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Karthikeyan R, Yadalam PK, Anand AJ, Padmanabhan K, Sivaram G. Morphological and Chemical Alterations of Root Surface after Er:YAG laser, Nd:YAG Laser Irradiation: A Scanning Electron Microscopic and Infrared Spectroscopy Study. J Int Soc Prev Community Dent 2020; 10:205-212. [PMID: 32670910 PMCID: PMC7339995 DOI: 10.4103/jispcd.jispcd_437_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Aims and Objectives This study aimed to evaluate the efficacy of Nd:YAG and Er:YAG lasers in removing the smear layer and to study the morphological and chemical alterations of the root surface using scanning electron microscopy (SEM) and infrared (IR) spectroscopy. Material and Methods Fifty-five extracted upper incisor teeth were collected and 110 specimens of size 3 mm × 4 mm × 1 mm were prepared. For SEM evaluation, these samples were divided into six groups: A, B, and C. Group A comprised five samples that served as control. Groups B and C were further divided into five subgroups and each subgroup comprised five samples. All the specimens within the subgroups of B and C irradiated with 100, 200, 300, 400, and 500 mJ of Er:YAG laser and 211.66, 423.33, 635, 846.66, and 1058.33 J/cm2 of Nd:YAG laser, respectively. The morphological changes of the laser-treated sites were observed qualitatively using an arbitrary scale under SEM. The data obtained were statistically analyzed by one-way analysis of variance (ANOVA) multiple range test by Turkey's honestly significant difference and Mann-Whitney U test. In chemical structural changes, Group D comprised five samples that served as nonirradiated control and Groups E and F were irradiated with the same aforementioned parameter and evaluated using Fourier-transform infrared spectroscopy. Results Er:YAG laser at 100 mJ effectively removed smear layer without any crater formation. The Nd:YAG laser removed the smear layer at the energy density of 211.66 J/cm2 and 423.33J/cm2. The energy density of 1058.33 J/cm2 showed visible charring and deep crater with increased area of melted and resolidified minerals in SEM. In the chemical changes, IR spectroscopy graph showed the reduction in peak intensity beyond 846.66 J/cm2 of and new absorption band was noticed (2010cm-1 and 2017cm-1) at samples treated with 846.66 and 1058.33 J/cm2 of Nd:YAG laser. Conclusion Er:YAG laser at lower energy density effectively removed smear layer without production of toxic substance as compared with Nd:YAG laser. Thus, Er:YAG laser can be used as an effective root biomodification agent.
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Affiliation(s)
- R Karthikeyan
- Depatment of Dental Surgery, Govt Royapettah Hospital, Kilpauk Medical College, Chennai, TN, India
| | - Pradeep Kumar Yadalam
- Department Of Periodontics, SRM Dental College and Hospitals, Katankulathur, Chennai, TN, India
| | - A J Anand
- Department of Periodontics, Tamilnadu Government Dental College and Hospital, Chennai, TN, India
| | - Kamalakannan Padmanabhan
- Department of Dental Surgery, Periyar Nagar Peripheral Hospital, Stanly Medical College, Chennai, TN, India
| | - G Sivaram
- Department of Periodontics, Ragas Dental College and Hospitals, Chennai, TN, India
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Reinhardt B, Klocke A, Neering SH, Selbach S, Peters U, Flemmig TF, Beikler T. Microbiological dynamics of red complex bacteria following full-mouth air polishing in periodontally healthy subjects-a randomized clinical pilot study. Clin Oral Investig 2019; 23:3905-3914. [PMID: 30729346 DOI: 10.1007/s00784-019-02821-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Suppression of periodontal pathogens in the oral cavity of periodontally healthy individuals may lower the risk for periodontal or periimplant diseases. Therefore, the present study aimed to analyze the effect of supragingival debridement (SD) with adjunctive full mouth glycine powder air polishing (FM-GPAP) on the prevalence of periodontal pathogens in periodontally healthy individuals. MATERIALS AND METHODS Eighty-seven systemically and periodontally healthy intraoral carriers of red complex bacteria, i.e., Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola or other periodontal pathogens including Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Eikenella corrodens were enrolled into the study and randomly assigned to receive SD with adjunctive FM-GPAP (test, n = 42) or SD alone (control, n = 45). In the first observation period, microbiological samples were obtained prior to, and 2, 5, and 9 days following intervention. If one of these periodontal pathogens could still not be identified, additional microbial sampling was performed after 6 and 12 weeks. RESULTS The prevalence of red complex bacteria was significantly reduced in the test compared to the control group following treatment (p = 0.004) and at day 9 (p = 0.031). Intragroup comparison showed a significant (test, p < 0.001; control, p ≤ 0.01) reduction in the mean prevalence in both groups from BL through day 9 with an additional significant intergroup difference (p = 0.048) at day 9. However, the initial strong reduction returned to baseline values after 6 and 12 weeks. CONCLUSION In periodontally healthy carriers of periodontal pathogens, FM-GPAP as an adjunct to SD transiently enhances the suppression of red complex bacteria. CLINICAL RELEVANCE Whether the enhanced suppression of red complex bacteria by adjunctive FM-GPAP prevents the development of periodontitis in periodontally healthy carriers requires further investigations.
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Affiliation(s)
| | | | | | | | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center of Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany
| | | | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center of Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany.
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De Angelis N, Hanna R, Signore A, Amaroli A, Benedicenti S. Effectiveness of dual-wavelength (Diodes 980 Nm and 635 Nm) laser approach as a non-surgical modality in the management of periodontally diseased root surface: a pilot study. BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1544034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Nicola De Angelis
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Reem Hanna
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Antonio Signore
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Andrea Amaroli
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Center, University of Genoa, Genoa, Italy
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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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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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Wadia R. Is there a place for lasers in periodontal therapy? Prim Dent J 2014; 3:57-61. [PMID: 25198641 DOI: 10.1308/205016814812736637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article aims to provide an overview on the clinical applications of lasers in periodontics.
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Low SB, Mott A. Laser Technology to Manage Periodontal Disease: A Valid Concept? J Evid Based Dent Pract 2014; 14 Suppl:154-9. [DOI: 10.1016/j.jebdp.2014.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sculean A, Schwarz F, Becker J. Anti-infective therapy with an Er:YAG laser: influence on peri-implant healing. Expert Rev Med Devices 2014; 2:267-76. [PMID: 16288590 DOI: 10.1586/17434440.2.3.267] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In addition to conventional treatment modalities (mechanical and chemical), the use of lasers has been increasingly proposed for the treatment of periodontal and peri-implant infections (i.e., cleaning and detoxification of implant surfaces). Preliminary results from basic studies have pointed to the high potential of the Erbium-doped: Yttrium, Aluminum and Garnet (Er:YAG) laser. Furthermore, preliminary clinical data indicate that treatment with this kind of laser may positively influence peri-implant healing. The aim of this research update is to evaluate, based on the currently available evidence, the use of an Er:YAG laser for the treatment of peri-implant infections and to indicate its potential as a new treatment modality.
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Affiliation(s)
- Anton Sculean
- Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands.
