Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration

• Published in: Lasers in medical science Vol. 38; no. 1; p. 30
• Main Authors: Uslu, Gülşah, Gündoğar, Mustafa, Üngör, Mete, Özyürek, Taha, Erkan, Erhan, Keskin, Neslihan Büşra
• Format: Journal Article
• Language: English
• Published: London Springer London 03.01.2023; Springer Nature B.V
• Subjects: Dental Pulp Cavity; Dental roots; Dentistry; Effectiveness; Humans; Irrigation; Laser applications; Lasers; Lavage; Medicine; Medicine & Public Health; Optical Devices; Optics; Original Article; Penetration depth; Photonics; Quantum Optics; Root Canal Irrigants; Root Canal Preparation - methods; Root canals; Roots; Scanning electron microscopy; Smear Layer; Teeth; Therapeutic Irrigation - methods; Ultrasonics; Vortices; PIPS; Passive ultrasonic irrigation; SWEEPS; EDDY; Confocal laser scanning microscopy
• ISSN: 1435-604X; 0268-8921; 1435-604X
• DOI: 10.1007/s10103-022-03697-8

The aim of this study was to examine the effectiveness of different irrigation activation methods on smear layer removal and tubular penetration. One hundred-five distal roots of mandibular molar teeth in total; 50 for smear removal efficiency ( n  = 10) analysis using scanning electron microscopy (SEM), and 55 roots were used to examine tubular penetration using confocal laser scanning microscope (CLSM). Five different irrigation activation methods were used in this study; conventional needle irrigation (CNI), sonic irrigation device of EDDY, passive ultrasonic irrigation (PUI), PIPS and SWEEPS techniques, which are two different laser irrigation activation methods. The obtained data were statistically analyzed and the significance level was determined as p  < 0.05. At the apical level, the cleanest canal walls were observed when laser methods PIPS and SWEEPS were used, while in the middle third, there was no difference in smear removal efficiencies between all groups except for the CNI ( p  > 0.05). Penetration depths and percentages increased from apically to coronally in all groups. The PUI and EDDY generally showed similar penetration depths and percentages to the CNI, except at the coronal root level ( p  > 0.05). In all groups, when PIPS was used, it showed greater penetration depth and percentage ( p  < 0.05). PIPS and SWEEPS techniques showed lowest and similar smear scores compared to PUI and EDDY in the apical area where access and effectiveness of the irrigation solution are difficult.