Assessment of the Effect of Different Irrigation Protocols on the Penetration of Irrigation Solution into Simulated Lateral Canals (In Vitro Study)

OBJECTIVE

To compare the effectiveness of lateral canal irrigation penetration by conventional needle, passive ultrasonic, sonic endo activator, and Erbium laser (2780nm).

METHODS

A total of 40 palatal roots of human maxillary first molars were collected and instrumented at a working length of 12 mm by an X1-X4 rotary Protaper Next system (Dentsply, Maillefer, Ballaigues, Switzerland) using the crown-down technique. Artificial lateral canals were made at 2, 4, and 6 mm from the apex on mesial and distal sides using an ISO rotary reamer (Dentsply, Maillefer, Ballaigues, Switzerland; #10 for mesial, #08 for distal). The samples were then cleared using methyl salicylate. A solution of black ink and normal saline was used as an irrigant for the root canal. The percentages of the penetration of the ink into the lateral canals were measured using a stereomicroscope (Q-Scope, Arnhem, The Netherlands) with the aid of program Image J. The Tukey test is used to assess the significant difference between intragroup and intergroup comparisons of different thirds, and the T-test is used to assess the significant difference between every two groups and for the mesial and distal sides of each group. The level of significance was set at 0.05.

RESULTS

Results showed that none of the activation techniques used resulted in complete lateral canal penetrations; however, on both sides at all thirds, the Erbium laser (2780 nm) achieved the highest results with a highly significant statistical difference (p=0.05) with all other groups, and the least penetration was in the conventional needle group.

CONCLUSION

The size of the lateral canal is a restricting factor for all activation methods; the best results can be achieved by laser. Conventional needles cannot be used alone to disinfect complex canal anatomy; however, passive ultrasonic and sonic endo activator activations can produce comparable results.

Dendritic Plasmonic CuPt Alloys for Closed-Loop Multimode Cancer Therapy with Remarkably Enhanced Efficacy

The outcome of laser-triggered plasmons-induced phototherapy, including photodynamic therapy (PDT) and photothermal therapy (PTT), is significantly limited by the hypoxic tumor microenvironment and the upregulation of heat shock proteins (HSPs) in response to heat stress. Mitochondria, the biological battery of cells, can serve as an important breakthrough to overcome these obstacles. Herein, dendritic triangular pyramidal plasmonic CuPt alloys loaded with heat-sensitive NO donor N, N'-di-sec-butyl-N, N'-dinitroso-1,4-phenylenediamine (BNN) is developed. Under 808 nm laser irradiation, plasmonic CuPt can generate superoxide anion free radicals (·O₂ ^- ) and heat simultaneously. The heat generated can then trigger the release of NO gas, which not only enables gas therapy but also damages the mitochondrial respiratory chain. Impaired mitochondrial respiration leads to reduced oxygen consumption and insufficient intracellular ATP supply, which effectively alleviates tumor hypoxia and undermines the synthesis of HSPs, in turn boosting plasmonic CuPt-based PDT and mild PTT. Additionally, the generated NO and ·O₂ ^- can react to form more cytotoxic peroxynitrite (ONOO^- ). This work describes a plasmonic CuPt@BNN (CPB) triggered closed-loop NO gas, free radicals, and mild photothermal therapy strategy that is highly effective at reciprocally promoting antitumor outcomes.

Effectiveness of Different Final Irrigation Procedures on Enterococcus faecalis Infected Root Canals: An In Vitro Evaluation

This study aimed to evaluate the antibacterial effect of three final irrigation protocols and to compare their ability to remove the smear layer and debris from the root canal. Methods: Sixty-three single-rooted human teeth were inoculated with Enterococcus faecalis for 14 days. The teeth were divided into a positive control group (N = 3) and three treatment groups (N = 20) as follows: final irrigation with saline solution (control group), irrigation with 5.25% NaOCl ultrasonically activated with EndoUltra (EU), standard needle irrigation with Qmix 2in1 (Qx) and irrigation with 5.25% NaOCl activated using SiroLaser Blue (SB). The bacterial load was evaluated by analyzing the colony-forming units (CFU/mL). Selected specimens were split longitudinally and examined using scanning electron microscopy in order to determine the presence of a smear layer and debris. Statistical analyses were performed using one-way ANOVA and the Kruskal−Wallis rank-sum test. Results: Activation of NaOCl with EndoUltra or SiroLaser Blue was superior at reducing intracanal bacteria relative to standard needle irrigation with Qmix 2in1 solution (p < 0.05). Even though SiroLaser Blue showed the best results for removing the smear layer and debris, no significant differences were detected between the groups (p > 0.05). Conclusions: Final irrigation with 5.25% NaOCl ultrasonically activated using EndoUltra or SiroLaser Blue demonstrated a higher efficacy in bacterial reduction than standard needle irrigation with Qmix 2in1.

