Evaluation of The Effect of 980nm Diode Laser Intracanal Irradiation on Levels of Interleukin-8 Expression

Evaluation of The Effect of 980nm Diode Laser Intracanal Irradiation on Levels of Interleukin-8 Expression in Lesions Refractory to Endodontic Treatment: A Randomized Control Trial

This clinical trial will be conducted to evaluate the amount of Il-8 expression before and after the application of intracanal irradiation with diode laser 980 nm versus placebo in failed endodontic cases with periapical lesions.

• Thorough medical and dental history for the eligible patients

• Thorough intraoral and extraoral diagnosis

• Local anesthesia

• Isolation and removal of any previous filling or restoration

• Removal of old gutta percha and establish patency to the full working length.

• 1st sample: will be collected using 3 sterile paper points

• Chemo-mechanical preparation.

• 2nd sample collection

  • Laser group: The canals will be irradiated with a high-power diode laser, with wavelength of 980 nm, maximum output of 3 watts and coupled with a fiber optic tip of 200 µm diameter.

  • Mock laser application (Placebo group): The fiberoptic tip will be inserted inside the root canal, mimicking the laser irradiation, but not activated.

• 3rd sample collection

• A piece of dry cotton will be placed in the access cavity, and then will be sealed with glass ionomer filling material

• 2nd visit: 1 week later, 4th sample collection then Obturation

• Number of visits & follow up period: Two visits

Inclusion Criteria:

• failed previously treated endodontic single-rooted teeth with chronic periapical lesions; with radiographic evidence of periapical radiolucency of not less than 1 cm diameter will be selected.
• Teeth with straight root canals.
• No contributory medical history.
• No previous administration of analgesics and/or antibiotics within the previous 2 weeks.

Exclusion Criteria:

• Retreatment cases with complications such as separated instruments, perforations, ledges, resorption, transportation, calcifications, immature apices and over fillings.
• Teeth with curved roots.
• Swelling or sinus tract.
• Mutilated teeth that interfere with proper isolation and seal between visits.
• Subjects with generalized periodontitis, or if the tooth has a probing depth of more than 3 mm.
• Subjects with uncontrolled diabetes or debilitating diseases.
• Pregnant or nursing females.
• Systemic disorders that necessitate antibiotic prophylaxis or prevent the use of Ibuprofen.