الفهرس 
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Abstract
Summary and Conclusion
The purpose of the present in vitro study was to evaluate the efficacy of Sodium hypochlorite activation in human extracted single rooted teeth using three different types of irrigation; passive ultrasonic irrigation, XP finisher and Er:YAG laser using PIPS tip as compared to conventional Sodium hypochlorite needle irrigation on biofilm eradication, smear layer removal.
For biofilm eradication analysis, 45 single-rooted anterior human teeth were prepared and inoculated with Enterococcus faecalis (ATCC 29212) and then divided into three groups of seven roots each. The colony forming units (CFUs) per milliliter were determined after infection to ensure the biofilm growth. Then, all teeth were subjected to 10 ml 2.5% Sodium hypochlorite either with XP finisher in group I, passive ultrasonic irrigation in group II, or Er:YAG laser activation utilizing PIPS tip in group III. Biofilm eradication in the individual group was evaluated using confocal laser scanning microscope (CLSM). For comparing the smear removal efficacy, another 45 single-rooted anterior human teeth, were irrigated with NaOCl after mechanical instrumentation and assigned to different groups as mentioned. The presence of a smear layer at different levels of the root canal was scored by scanning electron microscope (SEM) examination.
The results of biofilm eradication showed a statistically significant difference between XP group and Er:YAG group utilizing PIPS tip (p<0.0001), and between PUI group and Er:YAG group utilizing PIPS tip (p= 0.004). Regarding the smear layer removal, there was a statistically significant difference in the scores of smear layer removal in group III as compared to the other two Groups in the coronal and middle thirds (p=0.031). However, there was no statistically significant difference in the scores of smear layer removal between the three groups in the apical third (p=0.44).
Conclusions:
Within the limitations of this study, it could be concluded that:
• None of the root canal disinfection methods resulted in complete E. faecalis biofilm eradication.
• Activation of Sodium hypochlorite irrigant using Er:YAG laser utilizing PIPS technique increased its biofilm eradication capability, showing the best biofilm eradication in the apical third.
• With all activation systems, smear layer removal was the better in the coronal and middle thirds than at the apical third.
• Activation of NaOCl using Er:YAG laser utilizing PIPS technique presented the greatest potentiality in smear layer elimination.