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Tunar OL, Gursoy H, Ozkan Karaca E, Kuru BE. A Comparative Evaluation of Root Surface Biomodification with Erbium-Doped Yttrium Aluminum Garnet Laser, Ethylenediaminetetraacetic Acid Gel, and Titanium Nitride Curette: In Vitro Scanning Electron Microscope and Profilometry Analyses. Photobiomodul Photomed Laser Surg 2021; 39:766-773. [DOI: 10.1089/photob.2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ogul L. Tunar
- Faculty of Dentistry, Department of Periodontology, Yeditepe University, Istanbul, Turkey
| | - Hare Gursoy
- Faculty of Dentistry, Department of Periodontology, Yeditepe University, Istanbul, Turkey
| | - Ebru Ozkan Karaca
- Faculty of Dentistry, Department of Periodontology, Yeditepe University, Istanbul, Turkey
| | - Bahar Eren Kuru
- Faculty of Dentistry, Department of Periodontology, Yeditepe University, Istanbul, Turkey
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Zhuang H, Liang Y, Xiang S, Li H, Dai X, Zhao W. Dentinal tubule occlusion using Er:YAG Laser: an in vitro study. J Appl Oral Sci 2021; 29:e20200266. [PMID: 33825761 DOI: 10.1590/1678-7757-2020-0266] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/15/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES We analyzed the effects of the Er:YAG laser used with different parameters on dentinal tubule (DT) occlusion, intrapulpal temperature and pulp tissue morphology in order to determine the optimal parameters for treating dentin hypersensitivity. METHODOLOGY Dentin specimens prepared from 36 extracted human third molars were randomized into six groups according to the treatment method (n=6 each): control (A); Gluma desensitizer (B); and Er:YAG laser treatment at 0.5 W , 167 J/cm2 (50 mJ, 10 Hz) (C), 1 W , 334 J/cm2 (50 mJ, 20 Hz) (D), 2 W , 668 J/cm2 (100 mJ, 20 Hz) (E), and 4 W and 1336 J/cm2 (200 mJ, 20 Hz) (F). Treatment-induced morphological changes of the dentin surfaces were assessed using scanning electron microscopy (SEM) to find parameters showing optimal dentin tubule occluding efficacy. To further verify the safety of these parameters (0.5 W, 167 J/cm2), intrapulpal temperature changes were recorded during laser irradiation, and morphological alterations of the dental pulp tissue were observed with an upright microscope. RESULTS Er:YAG laser irradiation at 0.5 W (167 J/cm2) were found to be superior in DT occlusion, with an exposure rate significantly lower than those in the other groups (P<0.05). Intrapulpal temperature changes induced by Er:YAG laser irradiation at 0.5 W (167 J/cm2) with (G) and without (H) water and air cooling were demonstrated to be below the threshold. Also, no significant morphological alterations of the pulp and odontoblasts were observed after irradiation. CONCLUSION Therefore, 0.5 W (167 J/cm2) is a suitable parameter for Er:YAG laser to occlude DTs, and it is safe to the pulp tissue.
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Affiliation(s)
- Hongmin Zhuang
- Southern Medical University, Nanfang Hospital, Department of Stomatology, Guangzhou, Guangdong, China.,Guangzhou Hospital of Integrated Traditional and West Medicine, Department of Stomatology, Guangzhou, China
| | - Yuee Liang
- Southern Medical University, Nanfang Hospital, Department of Stomatology, Guangzhou, Guangdong, China
| | - Shaowen Xiang
- Southern Medical University, Stomatological Hospital, Guangzhou, Guangdong, China
| | - Huanying Li
- Southern Medical University, Nanfang Hospital, Department of Stomatology, Guangzhou, Guangdong, China
| | - Xingzhu Dai
- Southern Medical University, Nanfang Hospital, Department of Stomatology, Guangzhou, Guangdong, China
| | - Wanghong Zhao
- Southern Medical University, Nanfang Hospital, Department of Stomatology, Guangzhou, Guangdong, China
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Liu J, Zhou Z, Zhang S. Effects of Er:YAG Laser on the Attachment of Human Periodontal Ligament Fibroblasts to Denuded Root Surfaces Simulating Delayed Replantation Cases: An In Vitro Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:145-150. [PMID: 31742487 DOI: 10.1089/photob.2019.4699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To investigate the effects of Er:YAG laser on the attachment of human periodontal ligament fibroblasts (hPDLFs) to denuded root surfaces simulating delayed replantation cases. Background data: Dental avulsion is one of the most severe dental traumas, which is often treated with replantation. In delayed replantation scenarios, poor prognosis, including root resorption, usually occurs due to poor root surface conditioning and nonviable hPDLF attachment. Methods: Thirty-six root fragments (5 × 5 × 2 mm) were obtained from periodontium tissue-free premolar root surfaces. Specimens were randomly and equally assigned to the following: Group A, untreated control; Group B, 25 J/cm2 and 10 Hz of Er:YAG laser irradiation; and Group C, 50 J/cm2 and 10 Hz of Er:YAG laser irradiation. Some specimens in each group were then prepared for surface topography visualization under SEM, others were subjected to coculture with hPDLF suspension, and cell adhesion was further evaluated by SEM. Results: Group A presented homogenous smooth root surface, with fewer and round-shaped cells attached; Group B and C exhibited rather rough and irregular morphologies, and spindle-shaped fibroblasts were firmly attached by numerous lamellipodia and extensions. After a 3-day coculture, the number of fibroblasts attached in Group A was significantly lower compared with the other two laser-treated groups (p = 0.008 < 0.05). No significant alterations were observed between the two laser groups (p = 0.135 > 0.05). Conclusions: Er:YAG laser-treated root surfaces are compatible for the attachment of PDLFs, which suggests that Er:YAG laser irradiation may be used as a promising strategy for root surface conditioning in delayed replantation cases.
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Affiliation(s)
- Jingyi Liu
- Department of Stomatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Zhixiong Zhou
- Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, People's Republic of China
| | - Sun Zhang
- Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, People's Republic of China
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Berg BI, Peyer M, Kuske L, Augello M, Schötzau A, Steineck M, Deibel W, Mathys D, Jürgens P, Kunz C, Goldblum D. Comparison of an Er: YAG laser osteotome versus a conventional drill for the use in osteo- odonto-keratoprosthesis (OOKP). Lasers Surg Med 2019; 51:531-537. [PMID: 30645014 DOI: 10.1002/lsm.23053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The osteo-odonto-kerato-prosthesis (OOKP) procedure is a complex, multi-stage, multidisciplinary surgical intervention for the treatment of severe corneal blindness. One step of the OOKP consists of creating a precise hole into a tooth in which an optic cylinder is subsequently inserted; its shape must ensure a perfect watertight fit. The Er: YAG laser (L) used in this study is part of CARLO®, the first laser osteotome that enables surgical planning based on computed tomography data, robot guidance, and a precise execution of laser cuts in teeth and bone tissue, using laser photoablation rather than conventional mechanical methods. The purpose of this study was to assess whether the Er: YAG laser is non-inferior compared to a conventional drill. METHODS Thirty-two bovine incisors were grounded to a thickness of 1.5 mm. In 16 teeth, a 3.5 mm hole was drilled progressively into each tooth, using dental burs (B) of increasing diameter that were attached to a fixed drill machine. In the other 16 teeth, a hole was created using an Er: YAG laser at a wavelength of 2.94 µm (Part of CARLO®). In seven teeth of each group, the cylinder was inserted and fixated with polymethylmethacrylate (PMMA) bone cement. In the remaining seven teeth of each group, the cylinder was inserted without fixation material (press-fit). After bonding and drying, all specimens were stored in water until force measurements were recorded using a uniaxial traction machine. The force required to move the optical cylinder out of the hole in the tooth was measured using an Instron 3344 testing system. Scanning electron microscope (SEM) and light microscope (LM) visualization of the holes created with the laser and the drill were performed in two teeth (SEM)/four teeth (LM) per method. RESULTS Significant differences (P < 0.001) were found for the following parameters: B PMMA versus B press-fit; B PMMA versus L press-fit; L PMMA versus B press-fit; L PMMA-L press-fit. This shows that PMMA bone cement fixation is superior to press-fit. No significant differences were found between B PMMA-L PMMA (P = 0.93) and B press-fit-L press-fit (P = 0.83). The SEM pictures showed a smoother surface using L. CONCLUSIONS The laser cut holes were as strong as bur-drilled holes, although SEM pictures showed a smoother surface of the laser cut holes. Hence, laser osteotomes open the possibility to custom fit the hole exactly to the width of the cylinder, which represents a potential advantage of the laser over the conventional bur. Lasers Surg. Med. 51:531-537, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Britt-Isabelle Berg
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, Switzerland
| | - Michael Peyer
- Advanced Osteotomy Tools AG (AOT), Basel, Switzerland
| | - Lorenz Kuske
- Department of Ophthalmology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Marcello Augello
- Department of Cranio-Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Andreas Schötzau
- Department of Ophthalmology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Markus Steineck
- Department of Dentistry, University Basel, Basel, Switzerland
| | | | - Daniel Mathys
- Swiss Nanoscience Institute (SNI), Nano Imaging Lab, Basel, Bio-Pharma Centre, Basel, Switzerland
| | - Philipp Jürgens
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, Switzerland.,Advanced Osteotomy Tools AG (AOT), Basel, Switzerland
| | - Christoph Kunz
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, Switzerland
| | - David Goldblum
- Department of Ophthalmology, University Hospital Basel, University Basel, Basel, Switzerland
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Campi LB, Lopes FC, Soares LES, de Queiroz AM, de Oliveira HF, Saquy PC, de Sousa-Neto MD. Effect of radiotherapy on the chemical composition of root dentin. Head Neck 2018; 41:162-169. [PMID: 30552849 DOI: 10.1002/hed.25493] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/23/2018] [Accepted: 07/06/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The radiotherapy can directly affect the bond strength of the adhesive materials, interfering in the prognosis of restorative treatments, which may be caused by chemical changes in dentin structure. METHODS Twenty inferior homologues premolars were distributed in 2 groups (in vitro study) (n = 10): nonirradiated and irradiated. The specimens were submitted to the analysis of phosphate (ν1 PO4 3- ;ν2 PO4 3- ;ν4 PO4 3- ), carbonate (ν3 CO3 2- ), amide I, CH2 , amide III, and amide I/III ratio by confocal Raman spectroscopy. Data were submitted to statistical analysis (T test, P < .05). RESULTS In intracanal dentin, the irradiated group had lower ν4 PO4 3- values (1.23 ± 0.06) compared to nonirradiated group (1.40 ± 0.18) (P < .05), with no difference for ν1 PO4 3- and ν2 PO4 3 peaks (P > .05). The irradiated (1.56 ± 0.06) had lower carbonate, amide III (1.05 ± 0.19), and amide I/III ratio values (0.19 ± 0.06) compared to nonirradiated group (1.42 ± 0.10, 1.28 ± 0.24, and 0.31 ± 0.10, respectively) (P < .05). For medium dentin irradiated group (1.30 ± 0.12) had lower phosphate values compared to nonirradiated group (1.48 ± 0.22) (P < .05). In cementum, there was no statistical difference between the groups. CONCLUSION The radiotherapy was able to cause changes in ν4 PO4 3- , carbonate, and amide III peaks of root dentin.
