Efficacy of Er: YAG, continuous-wave, and pulsed diode laser-activated irrigation on smear layer removal: a comparative microscopic study
摘要
to evaluate the efficacy of Erbium: Yttrium-Aluminum-Garnet (Er: YAG), continuous-wave (CW), and pulsed diode laser- activation methods compared to conventional irrigation in removing the smear layer using different concentrations of sodium hypochlorite (NaOCl), saline, EDTA, and EDTA combined with NaOCl root canal irrigants.
MethodsThree hundred extracted human straight-root, single-canal premolars were decoronated and instrumented using a rotary NiTi system. The samples were randomly divided into five main groups (n = 60 each) according to the method of irrigation activation: Group 1 – conventional, Group 2 – Er: YAG laser-activated, Group 3 – CW diode laser-activated, Group 4–70%-duty cycle, pulsed diode laser-activated, and Group 5–50%-duty cycle, pulsed diode laser-activated irrigation techniques. Each group was further subdivided based on the type of root canal irrigant into 6 subgroups: NaOCl + EDTA, EDTA, 5.25%, 2.5%, and 1% NaOCl, and saline (n = 10 each). Smear layer removal was evaluated using environmental scanning electron microscopy (ESEM) at the coronal, middle, and apical thirds of the root canal.
ResultsEr: YAG laser-activated irrigation achieved significantly superior smear layer removal in all thirds compared to diode laser-activated and conventional methods (p < 0.001). Among irrigants, NaOCl + EDTA was the most effective (p < 0.001), while saline had the least effect. Higher NaOCl concentrations improved smear layer removal with diode and conventional methods, whereas Er: YAG performed better with lower NaOCl concentrations.
ConclusionEr: YAG and 976-nm diode laser activations significantly enhance the smear layer removal efficiency of root canal irrigants. NaOCl concentrations can influence the efficacy of conventional and laser-activated irrigations methods.