Root Canal Surface Research Articles

A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation

The aim of this study was to investigate the capability of a novel reference point indentation apparatus to test the indentation properties of root canal surface dentine treated with three intracanal medicaments used in endodontic regeneration. Immature human premolars were selected (n = 22). Four specimens were obtained from each root and randomly assigned to three treatment groups and a control group. Each specimen was exposed to one of the three treatment pastes (triple antibiotic (TAP), double antibiotic (DAP), or calcium hydroxide (Ca(OH)2)) or neutral deionized water (control) for 1 or 4 weeks. After each time interval, the indentation properties of the root canal dentine surfaces were measured using a BioDent reference point indenter. Two-way ANOVA and Fisher's protected least significant differences were used for statistical analyses. Significant differences in indentation parameters and estimated hardness between all groups at both time points were found. TAP-treated dentine had the highest significant indentation parameters, followed by DAP-treated dentine, untreated control dentine, and Ca(OH)2-treated dentine, respectively. Furthermore, TAP-treated dentine had the lowest significant estimated hardness, followed by DAP-treated dentine, untreated control dentine, and Ca(OH)2-treated dentine, respectively. BioDent reference point indenter was able to detect significant differences in indentation properties of root canal dentine treated with various medicaments. The use of a reference point indenter is a promising approach to characterize the indentation properties of root canal surfaces without any surface modification. This might provide an in vitro mechanical measurement that is more representative of the actual clinical situation.

Antibacterial Efficacy of a Human β-Defensin-3 Peptide on Multispecies Biofilms

IntroductionThe aggregation of mixed bacterial flora into sessile biofilms on root canal surfaces can be one of the causes of persistent apical periodontitis. The aim of this study was to evaluate the antibacterial efficacy of human β-defensin-3 (HBD3) peptide on multispecies biofilms by using confocal laser scanning microscopy. MethodsActinomyces naeslundii, Lactobacillus salivarius, Streptococcus mutans, and Enterococcus faecalis were cultured in a peptone-yeast-glucose broth, and their culture suspensions were combined in equal proportions. The mixed bacteria were inoculated on sterile coverslips placed into the wells of tissue culture plates to permit the formation of mixed species biofilm. After incubation for 3 weeks, the samples were treated for 24 hours with saline (control), saturated calcium hydroxide solution (CH), 2% chlorhexidine solution (CHX), and 50 μg/mL HBD3 solution. A commercial biofilm/viability assay kit was used to assess cell viability and analyze the 3-dimensional architecture of biofilms. The percentage of dead cells was determined from the ratio of biovolumes for the red subpopulation and the total biofilm. ResultsThree medication groups showed a significant reduction of biovolume within the biofilms compared with the control group (P < .001). The HBD3-treated biofilms had a higher percentage of dead cells than the other medication groups (P < .05). The CH and CHX groups showed higher levels of bactericidal activity than saline (P < .05), and there was no significant difference between the 2 groups (P > .05). ConclusionsHBD3 peptide exhibited more antibacterial activity against mature multispecies biofilms in vitro than either CH or CHX.

Mechanical effect of static loading on endodontically treated teeth restored with fiber‐reinforced posts

The aim of this study was to investigate the mechanical behavior of a dental system built up with fiber-reinforced composite (FRC) endodontic posts with different types of fibers and two cements (the first one used with a primer, the second one without it). Six FRC posts were used. Each system was characterized in terms of structural efficiency under external applied loads similar to masticatory forces. An oblique force was applied and stiffness and maximum load data were obtained. The same test was used for the dentine. The systems were analyzed by scanning electron microscope (SEM) to investigate the surface of the post and inner surface of root canal after failure. The mechanical tests showed that load values in dental systems depend on the post material and used cement. The highest load (281 ± 59 N) was observed for the conical glass fiber posts in the cement without primer. There was a 50 and 85% increase in the maximum load for two of the conical posts with glass fibers and a 229% increase for the carbon fiber posts in the cement without primer as compared with the cement with primer. Moreover, almost all the studied systems showed fracture resistances higher than the typical masticatory loads. The microscopic analysis underlined the good adhesion of the second cement at the interfaces between dentine and post. The mechanical tests confirmed that the strength of the dental systems subjected to masticatory loads was strictly related to the bond at the interface post/cement and cement/dentine.

Evaluation of the apical adaptation performance of various root canal instruments.