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Affiliation(s)
- Lívia Bueno Campi
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fabiane Carneiro Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luís Eduardo Silva Soares
- Laboratory of Dentistry and Applied Materials (LDAM), Research and Development Institute (IP&D), Universidade do Vale do Paraíba, Univap, São José dos Campos, São Paulo, Brazil
| | - Alexandra Mussolino de Queiroz
- Department Children's Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Harley Francisco de Oliveira
- Medical Clinic Department, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Paulo César Saquy
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Manoel Damião de Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Yumoto M, Saito N, Lin T, Kawamura R, Aoki A, Izumi Y, Wada S. High-energy, nanosecond pulsed Cr:CdSe laser with a 2.25-3.08 μm tuning range for laser biomaterial processing. BIOMEDICAL OPTICS EXPRESS 2018; 9:5645-5653. [PMID: 30460152 PMCID: PMC6238917 DOI: 10.1364/boe.9.005645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 05/31/2023]
Abstract
We have developed a mid-infrared (mid-IR) tunable Cr:CdSe laser with nanosecond pulse operation. A broad tuning range from 2.25 to 3.08 µm and an output energy exceeding 4 mJ at 2.64 μm were demonstrated. The maximum energy conversion for absorbed energy reached 35% when the pump fluence was 2.1 J/cm2. We showed that Cr:CdSe is an attractive laser material for obtaining high-energy pulses in the mid-IR region and that the Cr:CdSe laser has high potential for laser biomaterial processing.
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Affiliation(s)
- Masaki Yumoto
- Photonics Control Technology Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Norihito Saito
- Photonics Control Technology Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Taichen Lin
- Department of Dentistry, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N. Rd., Taichung 40201, Taiwan
- School of Dentistry, Chung Shan Medical University, No. 110, Section 1, Jianguo N. Rd., Taichung 40201, Taiwan
| | - Rie Kawamura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Satoshi Wada
- Photonics Control Technology Team, RIKEN Center for Advanced Photonics, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Yamakawa S, Niwa T, Karakida T, Kobayashi K, Yamamoto R, Chiba R, Yamakoshi Y, Hosoya N. Effects of Er:YAG and Diode Laser Irradiation on Dental Pulp Cells and Tissues. Int J Mol Sci 2018; 19:ijms19082429. [PMID: 30126087 PMCID: PMC6121961 DOI: 10.3390/ijms19082429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022] Open
Abstract
Vital pulp therapy (VPT) is to preserve the nerve and maintain healthy dental pulp tissue. Laser irradiation (LI) is beneficial for VPT. Understanding how LI affects dental pulp cells and tissues is necessary to elucidate the mechanism of reparative dentin and dentin regeneration. Here, we show how Er:YAG-LI and diode-LI modulated cell proliferation, apoptosis, gene expression, protease activation, and mineralization induction in dental pulp cells and tissues using cell culture, immunohistochemical, genetic, and protein analysis techniques. Both LIs promoted proliferation in porcine dental pulp-derived cell lines (PPU-7), although the cell growth rate between the LIs was different. In addition to proliferation, both LIs also caused apoptosis; however, the apoptotic index for Er:YAG-LI was higher than that for diode-LI. The mRNA level of odontoblastic gene markers-two dentin sialophosphoprotein splicing variants and matrix metalloprotease (MMP)20 were enhanced by diode-LI, whereas MMP2 was increased by Er:YAG-LI. Both LIs enhanced alkaline phosphatase activity, suggesting that they may help induce PPU-7 differentiation into odontoblast-like cells. In terms of mineralization induction, the LIs were not significantly different, although their cell reactivity was likely different. Both LIs activated four MMPs in porcine dental pulp tissues. We helped elucidate how reparative dentin is formed during laser treatments.
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Affiliation(s)
- Shunjiro Yamakawa
- Department of Endodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Takahiko Niwa
- Department of Periodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Takeo Karakida
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Kazuyuki Kobayashi
- Department of Dental Hygiene, Tsurumi Junior College, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Ryuji Yamamoto
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Risako Chiba
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Yasuo Yamakoshi
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Noriyasu Hosoya
- Department of Endodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
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Talebi-Ardakani MR, Torshabi M, Karami E, Vajar N, Rezaei Esfahrood Z, Meimandi M, Mojahedi SM. Comparison of Er:YAG Laser and Hand Instrumentation on the Attachment of Cultured Human Gingival Fibroblasts to Periodontally Involved Root Surfaces. J Lasers Med Sci 2017; 8:S51-S55. [PMID: 29071036 DOI: 10.15171/jlms.2017.s10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: The present study compared the effects of erbium-doped yttrium aluminium garnet (Er:YAG) laser and hand instrumentation on the attachment of human gingival fibroblast (HGF) cells to periodontally involved root surfaces. Methods: A total of 40 tooth specimens were collected and treated in four distinct groups: scaled and root planed with hand instruments, scaled with Er:YAG laser, treated with a combination of hand instruments and Er:YAG laser and non-treated control group. The attachment and proliferation rate of HGF were assessed using MTT assay and scanning electron microscope (SEM) examination was used for cell morphological evaluation. Results: The MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide) assay showed significant decrease in HGF cell viability in both hand instruments only and combination treated teeth specimens compared to control specimens (P<0.05), 24 hours after cell seeding. However, at time 48, the cell viability of attached cells in these 2 treated groups was almost similar to control. In contrast, at 24 and 48 hours after cell seeding, viability of attached cells was higher than control in Er:YAG laser treated only specimens (P<0.05). According to SEM study, the laser treated specimens showed more surface roughness. Conclusion: Er:YAG laser increased attachment and proliferation of HGF cells in comparison to the hand instruments method.
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Affiliation(s)
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Karami
- Department of Periodontics, School of Dentistry, Yazd University of Medical Sciences, Yazd, Iran
| | - Nazanin Vajar
- School of Dentistry, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Rezaei Esfahrood
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Meimandi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Arora S, Lamba AK, Faraz F, Tandon S, Ahad A. Evaluation of the Effects of Er,Cr:YSGG Laser, Ultrasonic Scaler and Curette on Root Surface Profile Using Surface Analyser and Scanning Electron Microscope: An In Vitro Study. J Lasers Med Sci 2017; 7:243-249. [PMID: 28491260 DOI: 10.15171/jlms.2016.43] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects. Methods: Thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A (n = 30) was taken as control and no instrumentation was performed. Part B (n = 30) was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser. Part C (n = 30) was treated by piezoelectric ultrasonic scaler. Part D (n = 30) was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average (Ra) value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope (SEM). The means across the groups were statistically compared with control using Dunnett test. Results: Among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness (mean Ra value of 4.14 μm) as compared to ultrasonic scaler (1.727 μm) and curette group (1.22 μm). However, surface with smear layer were found to be maximum (50%) in curette treated samples and minimum (20%) in laser treated ones. Maximum cracks (83.34%) were produced by ultrasonic scaler, and minimum (43.33%) by curettes. Crater formation was maximum (50%) in laser treated samples and minimum (3.33%) in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes. Conclusion: Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects.