Autocatalytic Laser Activator for Both UV and NIR Lasers: Preparation of Circuits on Polymer Substrates by Selective Metallization

In laser-induced selective metallization (LISM), conventional laser activators only work at a single laser wavelength. This study reported a new laser activator (MoO₃) very suitable for both 355 nm UV and 1064 nm near-infrared (NIR) lasers for the first time. When applying MoO₃ to polymers, the prepared Cu layer on laser-activated polymers showed a good conductivity (2.63 × 10⁶ Ω^-1·m^-1) and excellent adhesion. Scanning electron microscopy, optical microscopy, and resistance analysis revealed the excellent LISM performance of the polymer/MoO₃ composites, and the quality of the Cu layer prepared using the UV laser is much better than that using the NIR laser. The limit width of the copper wire prepared by the UV laser is as narrow as 30.1 μm. We also confirmed the mechanism of MoO₃ initiating electroless copper plating after laser activation to be the autocatalytic mechanism, which is very different from the conventional reduction mechanism. The effect of laser activation was only to expose the MoO₃ active species to the polymer surface. X-ray diffraction and tube experiments revealed that the activity of α·h-MoO₃ was higher than that of α-MoO₃. X-ray photoelectron spectroscopy indicated that a part of Mo⁶⁺ was reduced to Mo⁵⁺ during laser activations, leading to the increase of the oxygen vacancies in MoO₃ and possibly further enhancing the activity of MoO₃. Besides, the micro-rough structures caused by the laser on the polymer surface provided riveting points for successfully depositing the copper layer. The Ni-Cu, Ag-Cu, and Au-Ni-Cu layers were obtained via the continued deposit of other metals on the Cu layer. The resistances of these metal layers had much better stability than that of the neat Cu layer. Furthermore, the Au layer further enhanced the conductivity of the circuit. The proposed strategy is easy for large-scale industrial applications, which will greatly expand the application scenarios of the LISM field.

Selectively Metalizable Low-Temperature Cofired Ceramic for Three-Dimensional Electronics via Hybrid Additive Manufacturing

With increasing interest in the rapid development of customized ceramic electronics, hybrid additive manufacturing (HAM) technology has become a competent alternative to traditional solutions such as printed circuit boards and cofired ceramic technology. Herein, the novel HAM technology is proposed by combining a dispensing three-dimensional (3D) printing process and selectively laser-activated electroless plating for fabricating 3D fully functional ceramic electronic products. An appropriative 3D-printable and metalizable low-temperature cofired ceramic slurry is developed to build the green body of ceramic electronics. After the debinding and sintering process, the 3D ceramic structure can be selectively laser-activated and then electrolessly plated to achieve electronic functionality. The thickness of the plated copper layer approaches 10 μm after 4 h of plating, and the electrical conductivity is 5.5 × 10⁷ S m^-1, which is close to pure copper (5.8 × 10⁷ S m^-1). To reduce the surface roughness of the laser-activated ceramic surface and thereby enhance the conductivity of the copper layer, the laser parameters are optimized as a 1250 mm s^-1 scan speed, a 0.4 W laser power, and a 20 kHz laser-spot frequency. A high-power 3D light-emitting diode circuit board with an internal cooling channel is successfully developed to prove the feasibility of this HAM technology for customizing fully functional 3D conformal ceramic electronics.

Transient Solid-State Laser Activation of Indium for High-Performance Reduction of CO2 to Formate

Deficiencies in understanding the local environment of active sites and limited synthetic skills challenge the delivery of industrially-relevant current densities with low overpotentials and high selectivity for CO₂ reduction. Here, a transient laser induction of metal salts can stimulate extreme conditions and rapid kinetics to produce defect-rich indium nanoparticles (L-In) is reported. Atomic-resolution microscopy and X-ray absorption disclose the highly defective and undercoordinated local environment in L-In. In a flow cell, L-In shows a very small onset overpotential of ≈92 mV and delivers a current density of ≈360 mA cm^-2 with a formate Faradaic efficiency of 98% at a low potential of -0.62 V versus RHE. The formation rate of formate reaches up to 6364.4 µmol h^-1mgIn-1$mg_{{\rm{In}}}^{--1}$ , which is nearly 39 folds higher than that of commercial In (160.7 µmol h^-1mgIn-1$mg_{{\rm{In}}}^{--1}$ ), outperforming most of the previous results that have been reported under KHCO₃ environments. Density function theory calculations suggest that the defects facilitate the formation of *OCHO intermediate and stabilize the *HCOOH while inhibiting hydrogen adsorption. This study suggests that transient solid-state laser induction provides a facile and cost-effective approach to form ligand-free and defect-rich materials with tailored activities.

