Decontamination efficacy of photon‐initiated photoacoustic streaming (PIPS) of irrigants using low‐energy laser settings: an ex vivo study

AIM: To assess ex vivo, the antibacterial effectiveness of photon-initiated photoacoustic streaming (PIPS) of irrigants using an Er:YAG laser equipped with a newly designed, stripped and tapered tip in extracted teeth with infected root canals. METHODOLOGY: One hundred and forty-eight single-rooted extracted teeth were prepared to a size 25, 0.06 taper. The specimens were sterilized, and all teeth except ten (negative control group) were inoculated with Enterococcus faecalis and incubated in a CO(2) chamber at 37 °C for 15 days in Eppendorf tubes filled with trypticase soy broth medium changed every 2 days. Infected teeth were then randomly divided into four test groups (n = 32 for each): pulsed erbium/YAG laser at nonablative settings for 30 s with sterile bi-distilled water (Group A) or 5% sodium hypochlorite (NaOCl) (Group B); without laser-activated sterile bi-distilled water irrigation for 30 s (Group C) or 5% NaOCl irrigation for 30 s (Group D); the positive control group received no treatment in infected teeth (n = 10). Colony-forming units (CFUs) were counted from bacteriologic samples taken before (S1) and after treatment (S2). Data were analysed by Kruskal-Wallis and post hoc Dunn's multiple comparison tests. RESULTS: CFU counts were significantly lower in 5% NaOCl groups with or without laser activation than in sterile bi-distilled water without laser activation group (P < 0.001). Moreover, there was a significant difference between bi-distilled water groups with or without laser activation (P < 0.001). Sodium hypochlorite with laser activation group had the greatest CFU reduction, which was significantly greater than that evident in bi-distilled water groups with or without laser activation (P < 0.001). There were no significant differences between 5% NaOCl groups with or without laser activation (P > 0.05). None of the four groups generated negative samples predictably. CONCLUSIONS: Under the conditions of this ex vivo study, there were no significant differences in bacterial reduction between the laser and NaOCl or NaOCl alone groups. [Correction added after online publication, 18th April 2012: The following statement has been deleted: 'Thus, the use of a laser did not improve microbial killing over and above use of NaOCI alone.'].