The effectiveness of the Erbium:Yttrium aluminum garnet PIPS technique in comparison to different chemical solutions in removing the endodontic smear layer-an in vitro profilometric study.

This study evaluated the degree of endodontic smear layer removal using the Er:YAG PIPS technique (2.94 μm) in comparison with different irrigants. Sixty-four single-rooted teeth were endodontically prepared up to size #40 and were divided into 8 groups (a-h) (n = 8). Groups a, b, c, and d were irrigated with (3 % NaOCl + 20 % EDTA), (0.9 % NaCl), (3 % NaOCl), and (20 % EDTA), respectively. Groups e, f, g, and h were treated with (3 % NaOCl + 20 % EDTA + PIPS), (0.9 % NaCl + PIPS), (3 % NaOCl + PIPS), and (20 % EDTA + PIPS), respectively. The settings of the Er:YAG PIPS technique were (0.3 W, 20 mJ, 15 Hz, 50 μs, no water and air). The root canals were examined under a profilometer to evaluate the degree of smear layer removal using Hülsmann scores. The smear layer was present in the coronal, middle, and apical thirds of groups b, c, f, and g. Groups a, d, e, and h exhibited open dentinal tubules in the coronal and middle thirds. However, none of the apical thirds showed open dentinal tubules. No significant difference was observed between the groups treated only with irrigants and those treated with Er:YAG PIPS and the same irrigants (p ≥ 0.0018). The Er:YAG PIPS technique did not show any improved results in removing the smear layer when compared to the irrigants alone. Moreover, the open dentinal tubules in some groups were a result of the chelating action of 20 % EDTA.