Effectiveness of photon-initiated photoacoustic streaming in root canal models with different diameters or tapers

Wen, Cheng; Kong, Yuanyuan; Zhao, Jian; Li, Yang; Shen, Ya; Yang, Xuechao; Jiang, Qianzhou

doi:10.1186/s12903-021-01671-4

Cited by 9 publications

(11 citation statements)

References 36 publications

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“…[27,28] Our previous study showed ATP level could re ect the amount of bacteria. [11,29,30] And studies also have found that detection techniques based on ATP bioluminescence correlate well with conventional plate counting methods in food testing. [31] The present study showed that the ATP value of the PIPS group was signi cantly lower than that of the CNI group (P = 0.046), indicating that PIPS irrigation had a better bactericidal effect, which coincided with our previous in vitro research.…”

Section: Discussionmentioning

confidence: 88%

“…[31] The present study showed that the ATP value of the PIPS group was signi cantly lower than that of the CNI group (P = 0.046), indicating that PIPS irrigation had a better bactericidal effect, which coincided with our previous in vitro research. [11] Another randomized clinical trial likewise reported that irrigation with the PIPS device was signi cantly effective in reducing bacterial counts. [12] What's more, other in vitro study found that the use of a combination of NaOCl with PIPS was effective in eradicating E. faecalis and inhibiting new bacterial growth, thus minimizing the possibility of reinfection.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Our preliminary in vitro studies reported that the PIPS protocol exerted a stronger bactericidal effect in apical region and removed more microbial bio lm inside the canal system compared to traditional endodontic irrigation. [11] Moreover, irrigation with the PIPS device was signi cantly effective in reducing bacterial counts of teeth with a diagnosis of pulp necrosis with or without symptomatic or asymptomatic apical periodontitis bio lm disease in a randomized clinical trial. [12] To the best of our knowledge, few clinical evidence was presented about the antibacterial activity and residual pulp removal capacity of PIPS on teeth with symptomatic irreversible pulpitis.…”

Section: Introductionmentioning

confidence: 97%

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The effects of photon-induced photoacoustic streaming during root canal treatment of symptomatic irreversible pulpitis: a randomized clinical trial.

Chen

Zhao

et al. 2022

Preprint

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Objectives The authors of this study aimed to evaluate the effects of photon-induced photoacoustic streaming (PIPS) on antibacterial activity, residual pulp removal and postoperative pain in teeth with symptomatic irreversible pulpitis during root canal treatment (RCT). Materials and Methods In this superiority randomized clinical trial (ClinicalTrials.gov ID: ChiCTR2000037446), sixty patients with symptomatic irreversible pulpitis in need of RCT were selected. After preparation, they were randomly assigned into two groups according to final irrigation protocol: conventional needle irrigation (CNI) or PIPS. Bacterial suspensions in root canals were assessed using an Adenosine 5'-triphosphate (ATP) assay kit. The effect of root canal irrigation on residual pulp removal was evaluated by NaOCl-induced bubble formation. Patients were asked to register their pain intensity in the visual analogue scale (VAS) document after 1-day and 7-day intervals. Results Compared to CNI group, PIPS irrigation showed a greater antibacterial efficacy than the CNI group (P = 0.046). And the PIPS irrigation significantly reduced the NaOCl-induced bubble count(P<0.001). On Day 1 post operation, pain intensity was significantly lower in the PIPS group (0.34 ± 0.75) compared to the CNI group (1.24 ± 1.27) (P = 0.004). NaOCl-induced bubble count showed statistically correlated to the maximum postoperative pain on Day 1 (P<0.001), while the ATP values seemed not to be statistically correlated to the intensity of postoperative pain (P = 0.684). Conclusions Irrigation with 1% NaOCl delivered with PIPS could decrease bacterial levels, enhance root canal cleaning effect and lessen postoperative pain after root canal preparation. Clinical Relevance The PIPS is a safe and effective final irrigation protocol for teeth with symptomatic irreversible pulpitis during RCT.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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The effects of photon-induced photoacoustic streaming during root canal treatment of symptomatic irreversible pulpitis: a randomized clinical trial.

Chen

Zhao

et al. 2022

Preprint

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“…The study was approved by the ethics board of the School and Hospital of Stomatology, Guangzhou Medical University. A previous study [ 12 ] was used to identify an effect size of 0.50 required to calculate the total sample size for this study. α-type error = 0.05 and power (1 − β) = 0.80 were also inputted (F test family, ANOVA, G*Power for Windows).…”

Section: Methodsmentioning

confidence: 99%

The antibacterial efficacy of photon-initiated photoacoustic streaming in root canals with different diameters or tapers

