title: Decontamination efficacy of photon-initiated photoacoustic streaming (PIPS) of irrigants using low-energy laser settings: an ex vivo study.
abstract: OBJECTIVE
  To assess ex vivo, the antibacterial effectiveness of photon-initiated photoacoustic streaming (PIPS) of irrigants using an Er:YAG laser equipped with a newly designed, stripped and tapered tip in extracted teeth with infected root canals.
  
  
  METHODS
  One hundred and forty-eight single-rooted extracted teeth were prepared to a size 25, 0.06 taper. The specimens were sterilized, and all teeth except ten (negative control group) were inoculated with Enterococcus faecalis and incubated in a CO(2) chamber at 37 °C for 15 days in Eppendorf tubes filled with trypticase soy broth medium changed every 2 days. Infected teeth were then randomly divided into four test groups (n = 32 for each): pulsed erbium/YAG laser at nonablative settings for 30 s with sterile bi-distilled water (Group A) or 5% sodium hypochlorite (NaOCl) (Group B); without laser-activated sterile bi-distilled water irrigation for 30 s (Group C) or 5% NaOCl irrigation for 30 s (Group D); the positive control group received no treatment in infected teeth (n = 10). Colony-forming units (CFUs) were counted from bacteriologic samples taken before (S1) and after treatment (S2). Data were analysed by Kruskal-Wallis and post hoc Dunn's multiple comparison tests.
  
  
  RESULTS
  CFU counts were significantly lower in 5% NaOCl groups with or without laser activation than in sterile bi-distilled water without laser activation group (P < 0.001). Moreover, there was a significant difference between bi-distilled water groups with or without laser activation (P < 0.001). Sodium hypochlorite with laser activation group had the greatest CFU reduction, which was significantly greater than that evident in bi-distilled water groups with or without laser activation (P < 0.001). There were no significant differences between 5% NaOCl groups with or without laser activation (P > 0.05). None of the four groups generated negative samples predictably.
  
  
  CONCLUSIONS
  Under the conditions of this ex vivo study, there were no significant differences in bacterial reduction between the laser and NaOCl or NaOCl alone groups. [Correction added after online publication, 18th April 2012: The following statement has been deleted: 'Thus, the use of a laser did not improve microbial killing over and above use of NaOCI alone.'].
authors.affiliation: Department of Surgery, University of Catania, Catania, Italy. eugeniopedulla@gmail.com
authors.forename: E
authors.initials: E
authors.lastname: Pedullà
authors.forename: C
authors.initials: C
authors.lastname: Genovese
authors.forename: E
authors.initials: E
authors.lastname: Campagna
authors.forename: G
authors.initials: G
authors.lastname: Tempera
authors.forename: E
authors.initials: E
authors.lastname: Rapisarda
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects / Q000528:radiation effects; D003786:Dental Pulp Cavity / Q000382:microbiology; D004203:Disinfection / Q000379:methods*; D004492:Edetic Acid / Q000627:therapeutic use; D013293:Enterococcus faecalis / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008422:Materials Testing; D010545:Peroxides / Q000627:therapeutic use; D061088:Photoacoustic Techniques; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D014508:Urea / Q000627:therapeutic use; D014885:Waxes / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D010545:Peroxides; D012388:Root Canal Irrigants; D014885:Waxes; C025081:RC-Prep; D014508:Urea; D004492:Edetic Acid; D012973:Sodium Hypochlorite