Roeland De Moor: Laser Activated Irrigation with PIPS: Safe and Efficient. Insight into Cavitation, Fluid Streaming and Pressure Generation
In root canals filled with endodontic irrigants, cavitation and agitation generated by lasers create shock waves, fluid streaming and shear stresses with the goal of enhanced removal of the smear layer, debris and biofilm. Different options are possible when choosing Erbium laser-activated irrigation, i.e. fibres can be used within the confines of the fluid-filled root canal or the fiber can be activated above the orifice. The PIPS® approach has proven to be efficient, however, more insights have been gained into the way in which irrigants are agitated, which parameters affect the generation of cavitation, the type of cavitation and the fluid streaming. It became clear that not only the pulse peak power is playing an important role in the efficiency of PIPS, but also the pulse frequency. Other parameters such as the specific fiber design and the type of liquid in which the activation is performed also have to be taken into account. Clearly, all of this influences the specific laser-generated pressure waves. Concerns have been raised about the safety of laser-activated irrigation and the risk of apical irrigant extrusion due to the vigorous fluid agitation. Recent investigations (unpublished data of the Ghent Dental Laser Centre) have demonstrated that negative pressure can be gained during laser-activated irrigation, making this approach also “safe”.