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Affiliation(s)
- Shipra Arora
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Arundeep Kaur Lamba
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Farrukh Faraz
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Shruti Tandon
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Abdul Ahad
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
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Chowdhury SR, Marques MM, Franzen R, Pedroni ACF, Trevelin LT, Abe GL, Gutknecht N. Comparative ultrastructural analysis of Er:YAG laser scanner and conventional method for tooth cavity preparation. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s41547-017-0003-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Lin T, Aoki A, Saito N, Yumoto M, Nakajima S, Nagasaka K, Ichinose S, Mizutani K, Wada S, Izumi Y. Dental hard tissue ablation using mid-infrared tunable nanosecond pulsed Cr:CdSe laser. Lasers Surg Med 2016; 48:965-977. [PMID: 27020165 DOI: 10.1002/lsm.22508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Mid-infrared erbium: yttrium-aluminum-garnet (Er:YAG) and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers (2.94- and 2.78-μm, respectively) are utilized for effective dental hard tissue treatment because of their high absorption in water, hydroxide ion, or both. Recently, a mid-infrared tunable, nanosecond pulsed, all-solid-state chromium-doped: cadmium-selenide (Cr:CdSe) laser system was developed, which enables laser oscillation in the broad spectral range around 2.9 μm. The purpose of this study was to evaluate the ablation of dental hard tissue by the nanosecond pulsed Cr:CdSe laser at a wavelength range of 2.76-3.00 μm. STUDY DESIGN/MATERIALS AND METHODS Enamel, dentin, and cementum tissue were irradiated at a spot or line at a fluence of 0-11.20 J/cm2 /pulse (energy output: 0-2.00 mJ/pulse) with a repetition rate of 10 Hz and beam diameter of ∼150 μm on the target (pulse width ∼250 ns). After irradiation, morphological changes, ablation threshold, depth, and efficiency, and thickness of the structurally and thermally affected layer of irradiated surfaces were analyzed using stereomicroscopy, scanning electron microscopy (SEM), and light microscopy of non-decalcified histological sections. RESULTS The nanosecond pulsed irradiation without water spray effectively ablated dental hard tissue with no visible thermal damage such as carbonization. The SEM analysis revealed characteristic micro-irregularities without major melting and cracks in the lased tissue. The ablation threshold of dentin was the lowest at 2.76 μm and the highest at 3.00 μm. The histological analysis revealed minimal thermal and structural changes ∼20 μm wide on the irradiated dentin surfaces with no significant differences between wavelengths. The efficiency of dentin ablation gradually increased from 3.00 to 2.76 μm, at which point the highest ablation efficiency was observed. CONCLUSION The nanosecond pulsed Cr:CdSe laser demonstrated an effective ablation ability of hard dental tissues, which was remarkably wavelength-dependent on dentin at the spectral range of 2.76-3.00 μm. These results demonstrate the potential feasibility of the use of pulsed Cr:CdSe laser as a novel laser system for dental treatment. Lasers Surg. Med. 48:965-977, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Taichen Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Norihito Saito
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Masaki Yumoto
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Sadahiro Nakajima
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Keigo Nagasaka
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Shizuko Ichinose
- Research Center for Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Wada
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Phanombualert J, Chimtim P, Heebthamai T, Weera-Archakul W. Microleakage of Self-Etch Adhesive System in Class V Cavities Prepared by Using Er:YAG Laser with Different Pulse Modes. Photomed Laser Surg 2015; 33:467-72. [PMID: 26270129 DOI: 10.1089/pho.2015.3926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE In vitro studies evaluated cementum surface morphology and microleakage of three different energy density parameters of Erbium: Yttrium Aluminum Garnet (Er:YAG) laser compared with diamond bur preparation on class V cavities with self-etch adhesive system and composite resin restoration. MATERIAL AND METHODS Standard class V cavities were prepared at cervical area below the cementoenamel junction (CEJ) in 80 extracted premolars, by using a diamond bur on the buccal surface. All teeth were randomly allocated into four groups: Group 1, diamond bur; Group 2, Er:YAG 50 mJ/15 Hz, 3.77 J/cm(2); Group 3, Er:YAG 75 mJ/15 Hz, 5.65 J/cm(2); and Group 4, Er:YAG 100 mJ/15 Hz, 7.53 J/cm(2). Five cavities from each group were evaluated by scanning electron microscopy (SEM). The 15 remaining cavities from each group were restored with self-etch adhesive and nano-hybrid composite. After thermocycling, all sample teeth were immersed in 0.2% methylene blue dye and sectioned buccolingually. Statistics were analyzed using the one way ANOVA and Mann-Whitney U tests with Bonferroni correction. RESULTS The morphology showed micro-irregularities in the cementum surface of the laser group with the absence of a smear layer. The microstructure characteristics were increased surface roughness followed by increasing laser energy transmission. The Er:YAG laser groups were statistically significant, with less microleakage than the diamond bur group (p<0.05). There was statistically significant difference between the occlusal and gingival microleakage in all the groups (p<0.05). When the laser groups were compared, the lowest microleakage was achieved with energy density at 3.77 J/cm(2) on the occlusal and gingival cementum margin, which showed less microleakage than at energy densities of 5.65 and 7.53 J/cm(2) with Er:YAG laser. CONCLUSIONS These observations indicate that the micro-irregularities of the cementum surface could facilitate the formation of a hybridization zone with a self-etch adhesive system. Therefore, the microleakage of Er:YAG laser irradiation was significantly decreased compared with diamond bur cavities.
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Affiliation(s)
- Jutipond Phanombualert
- 1 Department of Hospital Dentistry, Khon Kaen University , Khon Kaen, Thailand .,2 Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
| | - Pijitta Chimtim
- 2 Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
| | - Thitirat Heebthamai
- 2 Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
| | - Wilawan Weera-Archakul
- 3 Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
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Laxman KV, Ghosh S, Dhingra K, Patil R. Effect of Er: YAG or Nd:YAG Laser Exposure on Fluorosed and Non-Fluorosed Root Surfaces: An In Vitro Study. Laser Ther 2015; 24:93-101. [PMID: 26246689 DOI: 10.5978/islsm.15-or-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/02/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Fluorosis affects tooth mineralization. The therapeutic benefit provided by lasers on fluorosed and non fluorosed cementum requires studying and comparing. The aim of this study was to evaluate and compare the root surface changes following Er:YAG or Nd:YAG laser irradiation on periodontally healthy fluorosed versus non-fluorosed teeth by scanning electron microscopy (SEM). MATERIALS AND METHODS A total of 76 periodontally healthy fluorosed (FH) and non-fluorosed (NFH) teeth specimens were included in this study. In one group, the experimental root specimens were irradiated using Er:YAG or with Nd:YAG laser in the other. A SEM evaluation was performed to assess the laser induced ultra structural changes in the root surface followed by statistical analysis using Fisher's exact test. RESULTS It was observed that both FH and NFH groups were similarly affected by Nd:YAG or Er:YAG laser. However, the former caused more surface changes than the latter on melting of surface (p=0.12 for FH and p=0.08 for NFH), and Er:YAG laser caused more smear layer formation (p=0.51 for FH and p=0.16 for NFH). CONCLUSION RESULTS suggest that undesirable morphological changes were observed almost similarly in FH and NFH groups using Er:YAG or Nd:YAG laser. Hence further in-vitro studies at lower energy settings followed by clinical trials are required in this aspect.
