975 nm Diode Laser-Mediated Dentin Surface Modification Enhances Bio-ceramic Sealer Retention: Comparative Study with Er: YAG Photoacoustic Irrigation

Abstract

Objective: To evaluate different irrigation protocols, Photon-Induced Photoacoustic Streaming (PIPs) using Sodium hypochlorite (NaOCl) and NaOCl with EDTA and diode laser (DL) compared to syringe irrigated (SI)-NaOCl+EDTA (control) on smear layer (SL) and dislocation resistance of Bioceramic (BC) sealers to canal dentin.

Methodology: This in vitro experimental study was approved by the institutional review board, King Saud University CDRC# FC-58-41-2026. The duration of the study was three months, 1^st Jan 2026 - 1^st March 2026. 75 central incisors were included. The prepared specimens were randomly divided into three experimental groups according to the disinfection protocol. Group-1: SI-NaOCl+EDTA (Control), Group-2: PIPS-NaOCl+EDA, and Group-3: NaOCl+ EDTA+DL.On five specimens from each category, SL removal was assessed using a scanning electron microscope (SEM). Ten specimens from each category were obturated with premixed Endosequence BC sealer (EBCS), and another 10 were bonded with two-component BioRoot RCS (BRS). The Universal Testing Machine was used to assess dislocation resistance. The failure type was evaluated using a stereomicroscope. ANOVA with post hoc comparisons of SL elimination and dislocation resistance among the tested categories.

Results: Group-3 NaOCl+EDTA+DL specimens displayed the highest SL removal and maximum scores of dislocation resistance. Group-1 SI-NaOCl+EDTA-treated canals showed the lowest SL removal and the lowest dislocation resistance.

Conclusion: DL as an adjunctive therapy after conventional syringe irrigation utilizing NaOCl and EDTA displayed the most satisfactory performance in terms of removing SL and improving the dislocation resistance of different bioceramic sealers.