Fotona Case Studies

Effect of Photon-Initiated Photoacoustic Streaming on Removal of Apically Placed Dentinal Debris

Written by National Dental Innovations | Jun 10, 2025 7:12:32 PM
 

Discover how PIPS is revolutionizing the removal of apically placed dentinal debris, offering superior cleanliness and efficiency in root canal treatments.

Authors: H. Arslan, I.D. Capar, G. Saygili, T. Gok, M. Akcay

Journal: International Endodontic Journal

Objective

The primary objective of this study was to compare the efficacy of photon-initiated photoacoustic streaming (PIPS) with conventional syringe irrigation, sonic activation, and ultrasonic irrigation in removing apically placed dentinal debris from artificial root canal grooves. By understanding the effectiveness of these different irrigation methods, the study aimed to identify the most efficient technique for enhancing root canal debridement, particularly in the challenging apical regions.

Materials and Methods

  • Sample: 48 extracted single-rooted human teeth instrumented to size 40 (ProTaper rotary system).
  • Artificial debris model: Teeth split longitudinally; standardized apical grooves filled with dentinal debris mixed with 5% NaOCl.
  • Irrigation groups:
    • Conventional irrigation (CI) with 1% NaOCl via 27G needle.
    • Sonic activation (EndoActivator).
    • Ultrasonic activation.
    • PIPS using Er:YAG laser (2940 nm, 20 mJ, 15 Hz)
  • Evaluation: Remaining debris scored under stereomicroscope (20× magnification) using a 4-grade system. Statistical analysis via Kruskal-Wallis and Mann-Whitney U-tests (P = 0.05)

Key Results

  • PIPS superiority:
    • Significantly outperformed CI (P < 0.001), sonic (P < 0.001), and ultrasonic irrigation (P = 0.005).
    • No significant difference between sonic and ultrasonic methods (P = 0.377).
  • Debris removal efficiency: PIPS achieved the highest cleanliness scores, particularly in challenging apical regions.

Conclusion

PIPS demonstrated superior efficacy in removing apical dentinal debris compared to conventional, sonic, and ultrasonic irrigation methods. This highlights its potential as a clinically valuable technique for enhancing root canal debridement, especially in complex apical anatomy. The study underscores the role of laser-induced photoacoustic streaming in optimizing irrigation dynamics.

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