Quantification of Calcium Ions From the Irrigants Activated With Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) Laser in the Root Dentin: An In Vitro Atomic Absorption Spectrophotometer Study

The present study aims to assess the quantity of calcium cation eliminated from the root canal by 0.2% chitosan nanoparticles (CNPs) (Sigma Aldrich, Mumbai, Maharashtra, India) and 17% ethylenediaminetetraacetic acid (EDTA) (Pyrax 17% EDTA Solution, Pyrax Polymars, Roorkee, Haridwar, Uttarakhand, India) which are activated with an erbium-doped yttrium aluminum garnet (Er:YAG) laser (LiteTouch™, Light Instruments Ltd., Yokneam Elite, Israel) for smear layer removal using a flame atomic absorption spectrophotometer (AASF) (Deeksha Analytical Pvt Ltd, Gokula Extension, Bengaluru, Karnataka, India). Using the crown-down technique, 60 non-carious single-rooted premolars were instrumented with rotary files and irrigated with 3% sodium hypochlorite. Based on the type of irrigation activation used, all the specimens were arbitrarily divided into five groups with 12 teeth in each group, as follows: G1, 17% EDTA activated with Er:YAG laser; G2, 17% EDTA without laser activation; G3, 0.2% CNP activated with Er:YAG laser; G4, 0.2% CNP without laser activation; and G5, controlled-deionized water. The AASF analysis for the removal of calcium ions in the irrigants was evaluated by collecting the overall quantity of each irrigating solution from the root canals. A one-way analysis of variance (ANOVA) and a Tukey post hoc test were done to determine the AASF data. 17% EDTA activated with Er:YAG laser (130.18 ± 10.3) and 0.2% CNP activated with Er:YAG laser (121.13 ± 3.9) showed the greatest concentration of calcium ions with no statistically significant difference. The lowest concentration of calcium ions was observed in 0.2% CNPs without laser activation (118.64 ± 2.9), while 17% EDTA (125.50 ± 3.0) without laser activation showed an intermediate outcome. The control group did not remove any calcium ions. The findings in the present study suggest that EDTA and CNPs, which were activated with lasers, yielded the greatest release of calcium ions equally. Hence, laser-activated CNPs can be employed for essential smear layer removal.