Among present-day marketed systems ultrasonic activation appears to be the best way to activate and potentiate endodontic irrigants. An alternative for ultrasonic activation of irrigants is laser activated irrigation (LAI) or photoninitiated acoustic streaming. Based on present-day research it appears that LAI (especially with Erbium lasers) can be more efficient for debris removal out of root canals and interaction with the endodontic biofilms thanks to the induction of specific cavitation phenomena and acoustic streaming. Other wavelengths are now explored to be used for LAI. Another way to interact with biofilms is to rely on laser-induced photoporation in combination with gold nanoparticles ( AuNPs). The latter is an alternative physical method for delivering macromolecules in cells. Nanosized membrane pores can be created upon pulsed laser illumination. Depending on the laser energy, pores are created through either direct heating of the AuNPs or by vapour nanobubbles that can emerge around the AuNPs.
The major problem of irrigation is the fluid motion within the confined geometry of the root canal : efficient
dispersion of the liquid is difficult, conventional irrigation is limited due to the absence of turbulence over much
of the canal volume, vapour lock may limit apical cleaning and disinfection, there is also a stagnation plane
beyond the needle tip. The best way to improve irrigant penetration and biofilm removal is achieved by means
of the agitation of the fluid.
Today ultrasonic activation appears to be the best way to activate and potentiate irrigants among the present-day
used means and marketed systems. Another way to activate irrigation solutions is the use of lasers: laser
activated irrigation or photon-initiated acoustic streaming have been investigated. Based on present-day research
it appears that the efficacy of laser activation (especially with Erbium lasers) can be more efficient thanks to the
induction of specific cavitation phenomena and acoustic streaming. Other wavelengths are now explored to be
used for laser activated irrigation.
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