(PR146) The Effectiveness of Apical Dentinal Plug Removal Using Passive Ultrasonic Irrigation and BioLase: An In Vitro Study

Objective: This study compares the effectiveness of Passive Ultrasonic Irrigation (PUI) and BioLase in removing dentinal apical plugs and re-establishing working length (WL) patency in extracted teeth. The aim is to evaluate the recaptured WL and time efficiency of each method.

Methods: Thirty-six extracted teeth were divided into three groups, each subjected to a different plug removal protocol. Dentinal apical plugs were created with an average size of 3.5 mm (Control), 4.0 mm (BioLase), and 4.1 mm (PUI). The protocols were: Passive irrigation using 5% NaOCl and 17% EDTA with a side-fluted tip. Ultrasonic irrigation with an IrriSafe tip 2 mm from the plug, using 5% NaOCl and 17% EDTA. Laser activation with irrigation using 5% NaOCl and 17% EDTA, laser tip positioned 2 mm above the plug. Post-operative periapical radiographs were used to measure recaptured WL.

Results: The mean recaptured WL was 2.13 mm (Control), 4.04 mm (BioLase), and 4.13 mm (PUI). A one-way ANOVA showed a significant difference (F = 6.12, p = 0.0055). Tukey’s post-hoc analysis revealed that both BioLase and PUI were more effective than the Control, with no significant difference between BioLase and PUI.

Conclusion: BioLase and PUI were both more effective than the Control in removing dentinal plugs. While BioLase showed a slight advantage in ease of application, PUI may be a more cost-effective choice. Further studies are needed to optimize these protocols for clinical use.