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Krohn-Dale I, Bøe OE, Enersen M, Leknes KN. Er:YAG laser in the treatment of periodontal sites with recurring chronic inflammation: a 12-month randomized, controlled clinical trial. J Clin Periodontol 2012; 39:745-52. [PMID: 22694321 DOI: 10.1111/j.1600-051x.2012.01912.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2012] [Indexed: 11/26/2022]
Abstract
AIM The objective of this randomized, controlled clinical trial was to compare the clinical and microbiological effects of pocket debridement using erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser with conventional debridement in maintenance patients. MATERIAL & METHODS Fifteen patients, all smokers, having at least four teeth with residual probing depth (PD) ≥ 5 mm were recruited. Two pockets in two jaw quadrants were randomly assigned to subgingival debridement using an Er:YAG laser (test) or ultrasonic scaler/curette (control) at 3-month intervals. Relative attachment level (RAL), PD, bleeding on probing and dental plaque were recorded at baseline and at 6 and 12 months. Microbiological subgingival samples were taken at the same time points and analysed using a checkerboard DNA-DNA hybridization technique. RESULTS A significant decrease in PD took place in both treatments from baseline to 12 months (p < 0.01). In the control, the mean initial PD decreased from 5.4 to 4.0 mm at 12 months. For the test, a similar decrease occurred. No significant between-treatment differences were shown at any time point. The mean RAL showed no overall significant inter- or intra-treatment differences (p > 0.05). No significant between-treatment differences were observed in subgingival microbiological composition or total pathogens. CONCLUSION The results failed to support that an Er:YAG laser may be superior to conventional debridement in the treatment of smokers with recurring chronic inflammation. This appears to be the first time that repeated Er-YAG laser instrumentation has been compared with mechanical instrumentation of periodontal sites with recurring chronic inflammation over a clinically relevant time period.
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Affiliation(s)
- Ivar Krohn-Dale
- Department of Clinical Dentistry - Periodontotics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Pesevska S, Nakova M, Gjorgoski I, Angelov N, Ivanovski K, Nares S, Andreana S. Effect of laser on TNF-alpha expression in inflamed human gingival tissue. Lasers Med Sci 2011; 27:377-81. [DOI: 10.1007/s10103-011-0898-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 02/14/2011] [Indexed: 11/29/2022]
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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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Dilsiz A, Aydin T, Canakci V, Cicek Y. Root surface biomodification with Nd:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts. Photomed Laser Surg 2010; 28:337-43. [PMID: 19860567 DOI: 10.1089/pho.2009.2559] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] 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 procedures, however. 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 Nd:YAG laser application for root surface biomodification. MATERIALS AND METHODS Thirty-four teeth in 17 patients with Miller Class 1 and 2 recession were treated with SCTG with (test group) or without (control group) the application of Nd:YAG laser (1 W, 10 Hz, 100 mj, 60 s, 1064 nm). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and six months postsurgery. RESULTS Both treatments yielded significant improvements in terms of RD and RW decrease and CAL gain compared to baseline values. For test and control groups, the average root coverage was 33% and 77%, respectively (p < 0.05), and the complete root coverage was 18% and 65%, respectively (p < 0.05). The control group showed a greater reduction in RD and RW compared with the test group (p < 0.05). CONCLUSIONS The use of Nd:YAG laser as a root surface biomodifier negatively affected the outcome of root coverage with the SCTG.
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Affiliation(s)
- Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
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Dilsiz A, Canakci V, Aydin T. The Combined Use of Nd:YAG Laser and Enamel Matrix Proteins in the Treatment of Periodontal Infrabony Defects. J Periodontol 2010; 81:1411-8. [DOI: 10.1902/jop.2010.100031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Rotundo R, Nieri M, Cairo F, Franceschi D, Mervelt J, Bonaccini D, Esposito M, Pini-Prato G. Lack of adjunctive benefit of Er:YAG laser in non-surgical periodontal treatment: a randomized split-mouth clinical trial. J Clin Periodontol 2010; 37:526-33. [PMID: 20507376 DOI: 10.1111/j.1600-051x.2010.01560.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM This split-mouth, randomized, clinical trial aimed to evaluate the efficacy of erbium-doped:yttrium-aluminium-garnet (Er:YAG) laser application in non-surgical periodontal treatment. MATERIALS AND METHODS A total of 27 patients underwent four modalities of non-surgical therapy: supragingival debridement; scaling and root planing (SRP)+Er:YAG laser; Er:YAG laser; and SRP. Each strategy was randomly assigned and performed in one of the four quadrants. Clinical outcomes were evaluated at 3 and 6 months. Subjective benefits of patients have been evaluated by means of questionnaires. RESULTS Six months after therapy, Er:YAG laser showed no statistical difference in clinical attachment gain with respect to supragingival scaling [0.15 mm (95% CI -0.16; 0.46)], while SRP showed a greater attachment gain than the supragingival scaling [0.37 mm (95% CI 0.05; 0.68)]. No difference resulted between Er:YAG laser+SRP and SRP alone [0.05 mm (95% CI -0.25; 0.36)]. CONCLUSIONS The adjunctive use of Er:YAG laser to conventional SRP did not reveal a more effective result than SRP alone. Furthermore, the sites treated with Er:YAG laser showed similar results of the sites treated with supragingival scaling.
