Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs

Introduction: The study assessed the efficacy of laser activated irrigation (LAI) with Erbium: Yttrium Aluminum Garnet (Er:YAG) and Erbium Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) wavelengths as compared with passive ultrasonic irrigation (PUI). Previously proposed irrigation times were used for LAI (4x 5 seconds) and the intermittent flush technique (3x 20 seconds). Methods: We used a split root model with an artificial root canal wall groove. Roots were prepared to an apical size # 40 with ProFiles 0.06 (Dentsply Maillefer, Baillaigues, Switzerland). Five groups of 20 straight canine roots were evaluated as follows: Group 1: hand irrigation for 20 s with 2.5% NaOCl (Cl); Group 2: PUI performed once for 20 s with the #20 Irrisafe (Satelec Acteon group, Merignac, France) (PUI 1); Group 3: PUI for 3x 20 s with the Irrisafe (PUI 2); Group 4: LAI with the Er,Cr:YSGG laser and Z2 (200 mu m) Endolase tip (Biolase, San Clemente, USA) at 75 mJ for 4x 5 s (LAI 1); Group 5: LAI with the Er:YAG laser (HoYa Versawave, Cortaboeuf, France) and a 200 Am endodontic fiber at 75 mJ for 4x 5 s (LAI 2). Images from the groove were taken before and after irrigation. The quantity of dentin debris in the groove after the experimental protocols was evaluated. Results: Statistically significant differences (p < 0.05) were found between Cl and all other groups and between PUI 1 and the other groups. Conclusion: LAI techniques using erbium lasers (Er:YAG or Er,Cr:YSGG) for 20 seconds (4x 5 seconds) are as efficient as PUI with the intermittent flush technique (3x 20 seconds)