Abstract
The aim of this study was to evaluate the ability of a PIPS (photon-induced photoacoustic streaming) Er:YAG laser to reduce the root canal system bacterial count in vivo in comparison to the traditional irrigation technique. The post-operative patients’ quality of life (QoL) after endodontic therapy was evaluated through a questionnaire. Fifty-four patients affected by pulp necrosis with or without apical periodontitis biofilm disease were selected for endodontic treatment and randomly assigned to Group A (n = 27) with traditional irrigation and Group B (n = 27), with PIPS irrigation applied according to the protocol. Shaping was performed with ProGlider and ProTaper Next, and irrigation was performed with 5% NaOCl and 10% EDTA. Intracanal samples for culture tests were collected before and after irrigation. The microbiological analysis was evaluated by the Kolmogorov–Smirnov normality and Mann–Whitney tests (p < 0.05). A self-assessment questionnaire was used to evaluate the QoL during the 7 days after treatment; differences were analysed with Student’s t-test. Irrigation with the PIPS device was significantly effective in reducing bacterial counts, which were higher for facultative than obligate anaerobic strains, particularly for Gram-negative bacteria, without statistical significance (p > 0.05). There were no significant differences among the QoL indicators, except for the maximum pain (p = 0.02), eating difficulty (p = 0.03) and difficulty performing daily functions (p = 0.02) in the first few days post-treatment. PIPS may represent an aid to root canal disinfection not affecting the patients’ QoL, particularly for the first day after treatment.
Highlights
Apical periodontitis biofilm disease is a periradicular inflammatory disease related to the presence of bacteria and toxins within the root canal system [1,2]
A total of 80 subjects were selected for inclusion, and 60 patients were enrolled and randomized between traditional endodontic irrigation (Group A, n = 30) and photon-induced photoacoustic streaming system (PIPS) irrigation (Group B, n = 30)
Three patients in Group B and two in Group A were lost to follow-up before the second visit, while one patient in Group A required an unscheduled intervention during the observation period, due to a post-operative flare-up
Summary
Apical periodontitis biofilm disease is a periradicular inflammatory disease related to the presence of bacteria and toxins within the root canal system [1,2]. The obligate anaerobes are rather eradicated during root canal treatment. A photon-induced photoacoustic streaming system (PIPS) requires the use of an Er:YAG laser to activate the water molecules contained in the irrigant solutions [14,15,16]. The laser light actively pushes the irrigating solutions three-dimensionally through the isthmuses, anastomoses and lateral canals, allowing a deeper cleaning of the entire root canal system. It is well known that extruded dentinal debris may induce periradicular inflammation, leading to post-operative pain, negatively affecting the patients’ quality of life (QoL) and their subjective assessment of alternative treatments [2,18,19,20]. The primary objective of this randomized clinical trial was to evaluate the ability of the PIPS technique to reduce the intracanal bacterial count in vivo compared to the traditional endodontic irrigation method. The secondary objective was to assess the influence of the PIPS technique on post-operative patients’ QoL
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