Objective:The aim of this study was to evaluate the apical root canal adaptation performance of various root canal instruments.Materials and Methods:A total of 40 freshly extracted single-rooted mandibular incisors were used in this study. Coroner parts of all teeth were removed from cemento-enamel junction and root canal of each tooth was explored with a size 8 K-file until the tip of the file was just visible at the apex. Working lengths (WLs) were determined as 1 mm short of these measurements. ProTaper, K-file, profile and hedstroem files were inserted into the root canals of 10 teeth to the WL following the flaring of the coronal and middle thirds. Instruments were fixed in the root canals with acrylic resin. The apical 1 mm of each root tip was ground on wet sandpaper to expose the canal and the instrument at the WL and the apical region of each tooth was examined under stereomicroscope. The stereoscopic images of the teeth were digitized and analyzed with software in order to determine the differences between the areas of root canals and file tips. Result data were analyzed using the one-way analysis of variance test (P = 0.05).Results:There were no significant differences between apical file/root canal areas of the evaluated instruments (P > 0.05).Conclusions:None of the evaluated instruments performed a perfect adaptation with the apical root canal surface at the WL in mandibular incisors. Therefore, total removal of the debris from the apical canal surface may not be achieved when these filing instruments are used.

Irrigation dynamics associated with positive pressure, apical negative pressure and passive ultrasonic irrigations: a computational fluid dynamics analysis.

Complexities in root canal anatomy and surface adherent biofilm structures remain as challenges in endodontic disinfection. The ability of an irrigant to penetrate into the apical region of a canal, along with its interaction with the root canal walls, will aid in endodontic disinfection. The aim of this study was to qualitatively examine the irrigation dynamics of syringe irrigation with different needle tip designs (open-ended and closed-ended), apical negative pressure irrigation with the EndoVac® system, and passive ultrasonic-assisted irrigation, using a computational fluid dynamics model. Syringe-based irrigation with a side-vented needle showed a higher wall shear stress than the open-ended but was localised to a small region of the canal wall. The apical negative pressure mode of irrigation generated the lowest wall shear stress, while the passive-ultrasonic irrigation group showed the highest wall shear stress along with the greatest magnitude of velocity.

Micro-CT assessment of two different endodontic preparation systems

The aim of this study was to compare two endodontic preparation systems using micro-CT analysis. Twenty-four one-rooted mandibular premolars were selected and randomly assigned to two groups. The samples (n = 12) of Group 1 were prepared using the ProTaper Universal rotary system, while Group 2 (n = 12) was prepared using the EndoEZE AET system complemented by manual apical preparation with K-type hand files up to #30. A 2.5% sodium hypochlorite solution was used in both groups for irrigating. Both groups were scanned by high-resolution microcomputed tomography before and after preparation (SkyScan 1172, SkyScan, Kontich, Belgium). The root canal volume and surface area was measured before and after preparation, and the differences were calculated and analyzed for statistically significant differences using ANOVA complemented by the Tukey test (p < 0.05). The results showed no statistically significant differences between the mean volumes of dentin removal by the two systems. However, the EndoEZE AET system presented a significantly greater mean surface area compared to the ProTaper system (p < 0.05). The EndoEZE AET system enabled preparation of a greater root canal surface area when compared to the ProTaper Universal system. There seemed to be no difference in dentin volume loss between the two systems used.

Micro-CT assessment of two different endodontic preparation systems

The aim of this study was to compare two endodontic preparation systems using micro-CT analysis. Twenty-four one-rooted mandibular premolars were selected and randomly assigned to two groups. The samples (n = 12) of Group 1 were prepared using the ProTaper Universal rotary system, while Group 2 (n = 12) was prepared using the EndoEZE AET system complemented by manual apical preparation with K-type hand files up to #30. A 2.5% sodium hypochlorite solution was used in both groups for irrigating. Both groups were scanned by high-resolution microcomputed tomography before and after preparation (SkyScan 1172, SkyScan, Kontich, Belgium). The root canal volume and surface area was measured before and after preparation, and the differences were calculated and analyzed for statistically significant differences using ANOVA complemented by the Tukey test (p < 0.05). The results showed no statistically significant differences between the mean volumes of dentin removal by the two systems. However, the EndoEZE AET system presented a significantly greater mean surface area compared to the ProTaper system (p < 0.05). The EndoEZE AET system enabled preparation of a greater root canal surface area when compared to the ProTaper Universal system. There seemed to be no difference in dentin volume loss between the two systems used.

