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Laser-Activated Versus Passive Ultrasonic Irrigation in Endodontic Retreatment
Sponsor: Inonu University
Summary
This study will compare three methods of activating the final irrigation solution in reducing living bacteria inside the root canals of teeth that require root canal retreatment because of apical periodontitis, an inflammatory condition of the tissues around the root tip. The three methods are photon-induced photoacoustic streaming (PIPS), shock wave-enhanced emission photoacoustic streaming (SWEEPS), and passive ultrasonic irrigation (PUI). Ninety adults requiring retreatment of a single-rooted, single-canal tooth will be randomly assigned to three groups; all treatment steps other than the activation method will be identical. Root canal samples will be collected at several stages of the single-visit treatment, and living bacteria will be counted using laboratory cultures. In addition, real-time PCR will be used to measure the relative amount of Enterococcus faecalis DNA compared with total bacterial DNA. Because PCR cannot distinguish living from dead bacteria, these molecular results will be interpreted as complementary to the culture findings.
Official title: Comparison of the Efficacy of PIPS and SWEEPS Laser-activated Irrigation Versus Passive Ultrasonic Irrigation in Reducing Viable Intracanal Bacteria During Endodontic Retreatment of Teeth With Apical Periodontitis: a Culture-based Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
90
Start Date
2026-11
Completion Date
2027-05
Last Updated
2026-10-29
Healthy Volunteers
No
Conditions
Interventions
Photon-Induced Photoacoustic Streaming
After S2 sampling, 3 mL of 17% EDTA will be delivered with the needle 2 mm short of the working length and left for 3 minutes without activation, then aspirated, and the canal will be rinsed with 5 mL of sterile saline. The canal and pulp chamber will be filled with 2 mL of 5% NaOCl and activated for 20 seconds with an Er:YAG laser (2940 nm; LightWalker ST-E Pro, Fotona d.o.o., Ljubljana, Slovenia) in PIPS mode at 20 mJ, 15 Hz, 0.3 W and 50-microsecond pulse duration, with water and air spray off. A tapered PIPS 600/9 tip (600 micrometers, 9 mm) will be held stationary in the access cavity above the canal orifice without insertion into the canal. This will be repeated three times with fresh 2 mL of NaOCl (total 6 mL, 60 seconds of activation), keeping the pulp chamber filled throughout.
Shock Wave Enhanced Emission Photoacoustic Streaming
After S2 sampling, 3 mL of 17% EDTA will be delivered with the needle 2 mm short of the working length and left for 3 minutes without activation, then aspirated, and the canal will be rinsed with 5 mL of sterile saline. The canal and pulp chamber will be filled with 2 mL of 5% NaOCl and activated for 20 seconds with an Er:YAG laser (2940 nm; LightWalker ST-E Pro, Fotona d.o.o., Ljubljana, Slovenia) in AutoSWEEPS mode at 20 mJ, 15 Hz and 0.3 W, with water and air spray off. A Radial SWEEPS 600/9 tip (600 micrometers, 9 mm) will be held stationary in the access cavity above the canal orifice without insertion into the canal. This will be repeated three times with fresh 2 mL of NaOCl (total 6 mL, 60 seconds of activation), keeping the pulp chamber filled throughout.
Passive Ultrasonic Irrigation
After S2 sampling, 3 mL of 17% EDTA will be delivered with the needle 2 mm short of the working length and left for 3 minutes without activation, then aspirated, and the canal will be rinsed with 5 mL of sterile saline. The canal and pulp chamber will be filled with 2 mL of 5% NaOCl and activated for 20 seconds with a Woodpecker DTE S6 ultrasonic device (Guilin Woodpecker Medical Instrument Co., Ltd., Guilin, China) and an ED60 tip in Endo mode at power level 2. The tip will be positioned 2 mm short of the working length and activated without contacting the root canal walls. This will be repeated three times with fresh 2 mL of NaOCl (total 6 mL, 60 seconds of activation), keeping the pulp chamber filled throughout.
Locations (1)
Inonu University, Faculty of Dentistry, Department of Endodontics
Malatya, Turkey (Türkiye)