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Affiliation(s)
| | - Saubhik Ghosh
- Dept. of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Kunaal Dhingra
- Department of Periodontics, Bangalore Institute of Dental Sciences, Bangalore, Karnataka, India
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14
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Belal MH, Watanabe H. Comparative Study on Morphologic Changes and Cell Attachment of Periodontitis-Affected Root Surfaces Following Conditioning with CO2and Er:YAG Laser Irradiations. Photomed Laser Surg 2014; 32:553-60. [DOI: 10.1089/pho.2014.3769] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Mahmoud Helmy Belal
- Department of Oral Medicine, Periodontology & Oral Diagnosis, Faculty of Oral & Dental Medicine, Fayoum University, Bahaariy Region, Al-Fayoum, Egypt
| | - Hisashi Watanabe
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
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15
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Mishra MK, Prakash S. A comparative scanning electron microscopy study between hand instrument, ultrasonic scaling and erbium doped:Yttirum aluminum garnet laser on root surface: A morphological and thermal analysis. Contemp Clin Dent 2013; 4:198-205. [PMID: 24015009 PMCID: PMC3757882 DOI: 10.4103/0976-237x.114881] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Scaling and root planing is one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time consuming. In search of more efficient and less difficult instrumentation, investigators have proposed lasers as an alternative or as adjuncts to scaling and root planing. Hence, the purpose of the present study was to evaluate the effectiveness of erbium doped: Yttirum aluminum garnet (Er:YAG) laser scaling and root planing alone or as an adjunct to hand and ultrasonic instrumentation. SUBJECTS AND METHODS A total of 75 freshly extracted periodontally involved single rooted teeth were collected. Teeth were randomly divided into five treatment groups having 15 teeth each: Hand scaling only, ultrasonic scaling only, Er:YAG laser scaling only, hand scaling + Er:YAG laser scaling and ultrasonic scaling + Er:YAG laser scaling. Specimens were subjected to scanning electron microscopy and photographs were evaluated by three examiners who were blinded to the study. Parameters included were remaining calculus index, loss of tooth substance index, roughness loss of tooth substance index, presence or absence of smear layer, thermal damage and any other morphological damage. RESULTS Er:YAG laser treated specimens showed similar effectiveness in calculus removal to the other test groups whereas tooth substance loss and tooth surface roughness was more on comparison with other groups. Ultrasonic treated specimens showed better results as compared to other groups with different parameters. However, smear layer presence was seen more with hand and ultrasonic groups. Very few laser treated specimens showed thermal damage and morphological change. INTERPRETATION AND CONCLUSION In our study, ultrasonic scaling specimen have shown root surface clean and practically unaltered. On the other hand, hand instrument have produced a plane surface, but removed more tooth structure. The laser treated specimens showed rough surfaces without much residual deposit or any other sign of morphological change.
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Affiliation(s)
- Mitul Kumar Mishra
- Department of Periodontology and Implantology, SDK Dental College and Hospital, Hingna, Nagpur, Maharashtra, India
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16
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Kim JS, Han SY, Kwon HK, Kim BI. Synergistic Effect of Dentinal Tubule Occlusion by Nano-Carbonate Apatite and CO2LaserIn Vitro. Photomed Laser Surg 2013; 31:392-7. [DOI: 10.1089/pho.2012.3470] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ji Sun Kim
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Sun Young Han
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Ho Keun Kwon
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Baek Il Kim
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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17
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Sabaeian M, Shahzadeh M. Simulation of temperature and thermally induced stress of human tooth under CO2 pulsed laser beams using finite element method. Lasers Med Sci 2013; 30:645-51. [PMID: 23868367 DOI: 10.1007/s10103-013-1390-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 07/08/2013] [Indexed: 12/13/2022]
Abstract
The authors report the simulation of temperature distribution and thermally induced stresses of human tooth under CO2 pulsed laser beam. A detailed tooth structure comprising enamel, dentin, and pulp with realistic shapes and thicknesses were considered, and a numerical method of finite element was adopted to solve time-dependent bio-heat and stress equations. The realistic boundary conditions of constant temperature for those parts embedded in the gingiva and heat flux condition for those parts out of the gingiva were applied. The results which were achieved as a function of energy density (J/cm(2)) showed when laser beam is irradiated downward (from the top of the tooth), the temperature and thermal stresses decrease quickly as a function of depth that is a result of strong absorption of CO2 beams by enamel. This effect is so influential that one can use CO2 beams to remove micrometer layers while underlying tissues, especially the pulp, are safe from thermal effects.
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Affiliation(s)
- Mohammad Sabaeian
- Physics Department, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran,
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18
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Han SY, Jung HI, Kwon HK, Kim BI. Combined Effects of Er:YAG Laser and Nano-Carbonate Apatite Dentifrice on Dentinal Tubule Occlusion: In Vitro Study. Photomed Laser Surg 2013; 31:342-8. [DOI: 10.1089/pho.2012.3449] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sun Young Han
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Hoi In Jung
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Ho Keun Kwon
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Baek Il Kim
- Department of Preventive Dentistry and Public Oral Health, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 Project, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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Zan R, Hubbezoglu I, Sümer Z, Tunç T, Tanalp J. Antibacterial effects of two different types of laser and aqueous ozone against Enterococcus faecalis in root canals. Photomed Laser Surg 2013; 31:150-4. [PMID: 23484588 DOI: 10.1089/pho.2012.3417] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the antibacterial effects of two different types of laser and aqueous ozone in human root canals infected by Enterococcus faecalis. BACKGROUND DATA Many techniques have been developed to find an alternative to sodium hypochlorite as a disinfection agent for infected root canals. However, no study has evaluated the exactly the same antimicrobial agent with sodium hypochlorite (NaOCl). METHODS Eighty mandibular premolar teeth with single roots and canals were selected. Following root canal preparation and irrigation, sterilization was performed in an autoclave. E. faecalis was incubated in the root canals and kept at 37°C for 24 h. The teeth contaminated with E. faecalis were divided into one negative control group (NaOCl) and three experimental groups; (Er:YAG laser, KTP laser, and aqueous ozone groups)(n=20). A disinfection procedure was performed for 3 min in order to standardize all groups. After this procedure, the microbial colonies were counted. RESULTS The results indicated that whereas the NaOCl group exhibited the highest antibacterial effect among all groups, the aqueous ozone showed the highest antibacterial effect among the experimental groups. Whereas a statistically significant difference was noted between the aqueous ozone and laser groups (p<0.05), the difference between the Er:YAG and KTP lasers was not statistically significant (p>0.05). CONCLUSIONS The results showed that when aqueous ozone was applied with the aim of disinfecting the root canals, it exhibited a higher antibacterial effect than the KTP and Er:YAG lasers. However, the antibacterial effect of the aqueous ozone was insufficient when compared with NaOCl.
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Affiliation(s)
- Recai Zan
- Department of Endodontics, Cumhuriyet University, Sivas, Turkey
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20
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Baraba A, Dukić W, Chieffi N, Ferrari M, Anić I, Miletić I. Influence of different pulse durations of Er:YAG laser based on variable square pulse technology on microtensile bond strength of a self-etch adhesive to dentin. Photomed Laser Surg 2013; 31:116-24. [PMID: 23421630 DOI: 10.1089/pho.2012.3286] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the microtensile bond strength of a composite resin to dentin modified with three different pulse durations of the Er:YAG laser based on variable square pulse technology and with one self-etch adhesive. MATERIALS AND METHODS The entire occlusal enamel was removed to obtain flat dentin surface for 48 human molar teeth. The teeth were randomly divided into four experimental groups (n=12 per group), according to the pretreatment of dentin: (1) control group; (2) super short pulse (SSP) (50 μsec); (3) medium short pulse (MSP) (100 μsec); and (4) short pulse (SP) (300 μsec) with Er:YAG laser. The energy of the laser used was 80 mJ with average power of 0.8 W. The microtensile bond strength was tested with a universal testing machine. Two specimens from each experimental group were subjected to scanning electron microscopic (SEM) examination, to observe the irradiated surface. RESULTS Dentin surface treated with SSP showed significantly lower microtensile bond strength values (24±9.8 MPa) in comparison with the control group and SP group (35.3±12.8 and 32.9±10.7 MPa, respectively), (p<0.05). The MSP and SP groups did not show any statistically significant difference in microtensile bond strength in comparsion with the control group (p>0.05). CONCLUSIONS The use of SP and MSP of the Er:YAG laser with one step self-etch adhesive does not impair or improve the microtensile bond strength in dentin, whereas SSP may not be suitable for dentin surface treatment prior to bonding procedures.
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Affiliation(s)
- Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
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21
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Yung FYW, Gutknecht N, Franzen R, Fischer H. Shear strength of composite bonded to Er:YAG laser-prepared enamel: an in vitro comparative study. Lasers Med Sci 2012; 28:879-89. [PMID: 22855382 DOI: 10.1007/s10103-012-1169-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 07/16/2012] [Indexed: 11/30/2022]
Abstract
UNLABELLED The primary objective of this study is to investigate the adhesion properties between four current generations of bonding systems and enamel surface conditioned by Er:YAG laser, using an energy density comparable to the ablation threshold of enamel. By including an energy density comparable to published adhesion studies, the secondary objective is to compare the adhesion effects of these selected laser conditioning parameters on enamel with other similar published studies. MATERIAL AND METHODS Buccal sides of randomly selected human molars (N=117) were prepared and divided into nine experimental groups depending on the generations of bonding system represented by the corresponding number (G4, G5, G6, G7) and the additional laser conditioning on the enamel surface represented by laser etch (LE) and laser etch with a higher pulse energy, followed by acid etch (AE), if required. The bonding resin systems and their specific requirements were applied after the enamel surfaces were laser conditioned following a specific set of laser parameters. Composite posts of 1.6 mm in diameter and approximately 6 mm in length were then restored on each of the sample surfaces. After 48 h, the composite assemblies were tested to failure under compression using a knife edge loading head at a cross head speed of 1 mm/min until the composite cylinders were separated from the surface. The data collected were then analyzed using one-way analysis of variance and SAS software program (9.1, TS1M3). RESULTS No significant difference was found among these groups: AE+G4/LEAE+G4, G6/LE+G6, and G7/LE+G7. Significant differences were found in the remaining groups: AE+G5/LEAE+G5, AE+G5/LEAE-H+G5, and LEAE+G5/LEAE-H+G5. The bond strength results were compared among similar published data and possible influences from different laser parameters, bonding systems, and their combined impact on the enamel surface and its adhesion properties were analyzed. CONCLUSION Under our specific settings, additional laser conditioning after phosphoric acid etch is beneficial to one generation of bonding resin (G5). There is no significant change or detrimental effect to the other three groups (G4, G6, and G7) of bonding resins with respect to their final bond strength. The published reports of lower bond strength after additional laser conditioning may be related to thermal damage or unfavorable alteration to the enamel surface by excessive laser energy and the chemistry of bonding systems studied. These factors will affect the overall wettability and the subsequent adhesion properties of the enamel surface.
