In-vitro efficacy of Er:YAG laser-activated irrigation versus photon-induced photoacoustic streaming (PIPS) irrigation for smear layer removal: A Scanning Electron Microscopy Study

Purpose to microscopically examine the effect of Er:YAG and Er,Cr:YSGG lasers agitation techniques on smear layer removing-capacity of NaOCl intracanal at the apical, middle, and coronal regions of root canal walls. Methods Eighteen freshly extracted human single-canal anterior dentitions were chosen for this study. After the root canals mechanically prepared to size X4, 0.06 taper byrotary files of ProTaper Next® system, they were randomly categorized into three equal groups (6 teeth each); syringe/needle- and Er,:YAG and Er,Cr:YSGG laser-activated groups. Lasers were operated at subablative level. For microscopic assessment, samples were longitudinally hemi-sectioned. Kruskal-Wallis and Mann-Whitney tests were utilized to statistically analyze the collected data. Results Laser-activated groups presented significant lower smear layer score values than that of syringe/needle activated group. Conclusion Erbium laser-activated irrigation technique has a favorable impact on agitation NaOCl root canal irrigant enhancing the cleaning procedure of root canal system.