The effect of 10% citric acid, 7% maleic acid &amp; MTAD on intracanal smear layer removal - An sem study

Various organic acids,ultrasonic instruments,and lasers have been used to remove the smear layer from the surface of instrumented root canals. The purpose of this study was to determine the effectiveness of MTAD(a mixture of tetracycline isomer,an acid,and a detergent) as the final irrigant to remove the smear layer,compared with that of 10% Citric acid and 7% Maleic acid all of them following root canal irrigation with 5.25% Sodium hypochlorite (NaOCl). Forty eight extracted single rooted human teeth were randomly divided into 4 groups and instrumented with crown down technique using rotary nickel titanium files.5.25% sodium hypochlorite was used as the intracanal irrigant. The canals were treated with 5ml of one of the following solutions as final rinse:5.25% sodium hypochlorite,10% Citric acid,7% Maleic acid,MTAD. The presence or absence of smear layer on the surface of root canal walls at the coronal,middle and apical portion of each canal were examined under a scanning electron microscope. The results showed that MTAD is an effective final rinse solution for removing the smear layer in canals irrigated with sodium hypochlorite. When 10% Citric acid and 7% Maleic acid were used as a final rinse, the smear layer was removed from the middle and coronal thirds of canal preparations, but it was less effective in the apical third of the canals.

Use of Titanium Tetrafluoride to alter the smear layer of root canal walls - An in vitro study

Objectives: To evaluate change in morphology, texture and thickness of the smear layer of root canal walls after 4% titanium tetrafluoride (TiF4) irrigation and to verify stability of this altered smear layer to EDTA and NaOCl wash. Study design: 40 prepared root canal specimens were randomly divided into control group (Group I) receiving normal saline irrigation and three experimental subgroups receiving-TiF4 (Group IIA), EDTA + NaOCl (Group IIB) and TiF4 followed by EDTA+ NaOCl (Group IIC) irrigation. The root canal surfaces were observed under SEM and the mean thickness of the smear layer were recorded. The data was statistically analyzed using anova and t test. Result: TiF4 irrigated samples showed an extensive granular coating with increased thickness (5.10μm + 0.16) and higher stability when compared to the controls. Statistically insignificant difference in the mean thickness was observed between subgroups IIA & IIC. Conclusion: The study extrapolated use of TiF4 to modify the smeared root canal dentine into a more stable state before root canal obturation.

To compare and contrast maintenance of root canal geometry using rotary NiTi systems - An in vitro study

Chemo-mechanical preparation is the basis for successful endodontic treatment and aims at debriding the root canal using various endodontic files. The infected canal consists of numerous bacteria, tissues and debris which need to be removed. During cleaning and shaping the dentin lining the root canal is shaved off for the purpose of shaping the canal though a major part of the canal is left untouched even after thorough cleaning and shaping. The most recent literature reports the removal of thin uniform hard tissue layer from the entire root canal surface, resulting in maintenance of original root canal geometry with a similar cross section but of larger dimensions and this results in avoidance of iatrogenic errors which are the most common errors occurring due to the taper of different files. The purpose of this study is to compare the maintenance of root canal geometry during root canal procedure performed on permanent tooth root with severely curved canals.

Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica (Neem) and 5% sodium hypochlorite on Candida albicans biofilm formed on tooth substrate: An in-vitro study

Introduction:Endodontic infections are polymicrobial in nature. Candida albicans is the most common fungus isolated from failed endodontic cases. The constant increase in antibiotic resistant strains and side-effects caused by synthetic drugs has prompted researchers to look for herbal alternatives such as propolis, Morinda citrifolia and Azadirachta indica (Neem) etc., since, the gold standard for irrigation, i.e., sodium hypochlorite has many disadvantages.Materials and Methods:Extracted human mandibular premolars were biomechanically prepared, vertically sectioned, placed in tissue culture wells exposing the root canal surface to C. albicans grown on Sabouraud Dextrose Agar to form a biofilm. At the end of 2 days, all groups were treated with test solutions and control for 10 min and evaluated for Candida growth and number of colony forming units. The readings were subjected to statistical analysis using analysis of variance and post hoc Tukey tests.Results:Sodium hypochlorite and propolis groups exhibited highest antimicrobial efficacy against C. albicans with no statistically significant difference. It was followed by the A. indica (Neem) group. M. citrifolia had limited antifungal action followed by the negative control group of saline.Conclusion:According to the results of this study, propolis can be used as an effective antifungal agent similar to that of sodium hypochlorite, although long-term in vivo studies are warranted.

