Abstract
Background and purpose: To determine the effectiveness of novel two Er:YAG lasers, photon-initiated photoacoustic streaming (PIPS\SSP) and shock wave-enhanced emission photoacoustic streaming (SWEEPS\AutoSWEEPS) in terms of removal Enterococcus faecalis (E. faecalis) with or without antimicrobial agents (NaOCl and chlorhexidine gluconate). 
 Methods: Forty-two extracted single-rooted mandibular premolars were prepared, sterilized, and then inoculated with E. faecalis for 4 weeks, and randomly divided into to two main and three subgroups (n= 7). Group Ia ( PIPS + distilled water), Group Ib (PIPS + 5% NaOCl), Group Ic (PIPS + CHX), and Group IIa (SWEEPS + distilled water), Group IIb (SWEEPS + 5% NaOCl), and Group IIc (SWEEPS + CHX). Following incubation for 48 hours at 37°C, the colonies formed (CFU) were counted. 
 Results: NaOCl and CHX activated with PIPS\SSP or SWEEPS\AutoSWEEPS modalities showed significantly higher reduction rates than distilled water activated with both laser-activated methods (p0.05). 
 Interpretation: Even novel laser activation methods or modalities are not sufficient alone to adequately reduce bacterial load and using antimicrobial agents with laser activation is necessary for the best reduction for microbial elimination. Novel SWEEPS\AutoSWEEPS modalıty with the conical 600μm tip showed no increased efficacy compared with PIPS\SSP mode. Besides, smaller fiber tip may increase the success of applications for minimally invasive access cavities and preparation.
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