Characteristics of Bubble Oscillations During Laser-Activated Irrigation of Root Canals and Method of Improvement.

BACKGROUND AND OBJECTIVES: Laser-activated irrigation of dental root canals is being increasingly used as its efficacy has been shown to be superior compared with conventional techniques. The method is based on laser-initiated localized fluid evaporation and subsequent rapid bubble expansions and collapses, inducing microfluid flow throughout the entire volume of the cavity. The irrigation efficacy can be further improved if optimally delayed "SWEEPS" double laser pulses are delivered into the canal. This study aims to show that the irrigation efficacy, as measured by the induced pressure within the canal, is related to the double pulse delay, with the maximal pressure generated at an optimal delay. The second aim is to find a method of determining the optimal delay for different cavity dimensions and/or laser parameters.

STUDY DESIGN/MATERIALS AND METHODS: Experiments were made in transparent models of root canals where Er:YAG laser (λ = 2.94 μm, pulse duration tp  = 25 or 50 microseconds, and pulse energies up to EL  = 40 mJ) was used with a combination of cylindrical and conical fiber-tip geometries (diameters 400 and 600 µm). High-speed photography (60,000 fps) and average pressure measurements inside the canal were used for process characterization.

RESULTS: The results show that a pressure amplification of more than 1.5 times occurs if the laser pulse delay approximately coincides with the bubble oscillation time. Correlations between normalized oscillation time and canal diameter for a wide range of laser pulse energies (R2  = 0.96) and between the average pressure within the canal and the bubble oscillation periods (R2  = 0.90) were found. A relationship between the bubble oscillation time and the diameter of the treated cavity was found depending on the bubble oscillation time in an infinite fluid reservoir.

CONCLUSIONS: The bubble oscillation time within a constrained volume can be determined based on the known oscillation time in infinite space, which offers a fast and simple solution for optimization of the laser parameters. These findings enable determination of optimal conditions for shock wave generation, and improvement of root canal irrigation at the same dose of laser energy input, leading to improved treatment efficacy and safety. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.