The effect of ultrasonically activated irrigation and laser based root canal irrigation methods on debris removal

To test the efficacy of debris removal of 5 in vitro irrigation protocols: conventional irrigation, irrigation activated by ultrasound, Er:YAG laser with photon-induced photoacoustic streaming (PIPS) tip, and 2 diode laser techniques.

The root canals of 75 extracted human canine teeth were enlarged and bisected longitudinally. Standardized grooves were prepared 2-6 mm from the root apex and filled with 0.5 mm of dentine debris. The teeth were reassembled and irrigated using 1 of the following techniques (n = 15/technique): (1) conventional irrigation, (2) diode laser irrigation - tip placed 2 mm from working length, (3) diode laser irrigation - tip placed at root canal orifice, (4) Er:YAG laser - PIPS, and (5) ultrasonically activated irrigation. The root segments were disassembled, and the amount of remaining debris was evaluated by 3 examiners under a stereomicroscope at ×20 magnification using a 4-grade scoring system. The data were statistically analyzed using Kruskal-Wallis and Dunn's multiple comparison tests, with a 95% confidence level (p = 0.05). Cohen's kappa test was used to evaluate inter-observer and intra-observer agreement.

Ultrasonically activated irrigation removed significantly more dentinal debris than conventional irrigation (p = 0.016), but there were no significant differences between the other groups.

Ultrasonically activated irrigation was more effective than conventional irrigation in the removal of apically placed dentine debris.