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In vitro evaluation of periapical safety of various laser-activated irrigation protocols using a quantitative assessment method

J Conserv Dent Endod. 2025 Sep;28(9):925-930. doi: 10.4103/JCDE.JCDE_463_25. Epub 2025 Sep 5.

ABSTRACT

CONTEXT: Successful root canal treatment (RCT) depends on effective irrigant activation to enhance disinfection and minimize the risk of apical periodontitis. Laser-activated irrigation (LAI) has shown promise; however, its periapical safety remains to be fully evaluated.

AIMS: The aim of this study was to assess and compare the periapical safety of erbium:yttrium-aluminum-garnet (Er: YAG) and diode laser irrigation protocols with passive ultrasonic irrigation (PUI) during RCT.

SETTINGS AND DESIGN: This was a quantitative in vitro experimental study.

METHODS: Sixty-six extracted human single-rooted teeth were standardized and fixed into a 96-well plate containing 300 μL of a pH indicator solution. Teeth were randomly allocated to three groups: PUI, diode laser, and Er: YAG laser. Irrigation with 5.25% sodium hypochlorite (NaOCl) was activated using the designated technique. Apical extrusion of NaOCl was quantified using ELISA-based spectrophotometry.

STATISTICAL ANALYSIS USED: Kruskal-Wallis and post hoc pairwise comparison tests were performed (P < 0.05).

RESULTS: All groups showed apical extrusion. The Er: YAG group had significantly less extrusion than the diode and PUI groups (P < 0.05).

CONCLUSIONS: Within the study’s limitations, Er: YAG and diode LAI reduced apical NaOCl extrusion compared to PUI, indicating improved periapical safety. Further clinical studies are needed.

PMID:40964642 | PMC:PMC12440348 | DOI:10.4103/JCDE.JCDE_463_25

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