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.

Visualization of removal of trapped air from the apical region of the straight root canal models generating 2-phase intermittent counter flow during ultrasonically activated irrigation.

INTRODUCTION: The purpose of this in vitro study was to obtain a better understanding of the mechanism of irrigant traveling apically and generating 2-phase intermittent counter flow in straight root canal models during activation of the irrigant by ultrasonic means in an endodontic procedure. METHODS: A high-speed imaging system, with high temporal and spatial resolution (FastCam SA5; Photron, Tokyo, Japan) at a frame rate of 100,000 frames per second using a macro lens (60 mm, f/2.8; Nikon, Tokyo, Japan), was used to visualize, in glass models of root canals, an ultrasonically induced acoustic pressure wave in an EDTA solution environment. A 25-mm stainless steel noncutting file #20 driven by an ultrasonic device (P5 Newtron; Satelec Acteon, Mérignac, France) at power settings of 5 and 7 produced disturbances at the solution-air interface. RESULTS: We found that apically directed travel of the irrigant was caused by disruption of the surface tension at the solution-air interface. This disruption caused by ultrasonic activation energy displaced air in the form of bubbles from the apical region toward the solution. CONCLUSIONS: The apical movement of the solution may be attributed to ultrasonically induced wave generation at the solution-air interface, resulting in the removal of trapped air from the root canal and allowing the solution to travel apically in the opposite directions (via a 2-phase intermittent counter flow).