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Affiliation(s)
- Roberto Rotundo
- Department of Periodontology, University of Florence, Firenze, Italy.
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Herrero A, García-Kass AI, Gómez C, Sanz M, García-Nuñez JA. Effect of Two Kinds of Er:YAG Laser Systems on Root Surface in Comparison to Ultrasonic Scaling: An in Vitro Study. Photomed Laser Surg 2010; 28:497-504. [DOI: 10.1089/pho.2009.2527] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Alicia Herrero
- Section of Graduate Periodontology, Faculty of Odontology, Universidad Complutense, Madrid, Spain
| | - Ana Isabel García-Kass
- Section of Graduate Periodontology, Faculty of Odontology, Universidad Complutense, Madrid, Spain
| | - Clara Gómez
- Department of Química Laser, Institute of Química Física Rocasolano, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, Universidad Complutense, Madrid, Spain
- Department of Buccofacial Medicine and Surgery, Faculty of Odontology, Universidad Complutense, Madrid, Spain
| | - Juan Antonio García-Nuñez
- Department of Buccofacial Medicine and Surgery, Faculty of Odontology, Universidad Complutense, Madrid, Spain
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Michida SMDA, Passos SP, Marimoto ARK, Garakis MCV, de Araújo MAM. Intrapulpal temperature variation during bleaching with various activation mechanisms. J Appl Oral Sci 2009; 17:436-9. [PMID: 19936522 PMCID: PMC4327670 DOI: 10.1590/s1678-77572009000500016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 01/07/2009] [Indexed: 11/21/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the intrapulpal temperature variation after bleaching treatment with 35% hydrogen peroxide using different sources of activation. Material and Methods: Twenty-four human teeth were sectioned in the mesiodistal direction providing 48 specimens, and were divided into 4 groups (n=12): (G1) Control - Bleaching gel without light activation, (G2) Bleaching gel + halogen light, (G3) Bleaching gel + LED, (G4) Bleaching gel + Nd:YAG Laser. The temperatures were recorded using a digital thermometer at 4 time points: before bleaching gel application, 1 min after bleaching gel application, during activation of the bleaching gel, and after the bleaching agent turned from a dark-red into a clear gel. Data were analyzed statistically by the Dunnet's test, ANOVA and Tukey's test (α=0.05). Results: The mean intrapulpal temperature values (°C) in the groups were: G1: 0.617 ± 0.41; G2: 1.800 ± 0.68; G3: 0.975 ± 0.51; and G4: 4.325 ± 1.09. The mean maximum temperature variation (MTV) values were: 1.5°C (G1), 2.9°C (G2), 1.7°C (G3) and 6.9°C (G4). When comparing the experimental groups to the control group, G3 was not statistically different from G1 (p>0.05), but G2 and G4 presented significantly higher (p<0.05) intrapulpal temperatures and MTV. The three experimental groups differed significantly (p<0.05) from each other. Conclusions: The Nd:YAG laser was the activation method that presented the highest values of intrapulpal temperature variation when compared with LED and halogen light. The group activated by LED light presented the lowest values of temperature variation, which were similar to that of the control group.
