The effectiveness of the Erbium:Yttrium aluminum garnet PIPS technique in comparison to different chemical solutions in removing the endodontic smear layer—an in vitro profilometric study

Abstract

This study evaluated the degree of endodontic smear layer removal using the Er:YAG PIPS technique (2.94 μm) in comparison with different irrigants. Sixty-four single-rooted teeth were endodontically prepared up to size #40 and were divided into 8 groups (a-h) (n = 8). Groups a, b, c, and d were irrigated with (3 % NaOCl + 20 % EDTA), (0.9 % NaCl), (3 % NaOCl), and (20 % EDTA), respectively. Groups e, f, g, and h were treated with (3 % NaOCl + 20 % EDTA + PIPS), (0.9 % NaCl + PIPS), (3 % NaOCl + PIPS), and (20 % EDTA + PIPS), respectively. The settings of the Er:YAG PIPS technique were (0.3 W, 20 mJ, 15 Hz, 50 μs, no water and air). The root canals were examined under a profilometer to evaluate the degree of smear layer removal using Hülsmann scores. The smear layer was present in the coronal, middle, and apical thirds of groups b, c, f, and g. Groups a, d, e, and h exhibited open dentinal tubules in the coronal and middle thirds. However, none of the apical thirds showed open dentinal tubules. No significant difference was observed between the groups treated only with irrigants and those treated with Er:YAG PIPS and the same irrigants (p ≥ 0.0018). The Er:YAG PIPS technique did not show any improved results in removing the smear layer when compared to the irrigants alone. Moreover, the open dentinal tubules in some groups were a result of the chelating action of 20 % EDTA.

Efficacy of the photon‐initiated photoacoustic streaming combined with different solutions on Enterococcus faecalis in the root canals

“…Recently, photon‐initiated photoacoustic streaming (PIPS) with Er:YAG laser at low pulse energy (20 mJ) and short pulse duration (50 μs) was introduced in root canal irrigation (Balic et al, ; DiVito, Peters, & Olivi, ). The technology is based on the mechanism of bubble cavitation involving strong shockwaves due to collapse of bubbles in a fluid and is effective in removing the smear layer from the surrounding walls (Nasher, Franzen, & Gutknecht, ). Studies evaluating the efficacy of PIPS in endodontic treatment revealed that it is a potential technique for elimination of the smear layer and dentinal debris (Passalidou, Calberson, De Bruyne, De Moor, & Meire, ; Verstraeten, Jacquet, De Moor, & Meire, ); however, those authors did not perform systematic comparison of antimicrobial efficacy among irrigation solutions in routine use combined with PIPS.…”

Laser Application to the Root Surface Increases the Bonding Strength of Surface-Treated Prefabricated Glass-Fiber Posts in Teeth with Excessive Substance Loss

“…Visuril et al reported good resin binding to dental tissues in laser treated samples, and that application of an Er: YAG laser to dentin yielded greater tensile strength than roughening [ 28 ]. Nasher et al found no smear layer in root canals prepared using an Er: YAG laser, together with opening of dentin tubules and increased tensile strength [ 29 ]. Akyüz et al also reported high tensile strength in samples activated using PIPS laser tips [ 30 , 31 ].…”

The Efficiency of the Er: YAG Laser and PhotonInduced Photoacoustic Streaming (PIPS) as an Activation Method in Endodontic Irrigation: A Literature Review

“…54 The remaining studies showed no superiority of the Er:YAG laser in removing smear layers from root canals versus other techniques including the EndoActivator, 55,56 EndoVac, 26,56,57 LAI (Nd:YAG, Er,Cr:YSGG), 58 and CSI. 26,43,59 Despite this, three studies still found that PIPS was better than CSI. 55,57,58 The rest only tested PIPS or LAI and did not compare them with other techniques (Table 3).…”