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

Abstract

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.