em casos complexos, mas ainda carece de mais estudos clínicos para validação definitiva.
This integrative review analyzes the role of the Er:YAG laser as an adjunct in endodontic disinfection, focusing on its effectiveness against Enterococcus faecalis, a bacterium often associated with endodontic treatment failure. The reviewed literature including in vitro and ex vivo studies, shows that Er:YAG—especially when combined with traditional irrigants such as sodium hypochlorite (NaOCl)—significantly improves bacterial elimination and smear layer removal. Techniques like PIPS (Photon-Induced Photoacoustic Streaming) enhance the laser's effect, facilitating deeper penetration into areas inaccessible to irrigants. However, the efficacy varies depending on parameters used (energy, frequency, duration), and improper use may cause a rise in temperature, underscoring the importance of continuous irrigation and standardized protocols. In conclusion, the Er:YAG laser shows promise as a complementary tool to conventional disinfection, particularly in complex cases, but further clinical studies are needed to confirm its definitive role.
This integrative review analyzes the role of the Er:YAG laser as an adjunct in endodontic disinfection, focusing on its effectiveness against Enterococcus faecalis, a bacterium often associated with endodontic treatment failure. The reviewed literature including in vitro and ex vivo studies, shows that Er:YAG—especially when combined with traditional irrigants such as sodium hypochlorite (NaOCl)—significantly improves bacterial elimination and smear layer removal. Techniques like PIPS (Photon-Induced Photoacoustic Streaming) enhance the laser's effect, facilitating deeper penetration into areas inaccessible to irrigants. However, the efficacy varies depending on parameters used (energy, frequency, duration), and improper use may cause a rise in temperature, underscoring the importance of continuous irrigation and standardized protocols. In conclusion, the Er:YAG laser shows promise as a complementary tool to conventional disinfection, particularly in complex cases, but further clinical studies are needed to confirm its definitive role.
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Er:YAG Desinfeção endodôntica Enterococcus faecalis Laser em endodontia Endodontic disinfection Laser in endodontic