Effectiveness of the erbium:YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation

Abstract

The aim of this study was to analyze in vitro the debriding ability of an Er:YAG laser system (2,940 nm) equipped with a newly designed radial and stripped tip of 400 µm diameter by scanning electron microscopy (SEM). A total of 80 single-rooted extracted human teeth were endodontically prepared with rotary instrumentation and standardized chemical irrigation using 5.25% sodium hypochlorite. At the end of mechanical instrumentation, four different final protocols were used. Group 1 was irrigated for 2 min with saline water as a control group. Groups 2, 3 and 4 were irradiated with an Er:YAG laser at 25 mJ and 15 Hz with a pulse duration of 50 μs and laser spray off using the tip in the coronal opening of the wet root canal. Different solutions and irradiation times were used: group 2 20 s, laser irradiation in sterile distilled water, wet canal; group 3 20 s, laser irradiation in 17% EDTA, wet canal; and group 4 40 s, laser irradiation in 17% EDTA, wet canal. Debridement of and smear layer removal from the apical third of root canals were evaluated by SEM. The study showed that standardized instrumentation, followed by a final Er:YAG laser irradiation in wet canals with EDTA irrigation resulted in more cleaning of the root canal walls and a higher quantity of open tubules in comparison with the traditional irrigation method.

Comparison of the Antibacterial Effect and Smear Layer Removal Using Photon-Initiated Photoacoustic Streaming Aided Irrigation Versus a Conventional Irrigation in Single-Rooted Canals: AnIn VitroStudy

“…The laser operating parameters were 20 mJ per pulse, 15 Hz, and 50 ls pulse duration. 11 The coaxial water spray feature of the handpiece was set to ''off.'' The tip was placed into the coronal access opening of the pulp chamber only, and kept stationary and activated for 1 min.…”

“…11 In the aforementioned study, 11 the PIPS was activated for 20 sec, whereas in the current study, the activation time was extended to 1 min. Despite the longer activation time in the present study, we found no significant enhancement of the antibacterial efficacy, compared with the use of hypochlorite.…”

“…It works on the principle of transferring the pulsed energy to activate the irrigation solutions, which makes it suitable for use in root canal disinfection and cleaning. 10 Recently, a photoacoustic technique called photon-induced photoacoustic streaming (PIPS), was reported to result in effective debris and smear layer removal with a newly designed radial and stripped tip 11 or a 21 mm long, 400 lm diameter endodontic fiber. 12 With this PIPS technique, the laser tip was placed into the pulp chamber only, with no need to advance into the orifice of the canal; therefore, more cleaning of the root canal walls and a higher quantity of open tubules was achieved in comparison with traditional irrigation.…”

“…12 With this PIPS technique, the laser tip was placed into the pulp chamber only, with no need to advance into the orifice of the canal; therefore, more cleaning of the root canal walls and a higher quantity of open tubules was achieved in comparison with traditional irrigation. 11,12 Therefore, we hypothesize that Er:YAG laser with PIPS technique may have greater efficacy in promoting root canal irrigation and disinfection.…”

Effect of Laser Treatment, Self-Adhesive Resin Cement Brand and Thermocycling on Push out Bond Strength of Fiber Reinforced Post

“…(15) The same results were found by Rebecca et al in (2014). (16) Divito E. et al (2010), (17) studied the effectiveness of the erbium YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation. The Er YAG showed significantly better smear layer removal than traditional syringe irrigation and no thermal effects or damage to the dentine surface was observed.…”