Efficacy of Laser Activated vs Sonic Activated Irrigation for Debris Removal in Conservatively Instrumented Root Canals

J Endod. 2024 Dec 18:S0099-2399(24)00680-0. doi: 10.1016/j.joen.2024.12.006. Online ahead of print.

Abstract

Introduction: To compare the efficacy of laser activated and sonic activated irrigation on the removal of debris in mesial root canal systems of mandibular molars using micro-computed tomographic (micro-CT) analysis.

Methods: Forty-eight mesial roots of extracted mandibular molars with isthmus were selected and randomly allocated into two groups: Sonic Group and Laser Group. The root canals were minimally instrumented to a maximum apical file size of 20/06v (DCTaper, SSWhite, NJ). The Sonic Group received irrigant activation using the SmartLite Pro EndoActivator (Dentsply Tulsa, OK) with a 15/02 tip. The Laser Group received irrigant activation using the WaterLase iPlus (Biolase, CA) with a RFT2 tip. The teeth were activated for the same time with the same volume of irrigants. Micro-CT scans were obtained pre-instrumentation, pre-irrigation, and post-irrigation. To quantify debris removal, the air-filled volume was measured pre-irrigation and post-irrigation, and the percentage increase in air-filled volume was calculated. Data was analyzed statistically (independent samples t-test, significance set at 5%).

Results: The Laser Group demonstrated a significantly higher mean percentage increase in air-filled volume (37.4%) compared to the Sonic Group (20.2%). This difference was statistically significant (p < 0.05).

Conclusion: The Laser Group was significantly more effective in removing debris compared to the Sonic Group in minimally instrumented root canal systems. However, due to the limitations of this study, further research is needed to assess the impact of laser activated irrigation on clinical outcomes.