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Xu M, Deng T, Mo F, Deng B, Lam W, Deng P, Zhang X, Liu S. Low-Intensity Pulsed Laser Irradiation Affects RANKL and OPG mRNA Expression in Rat Calvarial Cells. Photomed Laser Surg 2009; 27:309-15. [DOI: 10.1089/pho.2008.2283] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Min Xu
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Tietao Deng
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Feizhi Mo
- School for Information and Photonic Science and Engineering, South China Normal University, Guangzhou, China
| | - Bin Deng
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Wingho Lam
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Pingxiang Deng
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Xiaohui Zhang
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Songhao Liu
- School for Information and Photonic Science and Engineering, South China Normal University, Guangzhou, China
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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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Schwarz F, Aoki A, Becker J, Sculean A. Laser application in non-surgical periodontal therapy: a systematic review. J Clin Periodontol 2009; 35:29-44. [PMID: 18724840 DOI: 10.1111/j.1600-051x.2008.01259.x] [Citation(s) in RCA: 169] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The primary aim was to address the following focused question: What is the clinical effect of laser application compared with mechanical debridement in non-surgical periodontal therapy in patients with chronic periodontitis? A secondary aim was to survey the relevant literature in relation to safety of laser applications. MATERIAL AND METHODS Electronic databases of the PubMed and the Cochrane Library were searched and completed by manual searches up to December 2007. RESULTS Following screening, 12 publications (11 studies) were eligible for the review. A meta-analysis could not be performed due to the heterogeneity of the studies. The results from a narrative synthesis indicate that Er:YAG laser monotherapy resulted in similar clinical outcomes, both in the short and the long term (up to 24 months), compared with mechanical debridement. There is insufficient evidence to support the clinical application of either CO(2), Nd:YAG, Nd:YAP, or different diode laser wavelengths. CONCLUSIONS The Er:YAG laser seems to possess characteristics most suitable for the non-surgical treatment of chronic periodontitis. Research conducted so far has indicated that its safety and effects might be expected to be within the range reported for conventional mechanical debridement. However, the evidence from the evaluated studies is weak.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.
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Schwarz F, Jepsen S, Herten M, Aoki A, Sculean A, Becker J. Immunohistochemical characterization of periodontal wound healing following nonsurgical treatment with fluorescence controlled Er:YAG laser radiation in dogs. Lasers Surg Med 2007; 39:428-40. [PMID: 17523168 DOI: 10.1002/lsm.20509] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of the present study was to immunohistochemically characterize periodontal wound healing following nonsurgical treatment with fluorescence controlled Er:YAG laser radiation in dogs. STUDY DESIGN/MATERIALS AND METHODS Five beagle dogs suffering from naturally occurring chronic periodontitis were randomly allocated in a split-mouth design to nonsurgical periodontal treatment using either (a) an Er:YAG laser at 10.2, 12.8, 15.4, 18, and 20.4 J/cm2 (ERL1-5), or (b) an ultrasonic device (VUS) serving as control. The animals were sacrificed after 3 months. Histomorphometrical (e.g. inflammatory cell infiltrate, surface changes, cementum formation), and immunohistochemical parameters (collagen type I, CD68, matrix metalloproteinase (MMP)-8) were assessed. RESULTS Inflammatory cell infiltrates of different extent were commonly observed in all treatment groups. However, histomorphometrical analysis revealed new cementum formation with inserting collagen type I fibers along the instrumented root surfaces in most specimens of both ERL (ERL2: 31+/-81 to ERL5: 595+/-575 microm) and VUS (50+/- 215 microm) groups. This was associated with pronounced CD68 and weak MMP-8 antigen reactivity. CONCLUSION Within the limits of the present study, it was concluded that both treatment procedures (i) were effective in controlling inflammatory cell infiltrates, and (ii) may support the formation of a new connective tissue attachment.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, D-40225 Düsseldorf, Germany.
