Visualization of removal of trapped air from the apical region in simulated root canals by laser-activated irrigation using an Er,Cr:YSGG laser.

The aim of this visualization study was to obtain a better understanding of the mechanism by which trapped air is removed from the apical region of simulated root canals by activation of an irrigant using an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser during endodontic procedures. A high-speed imaging system with high temporal and spatial resolution was used to visualize laser-induced shock waves in a resin block model with a curved root canal (inner diameter at the apex 0.08 mm, taper 4 %, crown height 10 mm, overall length 40 mm) and a glass cylinder model with a straight root canal (inner diameter 1 mm, crown height 10 mm, overall length 40 mm). The study utilized MZ3 and RFT3 tips in each model, without water or air spray, and with an average power of 1 W at 35 Hz. Laser-activated irrigation overcame the airlock effect by releasing air trapped in the air column. The mechanism underlying the removal of trapped air from the apical region using an Er,Cr:YSGG laser in a dry root canal is via the disruption of the surface tension at the solution-air interface. This disruption, caused by bubble implosion (cavitation), displaces air in the form of bubbles from the apical region toward the solution, which allows the solution to travel apically.