Activation of endodontic irrigants using a 9.3 µm CO₂ and diode lasers: A laboratory proof of concept model.

Purpose: To investigate the differences between irrigant propagation and temperature changes using laser-activated irrigation (LAI) at different settings in an artificial root canal model.

Methods: Using an artificial resin root canal model, irrigant activation was achieved in 19 experimental groups with eight samples each. A 9,300 nm CO₂ laser, two diode lasers with different settings (wavelengths 455, 808, 970, and 980 nm) were compared to 2,940 nm Er:YAG laser and traditional needle irrigation. Er:YAG and CO₂ laser were activated in the pulpal chamber only, while diode lasers and needles were inserted into the main root canal. Lasers were activated for 5x 20 seconds resulting in 100 seconds of activation or rinsing for each sample. After each activation of 20 seconds, a photo was taken of the side canals and the propagation of the dye was measured with a digital measuring tool after calibration. Further, the temperature of the irrigant was reported after activation of 20 seconds and repeated 5 times. Data were checked for normality and statistically compared.

Results: All lasers increased the irrigant propagation compared to conventional irrigation. Significant differences were found between groups regarding propagation and temperature (P< 0.0027). Er:YAG and CO₂ laser had similar effects on irrigant propagation in middle and apical located side-canals with specific power parameters and were superior to diode lasers and syringe irrigation. The irrigant's temperature increased significantly with the diode and CO₂ lasers.

Clinical significance: Diode lasers and CO₂ lasers have not been established for irrigant activation. 9,300 nm CO₂ lasers absorb well in water and were shown to introduce vapor bubble formation and streaming in water. Diode lasers are highly accepted in periodontics. The laser light is not absorbed in water but interacts with bacteria as well as soft tissues and contributes therefore to infection control. With a modified laser tip it was however possible to introduce cavitation and streaming in irrigants.