Effectiveness of the erbium:YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation.

The aim of this study was to analyze in vitro the debriding ability of an Er:YAG laser system (2,940 nm) equipped with a newly designed radial and stripped tip of 400 µm diameter by scanning electron microscopy (SEM). A total of 80 single-rooted extracted human teeth were endodontically prepared with rotary instrumentation and standardized chemical irrigation using 5.25% sodium hypochlorite. At the end of mechanical instrumentation, four different final protocols were used. Group 1 was irrigated for 2 min with saline water as a control group. Groups 2, 3 and 4 were irradiated with an Er:YAG laser at 25 mJ and 15 Hz with a pulse duration of 50 μs and laser spray off using the tip in the coronal opening of the wet root canal. Different solutions and irradiation times were used: group 2 20 s, laser irradiation in sterile distilled water, wet canal; group 3 20 s, laser irradiation in 17% EDTA, wet canal; and group 4 40 s, laser irradiation in 17% EDTA, wet canal. Debridement of and smear layer removal from the apical third of root canals were evaluated by SEM. The study showed that standardized instrumentation, followed by a final Er:YAG laser irradiation in wet canals with EDTA irrigation resulted in more cleaning of the root canal walls and a higher quantity of open tubules in comparison with the traditional irrigation method.