Micro‐Computed Tomography and Scanning Electron Microscopy Comparisons of Two Nickel–Titanium Rotary Root Canal Instruments Used With Reciprocating Motion

The single-file root canal instrumentation technique using reciprocating motion has been gaining concern. Therefore, the purpose of this study was to compare the shaping ability of single ProTaper F2 file and WaveOne Primary file when they were used in the curved root canal with reciprocation motion and to investigate the durability of the file after use with a scanning electron microscopy (SEM). Changes in structure model index (SMI), root canal volume, curvature, surface area, and degree of transportation were measured from the cross-sectional images of the prepared canals using the micro-CT system with an isotropic resolution of 16 μm. Results showed that there were no differences in the changes of root canal volume, surface area, and SMI between the two file groups after the preparation (p > 0.05). The ProTaper group showed a curvature straightening value of 25.45 ± 12.51%, while the WaveOne group showed 27.30 ± 10.91%, and there was no statistically significant difference (p > 0.05). The transportation values between the two groups showed no significant differences (p > 0.05). SEM revealed that 60% of ProTaper files showed initiation of microcracks on the surface while those were detected on the only one WaveOne file. The single-file technique using either WaveOne Primary or ProTaper F2 can be safely used under each reciprocating motion without creating an increased apical transportation in curved canals. However, the metallurgic property resists cyclic fatigue was more favorable with WaveOne under the scanning evaluation.

Effect of MTAD as a Final Rinse on Removal of Smear Layer in Ten-minute Preparation Time

IntroductionThe aim of this study was to evaluate the effect of MTAD as final rinse on removal of the smear layer subsequent to primary irrigation with 1.3% sodium hypochlorite (NaOCl) during 10-minute instrumentation periods. MethodsForty teeth were divided into 2 experimental groups, each containing 15 teeth, and 1 positive control group of 10 teeth. The canals were prepared with hand and rotary instruments. In the MTAD group, the root canals were flushed with 1.3% NaOCl solution during 10-minute instrumentation, and MTAD was used as the final rinse. In other experimental group, 5.25% NaOCl was used during instrumentation, and 17% ethylenediaminetetraacetic acid (EDTA) was used as the final rinse. In the positive control group, sterile distilled water was used for irrigation. The overall instrumentation period for each canal was 10 minutes. The amount of the smear layer and degree of erosion qualified according to the study by Torabinejad et al by using a scanning electron microscope. Data were analyzed by Kruskal–Wallis and Mann–Whitney tests. All statistical analyses were set with a significance level of α = 0.05. ResultsIn the positive control group, debris and heavy smear layer covered the root canal surface and the tubules. In MTAD group, moderate smear layer covered the root canal surface and the tubules. In EDTA group, there was no smear layer on surface of canals. There were significant differences between groups (α < 0.0001). Mann–Whitney test showed significant difference between experimental groups (α = 0.01). ConclusionsIn 10-minute instrumentation period, the use of 5.25% NaOCl during instrumentation and 17% EDTA as the final rinse is more effective than using 1.3% NaOCl as primary irrigation and MTAD as final rinse on removal of the smear layer.

Effect of manual dynamic activation on smear layer removal efficacy of ethylenediaminetetraacetic acid and SmearClear: An in vitro scanning electron microscopic study

AbstractThe purpose of the present study was to evaluate the effect of manual dynamic activation (MDA) with a master gutta‐percha point on the smear layer removal efficacy of 17% ethylenediaminetetraacetic acid (EDTA) and SmearClear. Fifty freshly extracted human single‐rooted teeth were prepared using ProTaper rotary system up to F3 size. The prepared teeth were divided into five groups on the basis of final irrigation received. Group A: 3% NaOCl solution (negative control group). Group B: 5 mL of 17% EDTA. Group C: 1 mL of 17% EDTA + MDA for 2 min + 4 mL of 17% EDTA rinse. Group D: 5 mL of SmearClear. Group E: 1 mL of SmearClear + MDA for 2 min + 4 mL of SmearClear rinse. Prepared samples were decoronated and then longitudinally split into two halves and evaluated under scanning electron microscope. Representative images at coronal, middle and apical third level were taken and scored for the amount of smear layer present, using a three‐score system. The data were analysed through Kruskal–Wallis and Mann–Whitney U‐test. The root canal surfaces of samples of group C and group E (where MDA was done) were significantly cleaner in apical third regions than those of group B and group D (P &lt; 0.05).