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Histological and SEM analysis of root cementum following irradiation with Er:YAG and CO2 lasers. Lasers Med Sci 2012; 28:203-13. [PMID: 22580557 DOI: 10.1007/s10103-012-1110-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 04/17/2012] [Indexed: 12/15/2022]
Abstract
Recently, the Er:YAG and CO(2) lasers have been applied in periodontal therapy. However, the characteristics of laser-irradiated root cementum have not been fully analyzed. The aim of this study was to precisely analyze the alterations of root cementum treated with the Er:YAG and the CO(2) lasers, using non-decalcified thin histological sections. Eleven cementum plates were prepared from extracted human teeth. Pulsed Er:YAG laser contact irradiation was performed in a line at 40 mJ/pulse (14.2 J/cm(2)/pulse) and 25 Hz (1.0 W) under water spray. Continuous CO(2) laser irradiation was performed in non-contact mode at 1.0 W, and ultrasonic instrumentation was performed as a control. The treated samples were subjected to stereomicroscopy, scanning electron microscopy (SEM), light microscopy and SEM energy dispersive X-ray spectroscopy (SEM-EDS). The Er:YAG laser-treated cementum showed minimal alteration with a whitish, slightly ablated surface, whereas CO(2) laser treatment resulted in distinct carbonization. SEM analysis revealed characteristic micro-irregularities of the Er:YAG-lased surface and the melted, resolidified appearance surrounded by major and microcracks of the CO(2)-lased surface. Histological analysis revealed minimal thermal alteration and structural degradation of the Er:YAG laser-irradiated cementum with an affected layer of approximately 20-μm thickness, which partially consisted of two distinct affected layers. The CO(2)-lased cementum revealed multiple affected layers showing different structures/staining with approximately 140 μm thickness. Er:YAG laser irradiation used with water cooling resulted in minimal cementum ablation and thermal changes with a characteristic microstructure of the superficial layer. In contrast, CO(2) laser irradiation produced severely affected distinct multiple layers accompanied by melting and carbonization.
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Kaptan F, Karapinar-Kazandag M, Kayahan MB, Bora T, Bayirli G. Potential of an Er:YAG Laser in the Removal of Calcium Hydroxide from Root Canals. Photomed Laser Surg 2012; 30:250-4. [DOI: 10.1089/pho.2011.3093] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Figen Kaptan
- Department of Endodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | | | | | - Toygan Bora
- Private practice limited to endodontics, Istanbul, Turkey
| | - Gunduz Bayirli
- Department of Endodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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Bolortuya G, Ebihara A, Ichinose S, Watanabe S, Anjo T, Kokuzawa C, Saegusa H, Kawashima N, Suda H. Effects of dentin surface modifications treated with Er:YAG and Nd:YAG laser irradiation on fibroblast cell adhesion. Photomed Laser Surg 2011; 30:63-70. [PMID: 22107609 DOI: 10.1089/pho.2011.3132] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this in vitro study was to evaluate the effect of surface modifications induced by erbium (Er):YAG and neodymium (Nd):YAG laser irradiation on cell adhesion by comparing it to that of conventional methods for surface preparation after root-end resection. BACKGROUND DATA Many studies have been seeking a favorable method to produce a resected root end with optimal conditions for cell response. However, little improvement has been achieved. This study evaluated the biocompatibilities of resected root surfaces after Er:YAG or Nd:YAG laser irradiation on initial cell adhesion. MATERIALS AND METHODS Dentin disks were divided into three groups. Group A was left untreated, Group B was treated with Er:YAG laser irradiation (60 mJ/pulse, 10 pps, 60 sec), and Group C with Nd:YAG laser irradiation (60 mJ/pulse, 10 pps, 60 sec). After laser irradiation, the dentin disks were incubated with NIH/3T3 fibroblasts cultured in Dulbecco's modified Eagle's medium. A morphological analysis of the dentin surface and cell adhesion was observed under a scanning electron microscope. Surface roughness was measured using a confocal laser scanning microscope. The statistical analysis was undertaken using ANOVA at a level of significance of 5% (p<0.05). RESULTS Morphological analysis and roughness measurement showed that dentin surfaces treated with Er:YAG laser irradiation were rougher than those in Groups A and C. Group B (Er:YAG) exhibited the greatest number of attached cells among all groups after 12 and 24 h. CONCLUSIONS Morphological alteration induced by Er:YAG laser irradiation showed a favorable effect on the attachment of fibroblasts to dentin surfaces.
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Affiliation(s)
- Gombo Bolortuya
- Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Bolortuya G, Ebihara A, Ichinose S, Watanabe S, Anjo T, Kokuzawa C, Saegusa H, Kawashima N, Suda H. Initial fibroblast attachment to Erbium:YAG laser-irradiated dentine. Int Endod J 2011; 44:1134-44. [PMID: 21851368 DOI: 10.1111/j.1365-2591.2011.01934.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIMS To evaluate the effects of Erbium (Er):YAG laser irradiation on the morphology of resected dentine surfaces, and to investigate fibroblast attachment to laser-irradiated dentine surfaces. METHODOLOGY Dentine blocks obtained from single-rooted human teeth were divided into the following groups after sterilization in an autoclave: (i) Laser group treated with Er:YAG laser irradiation (30 mJ per pulse, 10 pps, 60 s); (ii) L-MTAD group treated with laser irradiation as in (i) plus a mixture of doxycycline, tetracycline isomer and citric acid; (iii) RC-Prep group treated with EDTA gel or cream (RC-Prep) and (iv) Control group left untreated. After each treatment, the dentine blocks were incubated with NIH/3T3 fibroblasts cultured to subconfluency in Dulbecco's modified Eagle's medium supplemented with 10% foetal bovine serum and antibiotics. The number of attached cells amongst the groups was analysed statistically at the 5% significance level. The dentine surface morphologies and cell attachments were evaluated by counting assays, histological observations and scanning electron microscopy (SEM). RESULTS The number of attached cells was significantly higher (P < 0.05) in the Laser group than in the RC-Prep and Control groups at 16 h. Dendritic cell extension of the fibroblasts was only observed in the Laser group at 8 h by SEM. In the histological analyses, significantly more attached cells were found on the dentine surfaces treated with laser irradiation. CONCLUSIONS Er:YAG laser irradiation induced morphological alterations in dentine surfaces, which may improve the attachment of fibroblasts to dentine.
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Affiliation(s)
- G Bolortuya
- Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Dilsiz A, Aydin T, Yavuz MS. Root surface biomodification with an Er:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts. Photomed Laser Surg 2010; 28:511-7. [PMID: 19780631 DOI: 10.1089/pho.2009.2584] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND/AIM Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such agents. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Er:YAG laser application for root surface biomodification. MATERIALS AND METHODS Twenty-four teeth in 12 patients with Miller class I and II recession were treated with SCTG with (test group) or without (control group) the application of an Er:YAG laser (2 Hz, 60 mJ/pulse, 40 s, with air spray). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and 6 months postsurgery. RESULTS There were no significant differences between test and control groups (p > 0.05). Postoperatively, significant root coverage, gains in CAL, and highly significant increases in the RW were observed in both groups. For test and control groups, the average root coverage was 80% and 86%, respectively (p > 0.05), and complete root coverage was 75% and 67%, respectively. CONCLUSIONS The present study showed that root surface conditioning with an Er:YAG laser does not enhance the results achieved when SCTG was performed alone.
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Affiliation(s)
- Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
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Baraba A, Miletic I, Krmek SJ, Perhavec T, Bozic Z, Anic I. Ablative potential of the erbium-doped yttrium aluminium garnet laser and conventional handpieces: a comparative study. Photomed Laser Surg 2010; 27:921-7. [PMID: 19731997 DOI: 10.1089/pho.2008.2416] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To compare the ability of the Variable Square Pulse technology (VSP-technology)-based erbium-doped yttrium aluminium garnet (Er:YAG) laser working in maximum speed (MAX) mode (1000 mJ, 300 micros, 20 Hz) and the high-speed handpiece to ablate enamel, to compare the ability of for the VSP-technology-based Er:YAG laser working in MAX mode and the low-speed handpiece to ablate dentin, and to analyze in vitro effects of Er:YAG ablation of enamel and dentine surfaces using scanning electron microscopy (SEM). BACKGROUND DATA A VSP-technology-based Er:YAG laser operating in MAX mode should be appropriate for achieving the maximum ablating speed in hard dental tissues. MATERIALS AND METHODS The experiment was conducted on extracted, cleaned, sterilized human molar teeth. Cavity preparations were made in hard dental tissues using the VSP-technology Er:YAG laser in MAX mode, in enamel using the high-speed handpiece, and in dentin using the low-speed handpiece at different time intervals. A laser triangulation profilometer was used to determine cavity volumes. The cavity surfaces of five specimens were examined using SEM. RESULTS The Er:YAG laser removed a volume of enamel that was 3.3 times as large as that removed by the high-speed handpiece in the same period of time. In dentin, the Er:YAG laser removed 8 to 18 times as much volume as the steel bur in the same period of time. The Er:YAG ablation rate in dentin was faster than in enamel. SEM of laser prepared cavities showed a well-defined surface, free of the smear layer. CONCLUSIONS The VSP-technology-based Er:YAG laser, working in MAX mode, is more efficient than mechanical drills for enamel and dentin ablation.
