Introduction: We have been developing dental fiberscopes （FS） which are used for visual examination of the intricate morphology of the canal system and inaccessible areas, such as periapical lesions, periodontal pockets, and so on. This study evaluated the effectiveness of FS-assisted Er:YAG laser irradiation in comparison to microscope （MS）-assisted Er:YAG laser irradiation in root canal treatment.
Method: The FS comprises three parts: image fibers （6,000 pixels, field depth: 5mm）, light guides and a working channel for the laser fiber. The outer diameter of the fiberscope needle with a gradual curve is 1.1mm. Twenty maxillary right central incisor tooth models with root canals （size: #60, taper: 6/100, root canal length: 10mm） that were mesiodistally separable were prepared. A black dot was marked immediately beneath the canal orifice of each tooth model that was cut in half beforehand. Five dental practitioners with experience in the FS and Er:YAG laser participated in the experiment. To remove the dot, the tooth models were treated with the Er:YAG laser assisted either with FS or MS. The laser beam was applied to each model at 50mJ, 10 pps with a water spray to cool the area being treated for 5 minutes. Then, the canal surface was observed and the removed area of the black dot was calculated.
Results: The mean rates of removed area were 41.7±36.1％ （FS） and 14.3±24.0％ （MS）, respectively. The mean rate of removed area in the FS group was significantly larger than that in the MS group （Mann–Whitney U test, p ＜ 0.05）.
Discussion: The MS has rapidly become a widely used tool for finding canals, diagnosing and treating cracks and fractures, repairing perforations, and considering different treatment options. Although the image quality of the FS is inferior to that of the MS, the FS is considered useful in clinical settings as it also enables visualization of root canals in detail. Furthermore, the FS allows the operator to visualize difficult-to-reach areas where straight-line access is not available by the MS. Further investigation is needed to clarify the advantages and disadvantages of the FS, as well as collecting and analyzing more basic experimental data.
Conclusion: The results suggest that the application of FS-assisted Er:YAG laser irradiation could lead to better clinical outcomes in comparison to MS-assisted Er:YAG laser irradiation in root canal treatment.

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