Back-scattered and secondary electron images of scanning electron microscopy in dentistry: a new method for surface analysis

Objective. A scanning electron microscope (SEM) is a popular tool for investigating the root canal surface to visualize dentinal tubules, the smear layer and various root canal filling materials in endodontics. Most of the SEM micrographs taken in endodontic research are in secondary electrons (SE) mode, in which the topographic view of a subject can be demonstrated without giving any information about the real structure. Back-scattered electron (BSE) images are also used, which reveal some information about the internal structure while providing no topographic details. The aim of this study was to investigate the possibility of using back-scattered (BSE) and secondary electron (SE) mode of scanning electron microscopy (SEM) together for obtaining detailed information about biomaterials in relation to dental structures. Materials and methods. Mesiobuccal roots of four permanent maxillary molars were cleaned and shaped with rotary instruments. Two samples were obturated with gutta-percha and sealer. After 2 weeks, gutta-perch was removed using rotary instruments and chloroform. In the other phase of the study, white mineral trioxide aggregate was mixed and packed into five glass tubes and exposed to blood, deionized water, synthetic tissue fluid and egg white. All the samples were prepared for visualization under SE and BSE modes of SEM to observe the characteristics of material remnants and surface structures. Results. BSE mode illustrated different grey scale views which made it possible to differentiate dentin chips from filling material remnants on the surface of root canal dentin. In addition, SE mode focused on image topography, while a BSE detector showed new texture formation on the surface of white mineral trioxide aggregate exposed to proteinaceous fluids such as blood or egg white. Conclusions. Mapping BSE and SE micrographs helped us to better understand the structure of materials on the surface of root canal dentin and MTA. Moreover, analysis of structure of materials on the surface of root canal dentine and MTA can be performed better by mapping of BSE and SE micrographs.

Effects of ultrasonically activated irrigants with or without surfactant on smear layer removal after post space preparation

The aim of this study was to compare the effects of different NaOCl and EDTA formulations with/without ultrasonic use on smear layer removal and root canal surface characteristics after post space preparation. Study design: After post space preparations, forty-six teeth were subjected to different post space irrigation regimes; G1, 17% EDTA; G2, 17% EDTA+Ultrasonic activation; G3, EDTA-T; G4, EDTA-T+Ultrasonic activation; G5, NaOCl; G6, NaOCl+Ultrasonic activation. Specimens were examined under scanning electron microscope and scored for debris and smear layer removal and dentinal tubule opening and statistically analyzed with Kruskal Wallis and Dunn's test. Significance value was set at p<0.05. Results: EDTA and EDTA-T groups showed significantly better efficiency than the other groups in the each parts of the samples in terms of smear layer removal (p<0.05). In terms of dentinal tubule opening, EDTA, EDTA+Ultrasonic and EDTA-T groups had significantly better efficacy than the other groups in the middle and coronal parts of the samples (p<0.05). Conclusions: Ultrasonic activation did not significantly improve the efficiency of the irrigants.

Identification of dental root canals and their medial line from micro-CT and cone-beam CT records

BackgroundShape of the dental root canal is highly patient specific. Automated identification methods of the medial line of dental root canals and the reproduction of their 3D shape can be beneficial for planning endodontic interventions as severely curved root canals or multi-rooted teeth may pose treatment challenges. Accurate shape information of the root canals may also be used by manufacturers of endodontic instruments in order to make more efficient clinical tools.MethodNovel image processing procedures dedicated to the automated detection of the medial axis of the root canal from dental micro-CT and cone-beam CT records are developed. For micro-CT, the 3D model of the root canal is built up from several hundred parallel cross sections, using image enhancement, histogram based fuzzy c-means clustering, center point detection in the segmented slice, three dimensional inner surface reconstruction, and potential field driven curve skeleton extraction in three dimensions. Cone-beam CT records are processed with image enhancement filters and fuzzy chain based regional segmentation, followed by the reconstruction of the root canal surface and detecting its skeleton via a mesh contraction algorithm.ResultsThe proposed medial line identification and root canal detection algorithms are validated on clinical data sets. 25 micro-CT and 36 cone-beam-CT records are used in the validation procedure. The overall success rate of the automatic dental root canal identification was about 92% in both procedures. The algorithms proved to be accurate enough for endodontic therapy planning.ConclusionsAccurate medial line identification and shape detection algorithms of dental root canal have been developed. Different procedures are defined for micro-CT and cone-beam CT records. The automated execution of the subsequent processing steps allows easy application of the algorithms in the dental care. The output data of the image processing procedures is suitable for mathematical modeling of the central line. The proposed methods can help automate the preparation and design of several kinds of endodontic interventions.