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Affiliation(s)
- Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Zagreb, Croatia.
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Raldi DP, Mello I, Neves ACC, Habitante SM, Miyagi SSP, Lage-Marques JL. Attachment of cultured fibroblasts and ultrastructural analysis of simulated cervical resorptions treated with high-power lasers and MTA. ACTA ACUST UNITED AC 2010; 109:e154-61. [PMID: 19969481 DOI: 10.1016/j.tripleo.2009.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 08/26/2009] [Accepted: 09/09/2009] [Indexed: 11/19/2022]
Affiliation(s)
- Denise Pontes Raldi
- Division of Endodontics, Department of Dentistry, University of Taubate, Taubate, Sao Paulo, Brazil.
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Romeo U, Palaia G, Botti R, Leone V, Rocca JP, Polimeni A. Non-surgical periodontal therapy assisted by potassium-titanyl-phosphate laser: a pilot study. Lasers Med Sci 2009; 25:891-9. [PMID: 19936872 DOI: 10.1007/s10103-009-0738-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2009] [Accepted: 10/07/2009] [Indexed: 11/28/2022]
Abstract
As the American Academy of Periodontology indicates, the treatment of chronic periodontitis should be achieved in the least invasive manner through non-surgical periodontal therapy. However, complete removal of subgingival plaque and calculus is hindered with increasing probing depth (PD) and furcation involvement using hand, sonic or ultrasonic instruments. Many authors have suggested that the use of laser as an adjunct to scaling and root planing (SRP) might improve the effectiveness of conventional periodontal treatment. The aim of this study was to evaluate potassium-titanyl-phosphate (KTP) laser in non-surgical periodontal therapy. Seven hundred and thirty sites with probing depths of 4-6 mm were involved in the study. The sites were divided into four groups: control (SRP, chlorhexidine gel 0.5%), group A (SRP, chlorhexidine gel 0.5%, three sessions of KTP laser irradiation); group B (SRP, three sessions of KTP laser irradiation) and group C (SRP, irrigation with povidone-iodine 10%, three sessions of KTP laser irradiation). KTP laser was used with the following parameters: output power 0.6 W, time on 10 ms, time off 50 ms, 30 s per irradiation, fluence 19 J/cm(2). All the sites showed improvement in all clinical parameters. Clinical attachment loss (CAL), pocket probing depths (PPDs) and bleeding on probing (BOP), especially in the lased groups, showed significant results (P < 0.001). Our experience showed KTP laser to be a significant help in SRP; nevertheless, more studies are necessary to confirm our results.
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Affiliation(s)
- Umberto Romeo
- Department of Dental Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy.
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Galli C, Passeri G, Cacchioli A, Gualini G, Ravanetti F, Elezi E, Macaluso GM. Effect of Laser-Induced Dentin Modifications on Periodontal Fibroblasts and Osteoblasts: A New In Vitro Model. J Periodontol 2009; 80:1648-54. [DOI: 10.1902/jop.2009.090152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Krmek SJ, Bogdan I, Simeon P, Mehicić GP, Katanec D, Anić I. A three-dimensional evaluation of microleakage of class V cavities prepared by the very short pulse mode of the erbium:yttrium-aluminium-garnet laser. Lasers Med Sci 2009; 25:823-8. [PMID: 19593602 DOI: 10.1007/s10103-009-0707-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Accepted: 06/12/2009] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate microleakage along resin restoration in cavities prepared with an erbium:yttrium-aluminium-garnet (Er:YAG) laser, with and without acid etching, and to compare it with that in diamond-drilled cavities. Thirty intact molars were divided into three equal groups. In the teeth in group I, class V cavities were prepared with a diamond drill. Cavities in groups II and III were prepared with an Er:YAG laser (400 mJ/15 Hz for enamel and 250 mJ/10 Hz for dentine). The cavities in groups I and II were acid-etched and adhesive and flowable composite were applied to all cavities. The specimens were first immersed in dye for 24 h and then in 5% nitric acid for 72 h for softening. The fillings were extracted and photographed through a dissecting microscope. The leakage area was measured with specially designed software. The Kruskal-Wallis test showed that the best ranking was group II [mean range (m.r.) = 27.46], followed by group I (m.r. = 33.48) and, lastly, group III (m.r. = 45.15). The differences between groups I and III (P = 0.023) and between groups II and III were statistically significant (P = 0.080). The least microleakage was found in those cavities prepared by Er:YAG laser and subsequently acid-etched, whereas the most leakage was in the lased cavities that had not been etched; the traditional diamond-drilled acid-etched cavities produced medium leakage.
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Affiliation(s)
- Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000, Zagreb, Croatia.
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Yoshino T, Aoki A, Oda S, Takasaki AA, Mizutani K, Sasaki KM, Kinoshita A, Watanabe H, Ishikawa I, Izumi Y. Long-term histologic analysis of bone tissue alteration and healing following Er:YAG laser irradiation compared to electrosurgery. J Periodontol 2009; 80:82-92. [PMID: 19228093 DOI: 10.1902/jop.2009.080097] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser is reportedly useful for periodontal therapy. However, the potential thermal damage that Er:YAG laser irradiation can produce on bone tissue has not been fully clarified. The purpose of this study was to histologically examine the effects of the Er:YAG laser on bone tissue and subsequent wound healing compared to electrosurgery in a long-term study. METHODS Calvarial bone from 30 rats was exposed to contact and non-contact Er:YAG laser irradiation (115 mJ/pulse, 10 Hz) without water coolant, or electrode contact. The treated surfaces were analyzed by scanning electron microscopy (SEM), and the healing process was histologically observed until 12 months post-surgery. RESULTS Contact irradiation resulted in substantial bone ablation, whereas non-contact irradiation produced slight tissue removal. Histologic and SEM analyses of the lased surface showed no severe thermal damage, except for the production of a superficially affected layer with a microstructured surface. The layer did not inhibit new bone formation, and the ablated defect was repaired uneventfully. Although the thickness of the layer gradually decreased, it generally remained in the cortical bone through the observation period. Electrosurgery produced a large area of thermal necrosis without ablation, and the damaged area was not replaced with new bone. CONCLUSIONS Unlike electrosurgery, Er:YAG laser irradiation without water coolant easily ablated bone tissue, and thermal alteration in the treated surface was minimal. The superficially affected layer did not interfere with the ensuing bone healing, resulting in favorable repair of the defect.
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Affiliation(s)
- Toshiaki Yoshino
- Section of Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Theodoro LH, Zezell DM, Garcia VG, Haypek P, Nagata MJH, de Almeida JM, de Paula Eduardo C. Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium–aluminum–garnet laser irradiation. A scanning electron microscopy study. Lasers Med Sci 2009; 25:485-91. [DOI: 10.1007/s10103-009-0665-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 03/02/2009] [Indexed: 11/24/2022]
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Effects of root planing procedures with hand instrument or erbium, chromium:yttrium–scandium–gallium–garnet laser irradiation on the root surfaces: a comparative scanning electron microscopy study. Lasers Med Sci 2009; 25:345-53. [DOI: 10.1007/s10103-009-0643-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Accepted: 01/07/2009] [Indexed: 11/26/2022]
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Maruyama H, Aoki A, Sasaki KM, Takasaki AA, Iwasaki K, Ichinose S, Oda S, Ishikawa I, Izumi Y. The effect of chemical and/or mechanical conditioning on the Er:YAG laser-treated root cementum: analysis of surface morphology and periodontal ligament fibroblast attachment. Lasers Surg Med 2008; 40:211-22. [PMID: 18366073 DOI: 10.1002/lsm.20609] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES This study compared the surface morphology as well as the biocompatibility of dental root cementum treated with Er:YAG laser irradiation alone and with the laser irradiation followed by chemical and/or mechanical conditioning. STUDY DESIGN/MATERIALS AND METHODS Healthy cementum plates were randomly assigned to the following control and treatment groups: (1) untreated control (C), (2) Er:YAG laser irradiation (L), (3) laser plus tetracycline HCl (TC) placement (L+TP), (4) laser plus TC burnishing (L+TB), (5) laser plus EDTA gel placement (L+EP), (6) laser plus EDTA gel burnishing (L+EB), (7) laser plus saline solution burnishing (L+SB), and (8) laser plus minocycline-HCl paste placement (L+MP). Specimens were subjected to scanning electron microscopy (SEM), histological observation and attachment assay using periodontal ligament (PDL) fibroblasts. RESULTS The laser irradiation produced a thin affected layer (5.7 microm thickness) with a superficial microstructure on the cementum surface. The characteristic microstructures of the lased surface were fragile and could be removed by chemical and/or mechanical conditioning treatments. The L+TB group exhibited marked exposure of collagen fibers after removal of the microstructures on the lased surface. The L+EP group presented a peculiar, smooth surface without exposure of collagen fibers and a uniform arrangement of spherical microparticles on the ultra-high magnification of SEM. In cell attachment assay, the L+TB group exhibited the greatest number of attached cells among all the groups, followed by the L+EP, L+SB and control group. The laser alone group exhibited the lowest number of cells. CONCLUSIONS The characteristic microstructure of the root cementum surface after Er:YAG laser irradiation has a tendency to hinder the early attachment of PDL cells. However, chemical and/or mechanical root conditioning treatment may improve and increase the biocompatibility of the Er:YAG laser-treated root cementum by removing the microstructures of the surface and/or further exposing the collagen fibers.
