Effects of Er:YAG laser on mineral content of sound dentin in primary teeth

Physiochemical characteristics: A robust tool to overcome teeth heterogeneity on predicting laser ablation profile

To avoid excessive tissue removal and collateral damage, the high-power density laser is apt for dental surgery also need to have high precision. For high-precision dental surgery with minimal tissue damage, the present work frames a method to predict laser ablation profile based on surface morphology and chemical composition of dentin. The surface morphology and chemical composition were studied on different dentin samples using scanning electron microscope (SEM) and Energy Dispersive X-ray Analysis (EDAX), respectively. The key laser ablation parameters (ω₀ , D_eff , and F_th ) were determined by laser irradiation study using 800 nm, Ti:Sapphire femtosecond laser at processing condition of 100 fs, 10 kHz and 10 mm/s. The dentin samples show a strong linear correlation between physiochemical characteristics and laser ablation parameters. The surface morphology exhibits a negative linear correlation with threshold fluence, whereas the converse is true for chemical composition. The laser ablation parameters of a random dentin sample are derived from the knowledge of linearity data. From the obtained laser ablation parameters, the complete theoretical ablation profile is constructed and validated with experimental ablation profile. Even though the surface morphology of dentin shows high linearity, the concentration of Ca and P can be used as the most feasible probe in clinical settings. Furthermore, the laser ablation rate and ablation efficiency are predicted by the method to optimize the laser processing condition for any specific teeth. The versatility of the method overcomes the problem of heterogeneity on various teeth and simplifies the method of finding optimal laser processing condition for immaculate laser surgery.

Selective Removal of Necrotic Dentin in Primary Teeth Using Laser Irradiation: One-Year Clinical Evaluation of Composite Restorations

Introduction: This study aimed to evaluate the child's salivary cortisol levels, clinical performance and marginal adaptation of restorations after selective removal of necrotic dentin in primary teeth using Er: YAG laser irradiation. Methods: A double-blind clinical study was performed in children at 7-10 years. Children who had at least 2 teeth with carious lesions involving the occlusal and proximal surfaces of primary molars counterparts were selected. Removal of necrotic dentin was performed by 2 methods: Er: YAG laser irradiation and bur-preparation. Cortisol levels (n =24) was evaluated by ELISA. Clinical analysis (n =20) was performed after the restorations polish, 6 and 12 months after restorative procedure using United States Public Health Service (USPHS) method and photographs. Scanning electron microscopy (SEM) was used to analyz the marginal gap formation (n =20). The analysis of the data was performed by 95% confidence interval, Shapiro-Wilk test, Friedman and Wilcoxon post hoc tests (α =5%). Results: Cortisol levels were higher during selective removal of necrotic dentin, regardless of the method used (P>0.05). After 12 months, there was no evidence of the difference in the restorations performed on cavities prepared by both methods. SEM analysis revealed that the laser-irradiated teeth showed 10% of gaps in the full extent of restoration. For bur-prepared teeth, 20% of gaps were found at the cavosurface margin. Conclusion: The salivary cortisol levels on children that received Er: YAG laser irradiation for removal the necrotic dentin was similar to the control group. Class II restorations evaluated after 1 year period did not suffer interference by the use of Er: YAG laser irradiation.

Cavity Preparation by Laser in Primary Teeth: Effect of 2 Levels of Energy Output on the Shear Bond Strength of Composite Restoration to Dentin

Introduction: One of the main applications of laser in dentistry is the removal of dental caries and preparation of restorative cavities. The morphology and wettability of laser prepared surfaces are different from that of those prepared with conventional method which may affect the quality of the adhesive potential of bonding agents in these surfaces. This study aimed to assess the shear bond strength of a total-etch and self-etch adhesive system to primary tooth dentin prepared by two different energy densities of Er:YAG laser in comparison with surfaces prepared by bur. Methods: A total of 60 human primary second molars extracted for orthodontic purposes were selected and randomly divided into 3 main groups of equal (n=20). Group A: Preparation of dentin surface by bur; group B: Preparation of dentin surface by laser with 300 mJ energy level; group C: Preparation of dentin surface by laser with 400 mJ energy level. In each of the main groups, the teeth were randomly assigned to 2 subgroups. Composite resin material was bonded with the total-etch adhesive system in subgroups A1, B1, and C1 and with the self-etch adhesive system in subgroups A2, B2, and C2. The samples were thermo-cycled, and composite restorations shear bond strength was measured in MPa. Data were analyzed using two-way analysis of variance (ANOVA), and P values less than 0.05 were considered statistically significant. Results: The highest and the lowest shear bond strength values were observed in group A2 (Preparation by bur- Composite resin material bonded by Clearfil SE Bond) and group C2 (Preparation by laser with 400 mJ energy level - Composite resin material bonded by Clearfil SE Bond), respectively. The results showed no statistically significant differences between the study subgroups (P > 0.05). Conclusion: It is concluded that in terms of shear bond strength to dentin, Single Bond and Clearfil SE Bond adhesive agents adequately perform in primary tooth dentin prepared by Er: YAG laser with energy levels of 300 and 400 mJ and frequency of 10 Hz.