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Apical Irrigant Extrusion Using Two Er: YAG Laser Irrigation Modes with Three Types of Laser Tips.

Damir Šnjarić1, Jelena Vidas Hrstić1, Ivana Brekalo Pršo1

  • 1Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.

Acta Stomatologica Croatica
|April 14, 2025
PubMed
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Conventional syringe needle irrigation (SNI) and super short pulse (SSP) laser-activated irrigation (LAI) with specific laser tips resulted in less extruded irrigant. AutoSWEEPS mode with various fiber tips showed a higher potential for irrigant extrusion.

Area of Science:

  • Endodontics
  • Dental Materials Science
  • Biomedical Engineering

Background:

  • Effective root canal irrigation is crucial for disinfection.
  • Laser-activated irrigation (LAI) offers advanced methods for irrigant delivery.
  • Understanding irrigant extrusion is vital for procedural safety.

Purpose of the Study:

  • To compare apical extrusion of 3% sodium hypochlorite.
  • To evaluate two Er:YAG LAI modes: super short pulse (SSP) and shock wave enhanced emission photoacoustic streaming (SWEEPS®).
  • To assess the influence of three laser fiber tip (FT) types combined with LAI and conventional syringe needle irrigation (SNI).

Main Methods:

  • Extracted human maxillary central incisors were prepared.
  • Irrigant volumetric flow (IVF) was standardized.
Keywords:
Er:YAGLaser TherapyLaser-Activated IrrigationMeSH terms: Root Canal PreparationPhoton-Induced Photoacoustic StreamingRoot CanalRoot Canal IrrigantsShock Wave Enhanced Emission Photoacoustic StreamingSodium Hypochlorite

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  • Tested protocols included SNI, SSP with various FTs, and AutoSWEEPS with various FTs.

    • Main Results:

    • SNI and SSP with radial SWEEPS and PIPS FTs showed significantly lower irrigant extrusion (p<0.05).
    • AutoSWEEPS groups exhibited similar irrigant extrusion regardless of FT type (p>0.05).
    • Laser-activated irrigation parameters significantly influenced apical extrusion.

    Conclusions:

    • In straight root canals, AutoSWEEPS mode with fiber FTs demonstrated a higher potential for irrigant extrusion.
    • Careful selection of LAI modes and tips is necessary to minimize apical extrusion.
    • Further research is needed to optimize LAI protocols for safety.