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Affiliation(s)
- Hiroaki Maruyama
- Section of Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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Colucci V, Lucisano Botelho do Amaral F, Pécora JD, Palma-Dibb RG, Milori Corona SA. Water flow on erbium:yttrium–aluminum–garnet laser irradiation: effects on dental tissues. Lasers Med Sci 2008; 24:811-8. [DOI: 10.1007/s10103-008-0563-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 03/19/2008] [Indexed: 12/23/2022]
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Abstract
The oral cavity is a unique and complex environment, where hard and soft tissues exist in close proximity, within bacteria-laden saliva. All oral tissues are receptive to laser treatment, but the biophysics governing laser-tissue interaction demands a knowledge of all factors involved in delivery of this modality; through this knowledge, correct and appropriate treatment can be delivered in a predictable manner.
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Takasaki AA, Aoki A, Mizutani K, Kikuchi S, Oda S, Ishikawa I. Er:YAG laser therapy for peri-implant infection: a histological study. Lasers Med Sci 2007; 22:143-57. [PMID: 17219255 DOI: 10.1007/s10103-006-0430-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Accepted: 11/22/2006] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to evaluate the effects of Er:YAG laser on degranulation and implant surface debridement in peri-implant infection. The peri-implant infection was experimentally induced in dogs, and the treatment was performed using an Er:YAG laser or a plastic curet. Animals were sacrificed after 24 weeks, and undecalcified histological sections were prepared and analyzed. Degranulation and implant surface debridement were obtained effectively and safely by Er:YAG laser. Histologically, a favorable formation of new bone was observed on the laser-treated implant surface, and the laser group showed a tendency to produce greater bone-to-implant contact than the curet group. These results indicate that the Er:YAG laser therapy has promise in the treatment of peri-implantitis.
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Affiliation(s)
- Aristeo Atsushi Takasaki
- Section of Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
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Moghare Abed A, Tawakkoli M, Dehchenari MA, Gutknecht N, Mir M. A comparative SEM study between hand instrument and Er:YAG laser scaling and root planing. Lasers Med Sci 2006; 22:25-9. [PMID: 17115236 DOI: 10.1007/s10103-006-0413-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2005] [Accepted: 12/31/2005] [Indexed: 12/16/2022]
Abstract
Scaling and root planing are one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time-consuming. In search for more efficient and less difficult instrumentation, investigators have proposed lasers as alternatives or adjuncts for scaling and root planing. The aim of the present study was to compare the effectiveness of subgingival scaling and root planing with erbium: yttrium, aluminium, garnet (Er:YAG) laser and hand instrumentation in vitro. The mesial and distal surfaces of 15 periodontal loosed extracted teeth were treated randomly either by hand instrumentation or by Er:YAG laser irradiation. After choosing the "very long pulse mode" (pulse duration of about 700 micros), the output energy of 160 mJ with 920-microm beam diameter (RO7 Perio tip, Fidelis, Fotona, Slovenia) and frequency of 12 Hz were selected, both according to the best results of past studies. In addition, air water spray was used during the procedures. The morphology of the root surface was evaluated by three observers with a scanning electron microscopy in magnifications of 50x and 400x. The result of this setting showed that the rate of remained roughness on treated root surfaces in two groups of hand instruments and Er:YAG laser had a meaningful difference: The surface roughness in Er:YAG laser group was more than in hand instruments group. The present study could demonstrate the in vitro capability of the Er:YAG laser for scaling and root planing in periodontitis, although the effectiveness of this setting did not reach that achieved by hand instrumentation. It could be concluded that lower frequency and long pulse duration maybe more suitable for the micro-morphology of root surface after treatment. This theory is going to be tested with the same laser instrument in the next study.
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Affiliation(s)
- A Moghare Abed
- Dental School, Isfahan Medical University, Isfahan, Tehran, Iran
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Zeredo JL, Sasaki KM, Kumei Y, Toda K. Hindlimb Withdrawal Reflexes Evoked by Er:YAG Laser and Scalpel Incisions in Rats. Photomed Laser Surg 2006; 24:595-600. [PMID: 17069489 DOI: 10.1089/pho.2006.24.595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE In this study, we assessed the magnitudes of nociceptive withdrawal reflexes evoked by skin and muscle incisions made with steel scalpel and erbium:yttrium-aluminum-garnet (Er:YAG) laser. BACKGROUND DATA A few studies have suggested that laser incisions would be less painful than conventional scalpel incisions. METHODS Twenty adult male Sprague-Dawley rats were used. Under light barbiturate anesthesia, graded incisions were made into the plantar surface of the animals' hindpaws. Electromyographic (EMG) recordings from a hamstring muscle were used to estimate the nociceptive response. RESULTS The mean amplitude of EMG activity was significantly higher during incisions made with steel scalpel than with any of the laser irradiation parameters. All laser irradiation parameters produced similar nociceptive responses. CONCLUSION Er:YAG laser incisions may be less painful, albeit considerably slower, than scalpel incisions. Laser incisional pain would be more closely related to the mechanical rather than the thermal effect of laser ablation.
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Affiliation(s)
- Jorge L Zeredo
- Division of Integrative Sensory Physiology, Department of Developmental and Reconstructive Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Theodoro LH, Sampaio JEC, Haypek P, Bachmann L, Zezell DM, Garcia VG. Effect of Er:YAG and Diode lasers on the adhesion of blood components and on the morphology of irradiated root surfaces. J Periodontal Res 2006; 41:381-90. [PMID: 16953814 DOI: 10.1111/j.1600-0765.2005.00846.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate in vitro, by scanning electron microscopy (SEM), the adhesion of blood components on root surfaces irradiated with Er:YAG (2.94 microm) and GaAlAs Diode (808 nm) lasers and the effects on the morphology of irradiated root surfaces. METHODS One hundred samples of human teeth were obtained. They were previously planed and scaled with manual instruments and divided into five groups of 20 samples each: G1 (control group) - absence of treatment; G2--Er:YAG laser (7.6 J/cm2); G3--Er:YAG laser (12.9 J/cm2); G4--Diode laser (90 J/cm2) and G5--Diode laser (108 J/cm2). After these treatments, 10 samples of each group received a blood tissue but the remaining 10 did not. After laboratory treatments, the samples were obtained by SEM, the photomicrographs were analysed by the score of adhesion of blood components and the results were statistically analysed (Kruskall-Wallis and Mann-Whitney test). RESULTS In relation to the adhesion of blood components, the study showed no significant differences between the control group and the groups treated with Er:YAG laser (p = 0.9633 and 0.6229). Diode laser radiation was less effective than control group and Er:YAG laser radiation (p < 0.01). CONCLUSIONS None of the proposed treatments increased the adhesion of blood components in a significant way when compared to the control group. Although the Er:YAG laser did not interfere in the adhesion of blood components, it caused more changes on the root surface, whereas the Diode laser inhibited the adhesion.
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Affiliation(s)
- Letícia Helena Theodoro
- Department of Periodontology, Araraquara Dental School, State University of São Paulo, Araraquara, São Paulo, Brazil.
