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Comparative Efficacy of Er:Yag Laser and Shock Wave Enhanced Emission Photoacoustic Streaming (Sweeps) for Smear Layer Removal: An Ex Vivo Study Publisher



Jamali A1 ; Khoshkhounejad M2 ; Chiniforush N3 ; Razlighi AV1 ; Khosraviani F4 ; Sarraf P2
Authors
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Authors Affiliations
  1. 1. Private Practice, Tehran, Iran
  2. 2. Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
  4. 4. DDS, UCLA School of Dentistry, Los Angeles, United States

Source: World Journal of Dentistry Published:2023


Abstract

Aim: This study aimed to compare the efficacy of conventional syringe irrigation (CSI), erbium-doped yttrium aluminum garnet (Er:YAG) light amplification by the stimulated emission of radiation (laser), and shock wave enhanced emission photoacoustic streaming (SWEEPS) for smear layer removal. Materials and methods: In this ex vivo study, the smear layer was removed from the root canals of 36 extracted single-canal teeth in six groups by using the following modalities—ethylenediaminetetraacetic acid (EDTA) + sodium hypochlorite (NaOCl), NaOCl + EDTA + Er:YAG laser, NaOCl + EDTA + SWEEPS, distilled water + Er:YAG laser, distilled water + SWEEPS, and distilled water alone. In all laser groups, Er:YAG laser (Fontana, Slovenia) was used with 20 mJ energy for 20 seconds. The laser was irradiated with 0.3 W power with 50 µseconds pulse width and 15 Hz frequency for 20 seconds with air and water spray in off mode. The amount of smear layer was quantified under a scanning electron microscope (SEM) at ×1000 magnification using a 5-point scoring system. Data were analyzed by the Kruskal–Wallis test. The p-value was set at <0.05. Results: A significant difference was noted in smear layer removal between the EDTA groups and distilled water groups (p < 0.001). However, the difference was not significant between the EDTA groups with each other or between the distilled water groups with each other (p > 0.05). In EDTA groups, laser activation of irrigant and use of SWEEPS mode showed better smear scores in the middle and apical thirds. Conclusion: According to the limitation of the present study, Er:YAG laser and SWEEPS technique can remove the smear layer effectively in the presence of EDTA. SWEEPS mode of Er:YAG laser can serve as a suitable alternative to the conventional Er:YAG laser and CSI for smear layer removal from the hard-to-reach areas of the root canal system. Clinical significance: Using Er:YAG or SWEEPS technique was comparatively efficient in cleaning the smear layer, and it can be used for effective removal of the smear layer for clinical usage. © The Author(s). 2023 Open Access.
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