Selectively Metalizable Stereolithography Resin for Three-Dimensional DC and High-Frequency Electronics via Hybrid Additive Manufacturing

Direct manufacturing of customized end-use electronic products is becoming an emerging trend of additive manufacturing (AM). This highly demands the evolution of the conventional AM processes from simply building single-material parts to simultaneously delivering complex structures and end-use functionalities. In this work, we propose a novel hybrid additive manufacturing solution that combines stereolithography (SLA) three-dimensional (3D) printing and laser-activated electroless plating for the manufacture of 3D fully functional electronic products. With our newly developed functional SLA resin that can be 3D printed, laser-activated, and thereafter selectively metalized, high-resolution circuitry can be free-formly patterned on 3D structures. In virtue of high-performance electrical materials, this technology is capable of creating not only 3D direct-current (DC) electronics but also 3D high-frequency devices like microwave/millimeter-wave antennas, which cannot be fabricated via traditional printed circuit board (PCB) technology and not even by most AM processes. This study represents a significant advance in additive manufacturing technologies, and more importantly offers a unique opportunity for the mass customization of fully functional 3D electronic products, which shows great potentials in consumer electronics, communication engineering, and automobile and aerospace industries.

Single-Grain Gate-All-Around Si Nanowire FET Using Low-Thermal-Budget Processes for Monolithic Three-Dimensional Integrated Circuits

We introduce a single-grain gate-all-around (GAA) Si nanowire (NW) FET using the location-controlled-grain technique and several innovative low-thermal budget processes, including green nanosecond laser crystallization, far-infrared laser annealing, and hybrid laser-assisted salicidation, that keep the substrate temperature (T_sub) lower than 400 °C for monolithic three-dimensional integrated circuits (3D-ICs). The detailed process verification of a low-defect GAA nanowire and electrical characteristics were investigated in this article. The GAA Si NW FETs, which were intentionally fabricated within the controlled Si grain, exhibit a steeper subthreshold swing (S.S.) of about 65 mV/dec., higher driving currents of 327 µA/µm (n-type) and 297 µA/µm (p-type) @ V_th ± 0.8 V, and higher I_on/I_off (>10⁵ @|V_d| = 1 V) and have a narrower electrical property distribution. In addition, the proposed Si NW FETs with a GAA structure were found to be less sensitive to V_th roll-off and S.S. degradation compared to the omega(Ω)-gate Si FETs. It enables ultrahigh-density sequentially stackable integrated circuits with superior performance and low power consumption for future mobile and neuromorphic applications.

Postoperative Quality of Life Following Conventional Endodontic Intracanal Irrigation Compared with Laser-Activated Irrigation: A Randomized Clinical Study

Objective: The aim of this randomized clinical study was to evaluate the effect of laser-activated irrigation using a photon-induced photoacoustic streaming (PIPS) technique on postoperative pain following completion of root canal obturation. Methods: Fifty-six patients were enrolled in this randomized clinical trial. Fifty-six healthy premolars or molars with asymptomatic irreversible pulpitis, symptomatic irreversible pulpitis, or symptomatic pulpal necrosis, with or without apical periodontitis, were mechanically prepared for endodontic treatment and divided into two groups. Patients were randomly allocated to treatment groups. In the positive control group G1, the final irrigation with 2 cc of 5.25% sodium hypochlorite (NaOCl) was achieved using a 27G needle, introduced into the canal to a distance of 5 mm from the predetermined working length. In the experimental group G2, the root canals were irrigated with 17% ethyldiamine tetric acid (EDTA) and 5.25% NaOCl following the PIPS protocol, using an Er:YAG 2940 nm laser (LightWalker ATS^®; Fotona, Slovenia) with a 600 μm diameter tip and operating parameters of 20 mJ per pulse, 15 Hz frequency, 0.3 W average power, and a 50-μs pulse duration. Postoperatively, the patients were advised to take a minor analgesic (ibuprofen 400 mg) in the event of pain perception. Postoperative pain levels were assessed after 24, 48, and 72 h and 7 days through the use of a Visual Analogue Scale questionnaire, completed by each patient. Data were analyzed using Kolmogorov-Smirnov, Fisher Exact, Chi square, Mann-Whitney test, and Friedman's test. The level of significance was set at α = 0.05. Results: There was no significant difference between the laser-irradiated group and the control group (p < 0.5). Laser activation of irrigating solutions did not increase postoperative pain. Conclusions: The outcome of this investigation indicated that PIPS was as effective as conventional irrigation in relation to postoperative pain, making this activation technique interesting to use for supplementary root canal disinfection.

