Effect of laser-activated and passive ultrasonic irrigation on apical sealing and dentinal tubule penetration of a bioceramic sealer: An in vitro study

Background: This in vitro study compared the effects of diode laser-activated irrigation (LAI) and Er: YAG LAI using the photon-induced photoacoustic streaming (PIPS) protocol on apical sealing ability and dentinal tubule penetration of a bioceramic sealer, with passive ultrasonic irrigation (PUI) as a control. Methods: Thirty-six extracted human mandibular premolars were standardized and randomly allocated to three groups (n = 12): Diode laser, Er: YAG laser (PIPS), and PUI. Each group was subdivided for evaluation of apical microleakage and sealer penetration (n = 6). Root canals were obturated using a bioceramic sealer labeled with 0.1% rhodamine B. Sealer penetration depth (PD), percentage of sealer penetration (PSP), and PD ratio (PDR) were assessed using confocal laser scanning microscopy, while apical microleakage was evaluated using a stereomicroscope. Statistical Analysis: Data were analyzed using one-way ANOVA followed by Bonferroni post hoc tests (P < 0.05). Results: The diode laser group demonstrated significantly greater sealer PD and lower apical microleakage compared with both the PIPS and PUI groups (P < 0.05). No significant differences were observed between PIPS and PUI. Conclusions: Diode LAI demonstrated greater apical sealing and dentinal tubule penetration of a bioceramic sealer compared with Er: YAG (PIPS) and PUI.