--- title: PIPS Outperforms Traditional Irrigation in Complex Canal Systems description: Revolutionizing root canal procedures, Photon-Induced Photoacoustic Streaming (PIPS) sets a new standard in irrigation effectiveness for complex canal systems. image: https://www.nationaldental.com/hubfs/AI-Generated%20Media/Images/The%20image%20depicts%20a%20dental%20laboratory%20setting%20featuring%20a%20bright%20welllit%20workspace%20with%20various%20dental%20tools%20and%20equipment%20neatly%20arranged%20on%20a%20stainless%20steel%20countertop%20In%20the%20foreground%20a%20closeup%20view%20shows%20a%20mandibular%20molar%20tooth%20mounted%20in%20a%20de-2.jpeg --- [Skip to content](https://www.nationaldental.com/fotona-case-studies/pips-outperforms-traditional-irrigation-in-complex-canal-systems#main-content) This is a search field with an auto-suggest feature attached. - There are no suggestions because the search field is empty. #### Stay informed on the latest dental innovations and educational programs ![Close-Icon](https://www.nationaldental.com/hs-fs/hubfs/Close-Icon.png?width=100&height=100&name=Close-Icon.png) # PIPS Outperforms Traditional Irrigation in Complex Canal Systems [ National Dental Innovations ](https://www.nationaldental.com/fotona-case-studies/author/national-dental-innovations) Jun 10, 2025 3:12:35 PM ![](https://www.nationaldental.com/hubfs/AI-Generated%20Media/Images/The%20image%20depicts%20a%20dental%20laboratory%20setting%20featuring%20a%20bright%20welllit%20workspace%20with%20various%20dental%20tools%20and%20equipment%20neatly%20arranged%20on%20a%20stainless%20steel%20countertop%20In%20the%20foreground%20a%20closeup%20view%20shows%20a%20mandibular%20molar%20tooth%20mounted%20in%20a%20de-2.jpeg) ### Contents [Jun 10, 2025 3:12:32 PM Effect of Photon-Initiated Photoacoustic Streaming on Removal of Apically Placed Dentinal Debris ](https://www.nationaldental.com/fotona-case-studies/effect-of-photon-initiated-photoacoustic-streaming-on-removal-of-apically-placed-dentinal-debris) [Jun 10, 2025 3:12:31 PM Disinfection of Root Canals with Photon-Initiated Photoacoustic Streaming ](https://www.nationaldental.com/fotona-case-studies/disinfection-of-root-canals-with-photon-initiated-photoacoustic-streaming) [Jun 10, 2025 3:12:39 PM Disinfection Efficacy of Photon-Induced Photoacoustic Streaming on Root Canals Infected with E. Faecalis ](https://www.nationaldental.com/fotona-case-studies/disinfection-efficacy-of-photon-induced-photoacoustic-streaming-on-root-canals-infected-with-enterococcus-faecalis-an-ex-vivo-study) - [Tweet](https://twitter.com/share) *Revolutionizing root canal procedures, Photon-Induced Photoacoustic Streaming (PIPS) sets a new standard in irrigation effectiveness for complex canal systems.* Authors: Lloyd A, Navarrete G, Marchesan MA, Clement D Journal: Journal of Applied Oral Science, 2016 Nov-Dec ## Objective The study compared the effectiveness of three irrigation techniques-photon-induced photoacoustic streaming (PIPS) with Er:YAG laser, passive ultrasonic irrigation (PUI), and standard needle irrigation (SNI)-for removing calcium hydroxide [Ca(OH)22] from the mesial roots of mandibular molars with Weine Type II canal configurations. ## Materials and Methods - Thirty mandibular molars with complex mesial root anatomy were prepared and filled with Ca(OH)22 paste. - Teeth were divided into three groups (n=10 each): - PIPS (Er:YAG laser, 15 Hz, 20 mJ, 9 mm tip) - PUI (EndoUltra, 15/.02 tip) - SNI (30 Ga. side-vented needle) - All groups used equal volumes of 8.25% NaOCl and 17% EDTA. - Micro-CT was used to measure the initial and residual Ca(OH)22 volumes after irrigation. ## Key Results - All three methods removed Ca(OH)22 similarly in the coronal and middle canal thirds. - In the apical third: - PIPS achieved significantly greater Ca(OH)22 removal (median 0% residual) than PUI (median 100% residual) and SNI (median 47% residual) (p<0.001). - PIPS was the only technique to consistently remove Ca(OH)22 from the apical and complex isthmus areas. ## Conclusion Unlike SNI and PUI, the PIPS tip remains in the access cavity providing, expanding, and collapsing cavitational bubbles that progress as shear forces along the canal walls. Our results showed no remaining Ca(OH)2 throughout the root canal system in mesial roots of mandibular molars with Weine Type II canal anatomy and isthmuses. Even the most apical area of the root canal, which