Laser-Induced Selective Metallization on Polymer Substrates Using Organocopper for Portable Electronics

Our work proposed a facile strategy for selective fabrication of the precise metalized patterns onto polymer substrates through the laser direct structuring (LDS) technology using organocopper compounds. Copper oxalate (CuC₂O₄) and copper acetylacetonate [Cu(acac)₂] which can be used as laser sensitizers were first introduced into an acrylonitrile-butadiene-styrene (ABS) matrix for preparing LDS materials. After the activation with 1064 nm pulsed near-infrared laser, the Cu⁰ (metal copper) was generated from CuC₂O₄ and Cu(acac)₂ and then served as catalyst species for the electroless copper plating (ECP). A series of characterizations were conducted to investigate the morphology and analyze the surface chemistry of ABS/CuC₂O₄ and ABS/Cu(acac)₂ composites. Specially, the X-ray photoelectron spectroscopy analysis indicated that 58.3% Cu²⁺ in ABS/CuC₂O₄ was reduced to Cu⁰, while this value was 63.9% for ABS/Cu(acac)₂. After 30 min ECP, the conductivities of copper circuit on ABS/CuC₂O₄ and ABS/Cu(acac)₂ composites were 1.22 × 10⁷ and 1.58 × 10⁷ Ω^-1·m^-1, respectively. Moreover, the decorated patterns and near-field communication circuit were demonstrated by this LDS technology. We believe that this study paves the way for developing organocopper-based LDS materials, which have the potential for industrial applications.

Activation of Alkaline Irrigation Fluids in Endodontics

In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers. Ultrasonic agitation and more recently pulsed lasers have emerged as two promising methods for activating endodontic irrigation fluids. Ultrasonic agitation with piezoelectric devices employs a moving tip, while laser agitation uses a stationary tip. Both methods cause cavitation, followed by implosions and shear forces which assist with debridement. Fluid streaming further enhances the activity of the fluids. While agitation enhances performance of irrigants, extrusion of fluids from the root canal during activation is a hazard that must be controlled.

Efficacy of photon-initiated photoacoustic streaming on apically extruded debris with different preparation systems in curved canals

AIM

To determine the effect of photon-initiated photoacoustic streaming (PIPS) on the extrusion of debris using multiple-file (ProTaper Next-PTN) and single-file (One Shape-OS) continuous rotary systems in curved canals in human molar teeth.

METHODOLOGY

Sixty extracted maxillary first molar teeth with curved mesial roots, mature apices and of similar lengths were selected. Teeth having canals with apical diameters larger than size 15 were discarded. The teeth were randomly divided into four experimental groups (n = 15 teeth per group) according to the file used and irrigation systems: (i) OS with PIPS with a 2940 nm Er:YAG laser (0.3 W, 15 Hz, and 20 mJ), (ii) OS with conventional needle irrigation (CNI) with a 27-G needle, (iii) PTN with PIPS and (iv) PTN with CNI. The PIPS and CNI was applied during each file change for 20 s. Total irrigation and activation time was 1 min, and a total volume of 7.5 mL of bidistilled water was used as the irrigant. The apically extruded debris was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of dry extruded debris was assessed by subtracting the initial weight of the tube from the final weight. The results were analysed statistically using one-way analysis of variance and Tukey's post hoc tests. Bonferroni correction was used to compare the groups.

RESULTS

The PIPS irrigation technique was associated with significantly more debris extrusion than the CNI system (P < 0.05). The single-file (One Shape-OS) rotary system was associated with more debris than the multiple-file (ProTaper Next-PTN) rotary systems when the same irrigation system was used (P > 0.05). The total amount of debris extruded apically by PIPS activation was significantly greater than that by CNI (P < 0.05).

CONCLUSIONS

All file and irrigation systems extruded debris apically. PIPS activation was associated with significantly more extrusion debris in curved canals compared with no activation.