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Crespi R, Romanos GE, Cassinelli C, Gherlone E. Effects of Er:YAG Laser and Ultrasonic Treatment on Fibroblast Attachment to Root Surfaces: An In Vitro Study. J Periodontol 2006; 77:1217-22. [PMID: 16805685 DOI: 10.1902/jop.2006.050416] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to analyze the effects of erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser and ultrasonic treatment on fibroblast attachment to periodontally diseased root surfaces. METHODS Thirty single-rooted human periodontally involved teeth were included in this study. A total of 60 specimens were obtained from all selected teeth and were randomly assigned to the following three groups: group A, untreated control group; group B, ultrasonic group; and group C, Er:YAG laser at 160 mJ/pulse at 10 Hz group. All of the specimens were incubated in petri dishes with fibroblast suspension and observed by scanning electron microscopy. RESULTS Laser-treated specimens showed a significantly higher cell density number, with a mean+/-SD of 3,720+/-316 cells/mm2. The ultrasonically treated group showed a lower cell density number, with a mean+/-SD of 658+/-140 cells/mm2. The untreated control group showed the lowest cell density number, with a mean+/-SD of 130+/-80 cells/mm2. Differences between all groups were significant (P<0.0001). CONCLUSION The results of the study indicate that untreated control surfaces and ultrasonically treated surfaces exhibited a significantly lower number of attached cells compared to laser-treated specimens, which showed a significantly higher cell density number.
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Abstract
BACKGROUND Despite the large number of publications, there is still controversy among clinicians regarding the application of dental lasers to the treatment of chronic periodontitis. The purpose of this review is to analyze the peer-reviewed research literature to determine the state of the science concerning the application of lasers to common oral soft tissue problems, root surface detoxification, and the treatment of chronic periodontitis. METHODS A comprehensive computer-based search combined the following databases into one search: Medline, Current Contents, and the Cumulated Index of Nursing and Allied Health. This search also used key words. In addition, hand searches were done for several journals not cataloged in the databases, and the reference lists from published articles were checked. All articles were considered individually to eliminate non-peer-reviewed articles, those dealing with commercial laser technology, and those considered by the author to be purely opinion articles, leaving 278 possible articles. RESULTS There is a considerable conflict in results for both laboratory studies and clinical trials, even when using the same laser wavelength. A meaningful comparison between various clinical studies or between laser and conventional therapy is difficult at best and likely impossible at the present. Reasons for this dilemma are several, such as different laser wavelengths; wide variations in laser parameters; insufficient reporting of parameters that, in turn, does not allow calculation of energy density; differences in experimental design, lack of proper controls, and differences in severity of disease and treatment protocols; and measurement of different clinical endpoints. CONCLUSIONS Based on this review of the literature, there is a great need to develop an evidence-based approach to the use of lasers for the treatment of chronic periodontitis. Simply put, there is insufficient evidence to suggest that any specific wavelength of laser is superior to the traditional modalities of therapy. Current evidence does suggest that use of the Nd:YAG or Er:YAG wavelengths for treatment of chronic periodontitis may be equivalent to scaling and root planing (SRP) with respect to reduction in probing depth and subgingival bacterial populations. However, if gain in clinical attachment level is considered the gold standard for non-surgical periodontal therapy, then the evidence supporting laser-mediated periodontal treatment over traditional therapy is minimal at best. Lastly, there is limited evidence suggesting that lasers used in an adjunctive capacity to SRP may provide some additional benefit.
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Affiliation(s)
- Charles M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri, Kansas City, MO 64113, USA.
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Mizutani K, Aoki A, Takasaki AA, Kinoshita A, Hayashi C, Oda S, Ishikawa I. Periodontal tissue healing following flap surgery using an Er:YAG laser in dogs. Lasers Surg Med 2006; 38:314-24. [PMID: 16568444 DOI: 10.1002/lsm.20299] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES The purpose of this study was to compare periodontal tissue healing following flap surgery using an Er:YAG laser with that of conventional surgery. STUDY DESIGN/MATERIALS AND METHODS Bilateral premolars with experimentally induced periodontitis in six dogs were treated by periodontal flap surgery. Degranulation and root debridement in the furcation were performed using an Er:YAG laser or curet. At 3 months postsurgery, animals were sacrificed and decalcified specimens were prepared for histological and histometric analysis. RESULTS Degranulation and root debridement were effectively performed with an Er:YAG laser without major thermal damage and significantly faster than with a curet. Histologically, the amount of newly formed bone was significantly greater in the laser group than in the curet group, although both groups showed similar amounts of cementum formation and connective tissue attachment. CONCLUSIONS The Er:YAG laser irradiation can be safely and effectively utilized in periodontal flap surgery, and has the potential to promote new bone formation.
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Affiliation(s)
- Koji Mizutani
- Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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Zeredo JL, Sasaki KM, Yozgatian JH, Okada Y, Toda K. Comparison of jaw-opening reflexes evoked by Er:YAG laser versus scalpel incisions in rats. ACTA ACUST UNITED AC 2005; 100:31-5. [PMID: 15953914 DOI: 10.1016/j.tripleo.2004.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Anecdotal remarks suggest that incisions in oral soft tissue would be less painful if performed with laser rather than with scalpel, but such an argument remains to be scientifically validated. STUDY DESIGN Twelve rats received graded incisions to lip, gingiva, mucosa, and tongue with either a pulsed Er:YAG laser (65 mJ/pulse at 10 Hz) or a stainless steel scalpel. The amplitude of the jaw-opening reflex, as measured by the digastric muscle electromyogram, was used to quantify the nociceptive response evoked by the surgical incisions. RESULTS Except for lip, mean reflex amplitudes evoked by laser were significantly smaller (P < .05) than those evoked by scalpel in all other incision sites. CONCLUSION Er:YAG laser surgery may be less painful and therefore require less use of anesthesia and sedation than conventional scalpel surgery in oral soft tissue procedures.
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Affiliation(s)
- Jorge L Zeredo
- Division of Integrative Sensory Physiology, Department of Developmental and Reconstructive Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Affiliation(s)
- Akira Aoki
- Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, JapanDepartment of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Japan
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Zeredo JL, Sasaki KM, Fujiyama R, Okada Y, Toda K. Effects of low power Er:YAG laser on the tooth pulp-evoked jaw-opening reflex. Lasers Surg Med 2004; 33:169-72. [PMID: 12949946 DOI: 10.1002/lsm.10217] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES Analgesic properties of laser irradiation have been of great interest in the field of dentistry. This study aimed at evaluating the analgesic effects of the Er:YAG laser system in rats during and after laser irradiation. STUDY DESIGN/MATERIALS AND METHODS A pulsed Er:YAG laser was applied to the oral mucosa of the mandibular incisor at an energy density of approximately 0.1 J/cm(2)/pulse for 10 minutes at 10 Hz, and the integrated digastric muscle electromyogram in tooth pulp-evoked jaw-opening reflex was used as an index of the nociceptive response. RESULTS Significant reflex suppression was observed 10 minutes after laser irradiation. The reflex amplitude started to return to its original level about 45 minutes after cessation of laser irradiation. CONCLUSIONS The Er:YAG laser used at low output levels presented inhibitory effects on the tooth pulp-evoked jaw-opening reflex, suggesting that this laser system may be of use for pain control during various dental treatments.
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Affiliation(s)
- Jorge L Zeredo
- Division of Integrative Sensory Physiology, Department of Developmental and Reconstructive Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan.
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Schwarz F, Sculean A, Berakdar M, Szathmari L, Georg T, Becker J. In vivo and in vitro effects of an Er:YAG laser, a GaAlAs diode laser, and scaling and root planing on periodontally diseased root surfaces: a comparative histologic study. Lasers Surg Med 2003; 32:359-66. [PMID: 12766958 DOI: 10.1002/lsm.10179] [Citation(s) in RCA: 218] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of the present histologic study was to compare the in vivo and in vitro effects of an erbium: yttrium, aluminum, and garnet (Er:YAG) laser (ERL), combined with a fluorescent calculus detection system, a diode laser (DL) and scaling and root planing (SRP) on periodontally diseased root surfaces. STUDY DESIGN/MATERIALS AND METHODS Twenty-four single rooted teeth, considered for extraction due to severe periodontal destruction, were included in the study. Prior to extraction all mesial root surfaces were randomly assigned to the following treatment groups: (1) ERL combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP DL radiation (160 mJ/pulse and 10 pulses/second under water irrigation) (ERL), or (2) GaAlAs DL (1.8 W, pulse/pause relation 1:10), or (3) SRP using hand instruments. Immediately after extraction, all distal root surfaces were treated with the same instruments under standardized conditions. For light microscopic investigation, a plastic embedding technique was used to cut the undecalcified roots into 30 microm thick crossections. The following parameters were recorded by on blind examiner: remaining debris, root surface morphology, and thermal side effects. RESULTS Root surfaces instrumented with both, ERL in vivo and DL in vitro exhibited no detectable surface alterations. In contrast, ERL scaling in vitro and SRP in vivo/in vitro produced superficial microchanges in root cementum. However, irradiation with DL in vivo caused severe damages to the root surface (i.e., crater formation). There were no signs of thermal side effects in all laser treated groups. ERL provided subgingival calculus removal on a level equivalent to that provided by SRP. DL was unsuitable for calculus removal, since macroscopic inspection revealed the presence of large amounts of subgingival calculus. CONCLUSIONS The present in vivo results showed that (i) ERL, combined with a fluorescent calculus detection system, provided a selective subgingival calculus removal on a level equivalent to that provided by SRP, and (ii) DL, using this power output, was unsuitable for calculus removal and altered the root surface in an undesirable manner.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, 40225 Düsseldorf, Germany.
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