Evaluation of dentin root canal permeability after instrumentation and Er:YAG laser application.

BACKGROUND AND OBJECTIVES Smear layer removal with EDTA from root canal walls allows greater cleaning and disinfection of root canals. However, because Er:YAG laser acts on the removal of the smear layer, the objective of investigation was to analyze in vitro the effect of Er:YAG laser on dentin root canal wall permeability after endodontic instrumentation and irrigation with water or sodium hypochlorite and Er:YAG laser application. STUDY DESIGN/MATERIALS AND METHODS A total of 25 extracted human maxillary incisors were divided into five groups: Group I, instrumentation with deionized distilled water as the irrigating solution; Group II, instrumentation with 1% sodium hypochlorite as the irrigating solution; Group III, instrumentation with deionized distilled water as the irrigating solution and Er:YAG laser application; Group IV, instrumentation with 1% sodium hypochlorite solution as the irrigating solution and Er:YAG laser application; Group V, instrumentation only up to #20 file with deionized distilled water as the irrigating solution and Er:YAG laser irradiation. The laser parameters were 15 Hz, 140 mJ, total energy 42 J, 300 pulses (Kavo Key Laser). Copper sulfate (10%) was used to evaluate dentin permeability. The penetration of copper ions into the dentinal tubules was observed using 1% rubeanic acid, which reveals copper ions, forming a stained compound ranging in color from deep blue to black. Transverse sections (500-microm thick) were obtained with a diamond disk from the cervical, middle, and apical thirds. RESULTS The instrumentation of the root canal that used water as the irrigating solution followed by Er:YAG laser irradiation promoted the greatest increase in dentin permeability. The use of Er:YAG laser, 1% sodium hypochlorite + Er:YAG, and 1% sodium hypochlorite used alone showed an intermediate capacity of increasing dentin permeability. The use of water as the irrigating solution without Er:YAG laser promoted the least dentin permeability. CONCLUSIONS The use of water as the irrigating solution after instrumentation and Er:YAG laser irradiation was an effective procedure for increasing dentin permeability.