et al. 2021

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Background In recent years, the concept of minimally invasive endodontics has been proposed, which could be described as preventing or treating diseases by preserving more dental tissue and creating minimal damage. In the process of root canal preparation, it was recommended to use instruments with a smaller taper to preserve more tooth tissue and improve the preservation rate of the affected teeth. Photon-induced photoacoustic streaming (PIPS) was a new type of laser-activated irrigation technology, which was now widely used in endodontic treatment. The purpose of this article was to evaluate the bactericidal effect of PIPS with NaOCl in root canals with different widths or tapers. Methods Twenty-three maxillary first molars with three independent root canals were included in this study. The mesiobuccal (MB), distobuccal (DB), and palatal (P) root canals were prepared at sizes of #10/.02, #25/.02, and #25/.06, respectively. After being incubated with a bacterial suspension for 4 weeks, the specimen were irrigated with 2% NaOCl activated by conventional needle irrigation (CNI) (n = 10) or PIPS (n = 10). Three specimen were not treated (control group). Before and after irrigation, the presence of bacteria was assessed with an adenosine 5'-triphosphate (ATP) assay kit and biofilms were assessed using confocal laser scanning microscopy and scanning electron microscopy. Results In specimen prepared using PIPS irrigation, the ATP was reduced by more than 98%. When the root canal taper was 0.02, the size #25 root canals had a higher percentage of dead bacteria than the size #10 root canals in all regions (P < 0.05) in the PIPS group. When the root canal width was #25, the 0.02 taper group had a higher percentage of dead bacteria than the 0.06 taper group in the apical region (P < 0.05), except coronal and middle regions (P > 0.05). PIPS irrigation results in a greater percentage of dead bacteria and reduction of ATP in size #10/.02 root canals than CNI in size #25/.06 root canals in three regions (P < 0.05). Conclusion Increasing the width from #10 to #25 improves the bactericidal effect of PIPS in the root canal. Increasing the taper of the root canal from 0.02 to 0.06 at size #25 did not affect the bactericidal effects of PIPS. PIPS resulted in more dead bacteria in specimen with smaller tapers and root canal widths than CNI. PIPS can be used to clean the smear layer in the coronal region and open the dentin tubules. Clinical significance: Activation of irrigants with PIPS brought about significant bacterial reduction smaller tapers and width root canals compared to CNI, which was beneficial to prevent excessive loss of tooth tissue and conserve the structural integrity of teeth.

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“…Nevertheless, well‐designed laboratory studies using exactly standardized situations allow reproducible comparisons of special devices and settings. Available studies investigating the removal efficacy of biofilm‐mimicking hydrogel used prefabricated tooth models with relatively simple root canal anatomy (Nagahashi et al., 2022; Wen et al., 2021) or straight root canals (De Meyer et al., 2017; Macedo et al., 2014). Only very few studies used severely curved root canals (Peeters et al., 2015; Swimberghe et al., 2021), and only two studies addressed different insertion depths and different tips for laser activated irrigation using the AdVerL EVO (Hoshihara et al., 2021; Kouno et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

Bürklein,

Abdi,

Schäfer

et al. 2023

Int Endodontic J

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AimTo investigate the influence of pulse energy, tip geometry and tip position in simulated 3D‐printed root canals with multiple side canals at different levels in all directions on the cleaning performance of laser‐activated irrigation (LAI) compared to sonic activation (EDDY) and conventional needle irrigation (NI).Methodology3D‐printed root canal models (25/.06, length 20 mm, curvature 60°, radius 5 mm) with side canals (diameter 0.2 mm) at 2, 5 and 8 mm from the apex were filled with coloured biofilm‐mimicking hydrogel. LAI (Morita AdvErL Evo, Kyoto, Japan) was performed with six settings (n = 20; pulse‐energy, pulses per second [PPS], tip position): LAI1 (50 mJ, 25 PPS, P400FL, canal entrance [CE]), LAI2 (same as LAI1, but insertion depth 9 mm before the apical endpoint [AE] [corresponding to 1 mm above the first lateral canals]), LAI3 (80 mJ, 25 PPS, P400FL, 9 mm before AE), LAI4 (same as LAI 3, but at CE) for 3 × 20 s each, LAI5 (50 mJ, 25 PPS, P400FL 2 × 20 s, CE & R200T (30 mJ, 25 PPS, 1 × 20 s, 9 mm before AE), LAI6 (30 mJ, 25 PPS, R200T, 9 mm before AE, 3 × 20 s). A continuous irrigation (3 mL/20 s) using distilled water accompanied the irrigation cycles. NI and EDDY (3 × 20 s each; 3 mL/20 s irrigation, insertion AE minus 1 mm, amplitude 4 mm) served as control groups. Biofilm‐mimicking hydrogel removal (ImageJ, NIH) was assessed for the entire system, the central canal and the lateral canals using standardized photographs with a microscope (Expert DN, Müller‐Optronic) and statistically analysed was performed using Kruskal–Wallis and Dunn tests (p = .05). Irrigant extrusion beyond the foramina was also recorded.ResultsLAI2 (99.08%; interquartile range [IQR]: 96.85–100.00) and LAI3 (97.50%; 96.24–100.00) achieved the significantly best and LAI6 (80.08%; 73.41–84.69) the significantly worst removal of hydrogel from the entire root canal system amongst all LAI configurations (p < .05). There were no significant differences between LAI6, EDDY (72.89%; 67.49–76.22) and manual irrigation (54.39%; 51.01–56.94) (p > .05). R200T laser tip caused significantly more often irrigant extrusion than all other techniques (p < .05).ConclusionTip design, energy settings, and the positioning of the laser tip below the canal entrance caused an improvement in cleaning performance of the LAI. However, the small R200T tip created significantly more procedural errors (irrigant extrusion) due to higher concentrated energy.

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Effectiveness of photon-initiated photoacoustic streaming in root canal models with different diameters or tapers

Cited by 9 publications

References 36 publications

The effects of photon-induced photoacoustic streaming during root canal treatment of symptomatic irreversible pulpitis: a randomized clinical trial.

The effects of photon-induced photoacoustic streaming during root canal treatment of symptomatic irreversible pulpitis: a randomized clinical trial.

The antibacterial efficacy of photon-initiated photoacoustic streaming in root canals with different diameters or tapers

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

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