Comparison of final irrigation techniques in removal of calcium hydroxide

The aim of this study was to compare new irrigation systems with a conventional irrigation technique for the removal of inter-appointment calcium hydroxide [Ca(OH)2 ]. Forty-seven extracted human single-rooted teeth were instrumented, and Ca(OH)2 paste was placed into root canals by using a lentulo spiral at the apical third. Teeth were randomly divided into three groups according to different irrigation protocols using a 30-gauge slot-tipped needle, EndoVac system and ProUltra® PiezoFlow™ ultrasonic irrigation system. Scanning electron microscopic images of the selected root canal surfaces (cervical, middle and apical third) were evaluated using a 5-grade scale. The influence of the irrigation system was evaluated using a two-way analysis of variance test and Tukey's test. The EndoVac and PiezoFlow groups demonstrated the lowest scale values (cleanest canals); however, there was no statistical difference between these two groups. The conventional irrigation group exhibited significantly higher scores (P < 0.05). The conventional needle irrigation was not sufficient to remove Ca(OH)2 from the root canal system. Irrigation with EndoVac and PiezoFlow™ ultrasonic irrigation systems improved the removal of the intracanal medicament resulting in cleaner root canal walls.

Chemical Interaction of Alexidine and Sodium Hypochlorite

Introduction Recent studies have reported the color change and formation of precipitates containing para-chloroaniline (PCA) after a reaction of sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Alexidine (ALX), a biguanide disinfectant similar to CHX, has greater affinity for bacterial virulence factors than CHX. This study determined by electrospray ionization mass spectrometry (ESI-MS) and scanning electron microscopy (SEM) whether the chemical interaction between ALX and NaOCl results in PCA or precipitates. Methods ESI-MS was performed on 4 different concentrations of ALX (1%, 0.5%, 0.25%, and 0.125%) with 4% NaOCl to detect the presence of PCA. As control groups, 1% ALX, 0.5% PCA, and a mixture of 2% CHX and 4% NaOCl were analyzed. The formation of precipitates on the dentinal surfaces of premolar root canals treated with the solutions of ALX and NaOCl (AN) or CHX and NaOCl (CN) was observed by SEM and the color change in the reaction solutions was also analyzed. Results ESI-MS showed that the peak (mass/charge ratio = 128.026) in the PCA spectrum was not detected in any of the 4 AN solutions, whereas the peak was found in the CN solution. SEM revealed precipitates covering dentinal surfaces in the CN solution. The AN solutions produced no precipitate. The AN solutions changed in color from light yellow to transparent with decreasing ALX concentration, whereas peach-brown discoloration was observed in the CN solution. Conclusions The interaction of ALX and NaOCl did not produce PCA or precipitates, and the color of the reacted solution changed transparent with decreasing ALX concentration.

Lasers in Endodontics

Er: YAG laser irradiation utilizing the newly developed RCLase side-firing spiral tip was used for the cleansing of root canals following their bio-mechanical preparation with ProTaper Ni-Ti files. The distal and palatal roots of 20 freshly extracted molar teeth were instrumented to size F3 with ProTaper files. In the experimental group (10 teeth) the pulp chamber and the root canals were filled with EDTA 17% and the root canals were lased for 30 s using the Er: YAG laser irradiation at 600 mJ per pulse and a frequency of 12 Hz. In the control group (10 teeth) the root canals were not lased. Scanning electron microscope analysis showed clean wall surfaces of the lased root canals with open dentinal tubules, free of smear layer and debris. In the scanning electron microscope photographs of the walls of the non-lased root canals a considerable amount of debris could be detected. It appears that an efficient cleansing of the root canal system can be achieved by using the Er: YAG laser irradiation with the RCLase Side-firing Spiral Tip following bio-mechanical preparation of the root canal with Ni-Ti Taper files.