Value added cleaning and disinfection of the root canal: laser-activated irrigation and laser-induced photoporation

Among present-day marketed systems ultrasonic activation appears to be the best way to activate and potentiate endodontic irrigants. An alternative for ultrasonic activation of irrigants is laser activated irrigation (LAI) or photon-initiated acoustic streaming. Based on present-day research it appears that LAI (especially with Erbium lasers) can be more efficient for debris removal out of root canals and interaction with the endodontic biofilms thanks to the induction of specific cavitation phenomena and acoustic streaming. Other wavelengths are now explored to be used for LAI. Another way to interact with biofilms is to rely on laser-induced photoporation in combination with gold nanoparticles (AuNPs). The latter is an alternative physical method for delivering macromolecules in cells. Nanosized membrane pores can be created upon pulsed laser illumination. Depending on the laser energy, pores are created through either direct heating of the AuNPs or by vapour nanobubbles that can emerge around the AuNPs.