normally imposes increased irrigation difficulties was free of Ca(OH)2. [ACCESS THE FULL ARTICLE HERE](https://pmc.ncbi.nlm.nih.gov/articles/PMC5161252/) ![0d1c16a5b1c8ca72ccde519789a56055b58a0846](https://20651098.fs1.hubspotusercontent-na1.net/hub/20651098/hubfs/0d1c16a5b1c8ca72ccde519789a56055b58a0846.jpeg?width=1200&length=1200&name=0d1c16a5b1c8ca72ccde519789a56055b58a0846.jpeg) [![0d1c16a5b1c8ca72ccde519789a56055b58a0846-1](https://20651098.fs1.hubspotusercontent-na1.net/hub/20651098/hubfs/0d1c16a5b1c8ca72ccde519789a56055b58a0846-1.jpeg?width=1200&length=1200&name=0d1c16a5b1c8ca72ccde519789a56055b58a0846-1.jpeg) ](https://pmc.ncbi.nlm.nih.gov/articles/PMC5161252/) Three-dimensional reconstructions of mesial roots of mandibular molars with Weine Type II canal configurations illustrating remaining Ca(OH)2 in the different canal thirds (coronal – red; middle – yellow; apical – green) before (A1–C1) and after irrigation protocols (A2) PIPS, (B2) PUI, (C2) SNI [Scientific Study](https://www.nationaldental.com/fotona-case-studies/tag/scientific-study) [Endodontics](https://www.nationaldental.com/fotona-case-studies/tag/endodontics) [Jun 10, 2025 3:12:32 PM Effect of Photon-Initiated Photoacoustic Streaming on Removal of Apically Placed Dentinal Debris ](https://www.nationaldental.com/fotona-case-studies/effect-of-photon-initiated-photoacoustic-streaming-on-removal-of-apically-placed-dentinal-debris) [Jun 10, 2025 3:12:31 PM Disinfection of Root Canals with Photon-Initiated Photoacoustic Streaming ](https://www.nationaldental.com/fotona-case-studies/disinfection-of-root-canals-with-photon-initiated-photoacoustic-streaming) [Jun 10, 2025 3:12:39 PM Disinfection Efficacy of Photon-Induced Photoacoustic Streaming on Root Canals Infected with E. Faecalis ](https://www.nationaldental.com/fotona-case-studies/disinfection-efficacy-of-photon-induced-photoacoustic-streaming-on-root-canals-infected-with-enterococcus-faecalis-an-ex-vivo-study) [Previous Enhanced Removal of E. faecalis Biofilms in the Root Canal Using NaOCl Plus PIPS ](https://www.nationaldental.com/fotona-case-studies/enhanced-removal-of-e.-faecalis-biofilms-in-the-root-canal-using-sodium-hypochlorite-plus-pips) [Next Elimination of Intracanal Tissue and Debris Through a Novel Laser-Activated System ](https://www.nationaldental.com/fotona-case-studies/elimination-of-intracanal-tissue-and-debris-through-a-novel-laser-activated-system-assessed-using-high-resolution-micro-computed-tomography-a-pilot-study) ## Leave a Comment ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "dateModified" : "2024-10-01", "datePublished" : "2024-10-01", "headline" : "PIPS Outperforms Traditional Irrigation in Complex Canal Systems", "image" : [ "https://20651098.fs1.hubspotusercontent-na1.net/hubfs/20651098/AI-Generated%20Media/Images/The%20image%20depicts%20a%20dental%20laboratory%20setting%20featuring%20a%20bright%20welllit%20workspace%20with%20various%20dental%20tools%20and%20equipment%20neatly%20arranged%20on%20a%20stainless%20steel%20countertop%20In%20the%20foreground%20a%20closeup%20view%20shows%20a%20mandibular%20molar%20tooth%20mounted%20in%20a%20de-2.jpeg" ], "mainEntityOfPage" : { "@id" : "https://www.nationaldental.com/fotona-case-studies/pips-outperforms-traditional-irrigation-in-complex-canal-systems", "@type" : "WebPage" } } ``` ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "National Dental Innovations", "url" : "https://www.nationaldental.com/fotona-case-studies/author/national-dental-innovations" }, "dateModified" : "2025-06-16T15:24:30.237Z", "datePublished" : "2025-06-10T19:12:35.000Z", "headline" : "PIPS Outperforms Traditional Irrigation in Complex Canal Systems", "image" : [ "https://www.nationaldental.com/hubfs/AI-Generated%20Media/Images/The%20image%20depicts%20a%20dental%20laboratory%20setting%20featuring%20a%20bright%20welllit%20workspace%20with%20various%20dental%20tools%20and%20equipment%20neatly%20arranged%20on%20a%20stainless%20steel%20countertop%20In%20the%20foreground%20a%20closeup%20view%20shows%20a%20mandibular%20molar%20tooth%20mounted%20in%20a%20de-2.jpeg" ], "mainEntityOfPage" : { "@id" : "https://www.nationaldental.com/fotona-case-studies/pips-outperforms-traditional-irrigation-in-complex-canal-systems", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://www.nationaldental.com/hubfs/2019%20ND%20Innovations%20logo%20PMS%200819C-02.jpg" }, "name" : "National Dental Innovations" } } ```