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Abstract
Periodontology exists as a major specialty within clinical dentistry that has developed through the extensive research carried out into all parameters pertaining to a 'best practice' approach. With the advent of surgical lasers into clinical dentistry, considerable interest has been shown in the possible benefits that might be derived from the adjunctive effects of bacterial control and haemostasis that are associated with laser use. Despite the number of publications on the subject, there is still controversy over the use of lasers in periodontology. The following paper will outline the procedures that have been advocated for laser use and provide a review of the literature.
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Abstract
Within a general practice setting, there are few benign pathological conditions of the attached or keratinised gingival complex that are not amenable to simple surgical intervention. The majority of surgical procedures are adjunctive to the delivery of restorative dentistry. There is an understandable dogma worldwide towards the management of soft tissues as they interface with restorative procedures. Contemporary teaching, both at undergraduate and postgraduate level, would recognise the need for a period of wound healing and stability, based on scalpel-induced incisional therapy. The use of laser wavelengths, based on predictable evidence-based protocols, has re-defined the surgical management of keratinised mucosa that is bound to the underlying periosteum and bone. This can be seen as being of benefit to the clinician in determining the outcome, and the patient in achieving quality results.
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Affiliation(s)
- S Parker
- 30 East Parade, Harrogate, North Yorkshire, UK.
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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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Schwarz F, Becker J. Treatment of periodontitis and peri-implantitis with an Er:YAG laser: Experimental and clinical studies. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.mla.2005.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Kreisler M, Al Haj H, d'Hoedt B. Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing. Lasers Surg Med 2005; 37:350-5. [PMID: 16365890 DOI: 10.1002/lsm.20252] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of the in vitro study was to examine the clinical efficacy of semiconductor laser periodontal pocket irradiation as an adjunct to conventional scaling and root planing. MATERIALS AND METHODS Twenty-two healthy patients with a need of periodontal treatment (15 women, 7 men, mean age 45.0 +/- 10.8 years) with at least four teeth in all quadrants, were included. All of them underwent a conventional periodontal treatment including scaling and root planing. Using a split mouth design, two randomly chosen quadrants (one upper and the corresponding lower one) were subsequently treated with an 809 nm GaAlAs laser operated at a power output of 1.0 Watt using a 0.6 mm optical fiber. The teeth in the control quadrants were rinsed with saline. The clinical outcome was evaluated by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR), Periotest (PT), probing pocket depth (PPD), and clinical attachment loss (CAL) at baseline and at 3 months after treatment. A total of 492 teeth in both groups were evaluated and differences between the laser and the control teeth were analyzed using the Wilcoxon test (P < 0.05). RESULTS Teeth treated with the laser revealed a significantly higher reduction in tooth mobility, pocket depth, and clinical attachment loss. Twelve percent of the teeth in the laser group showed an attachment gain of 3 mm or more, compared to 7% in the control group. An attachment gain of 2-3 mm was found in 24% of the teeth in the laser group and 18% in the control group. No significant group differences, however, could be detected for the plaque index, gingival index, bleeding on probing, and the sulcus fluid flow rate. CONCLUSIONS The higher reduction in tooth mobility and probing depths is probably not predominantly related to bacterial reduction in the periodontal pockets but to the de-epithelization of the periodontal pockets leading to an enhanced connective tissue attachment. The application of the diode laser in the treatment of inflammatory periodontitis at the irradiation parameters described above is a safe clinical procedure and can be recommended as an adjunct to conventional scaling and root planing.
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Affiliation(s)
- Matthias Kreisler
- Department of Oral Surgery, Johannes Gutenberg-University Mainz, Mainz, Germany.
