Influence Of Photon-Initiated Photoacoustic Streaming (Pips) Laser-Activation Method On The Efficiency Of Salvadora Persica Extract And Sodium Hypochloride Final Irrigating Solutions In Removing Smear Layer: A Scanning Electron Microscopy Analysis
Abstract
Objective: to investigate the influence of Er:YAG-laser-activated and conventional irrigation techniques on intracanal smear layer eradication at the apical, middle, and coronal regions of root canal walls utilizing environmental scanning electron microscope (ESEM). Methods: Thirty-six freshly extracted human single-canal single-rooted anterior dentitions were involved in this study. After the root canals had been accessed and mechanically instrumented up to size X4, 0.06 taper utilizing ProTaper Next® system, they were allocated to two equal groups (18 teeth each); syringe/needle- and laser- activated groups. Each group was further subdivided into three subgroups; saline, NaOCl, and S. persica (n = 6).Arya-laser was irradiated at pulse energy of 20 mJ, pulse width of 50 μs, pulse frequency of 15 Hz and delivered by a PIPS tip. Then, Teeth were longitudinally split for ESEM assessment. Kruskal-Wallis and Mann-Whitney tests were employed to statistically analyze the collected data.
Results: Er:YAG-laser-activated exhibited better smear layer elimination results than syringe/needle activated group. The significant differences occurred between NaOCl subgroups at coronal and apical thirds and between saline and S. persica subgroups at middle third. Conventionally-activated S. persica showed the highest statistical smear layer elimination efficacy between the comparative subgroups at coronal and middle thirds while, Laser- activated saline demonstrated the greatest smear layer removing-capacity at coronal and middle thirds. Conclusion: Er:YAG-laser-activated irrigation technique has a beneficial influence on smear layer elimination. S. persica can eliminate more smear layer than saline and NaOCl at coronal and middle thirds.
Clinical significance: Er:YAG laser can efficiently enhance the efficacy of intracanal irrigants.