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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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Sculean A, Schwarz F, Berakdar M, Romanos GE, Arweiler NB, Becker J. Periodontal treatment with an Er:YAG laser compared to ultrasonic instrumentation: a pilot study. J Periodontol 2004; 75:966-73. [PMID: 15341354 DOI: 10.1902/jop.2004.75.7.966] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of ultrasonic scaling for non-surgical periodontal treatment. METHODS Twenty patients with moderate to advanced periodontal disease were randomly treated in a split-mouth design with a single episode of subgingival debridement using either an Er:YAG laser device (160 mJ/pulse, 10 Hz) combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP diode laser radiation (ERL), or an ultrasonic instrument (UI). Clinical assessments of full-mouth plaque score (FMPS), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made at baseline and at 3 and 6 months following therapy. RESULTS No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the ERL group from 40% at baseline to 17% after 6 months (P<0.0001) and in the UI group from 46% at baseline to 15% after 6 months (P<0.0001). The sites treated with ERL demonstrated mean CAL gain of 1.48 +/- 0.73 mm (P<0.001) and of 1.11 +/- 0.59 mm (P<0.001) at 3 and 6 months, respectively. The sites treated with UI demonstrated mean CAL gain of 1.53 +/- 0.67 mm (P<0.001) and of 1.11 +/- 0.46 mm (P<0.001) at 3 and 6 months, respectively. No statistically significant differences were observed between the groups (P>0.05). CONCLUSION Within the limits of the present study, it can be concluded that both therapies led to significant improvements of the investigated clinical parameters.
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Affiliation(s)
- Anton Sculean
- Department of Conservative Dentistry and Periodontology, Johannes Gutenberg University, Mainz, Germany.
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Sculean A, Schwarz F, Berakdar M, Windisch P, Arweiler NB, Romanos GE. Healing of intrabony defects following surgical treatment with or without an Er:YAG laser. J Clin Periodontol 2004; 31:604-8. [PMID: 15257735 DOI: 10.1111/j.1600-051x.2004.00525.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM The aim of this controlled, parallel design clinical study was to compare the healing of intrabony periodontal defects following treatment with access flap surgery with and without debridement with an Er:YAG laser. METHODS Twenty-three patients each of whom exhibited one deep intrabony defect were randomly treated with either access flap surgery followed by root surface and defect debridement using an Er:YAG laser (KEY3) (160 mJ, 10 Hz) (test), or with access flap surgery followed by root surface and defect debridement using hand and ultrasonic instruments (control). The following clinical parameters were recorded at baseline and at 6 months: plaque index; gingival index; bleeding on probing; probing depth (PD); gingival recession; and clinical attachment level (CAL). The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline. RESULTS No serious adverse events were observed after any of the treatments. The results have shown that in the test group the PD decreased from 7.8+/-1.3 to 4.1+/-1.3 mm (p<0.001) and the CAL changed from 9.8+/-2.9 to 7.2+/-2.5 mm (p<0.001). In the control group the PD decreased from 7.8+/-0.8 to 4.6+/-1.6 mm (p<0.001) and the CAL changed from 9.2+/-1.2 to 7.7+/-1.6 mm (p<0.01). The test group displayed a higher tendency for CAL gain, although this tendency did not prove to be statistically significant. CONCLUSION Within the limits of the present study, it can be concluded that: (i) at 6 months following treatment both therapies led to significant improvements of the investigated clinical parameters, and (ii) an Er:YAG laser may represent a suitable alternative for defect and root surface debridement in conjunction with periodontal surgery.
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Affiliation(s)
- Anton Sculean
- Department of Conservative Dentistry and Periodontology, Johannes Gutenberg-University, Mainz, Germany.
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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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Abstract
Publicity about the use of lasers in dentistry has generated considerable interest in both professional and lay audiences. The purpose of this report is to provide information for members of the dental profession about the current and potential application of laser technology to periodontal practice. This report was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology.
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Abstract
BACKGROUND The removal of calculus and plaque is an essential component of a therapeutic approach to control periodontal disease. Er:YAG laser scaling was recently introduced as an alternative to conventional scaling procedures. In this histological study, the effects of laser instrumentation of diseased root surfaces are compared to mechanical removal of plaque and calculus with ultrasonic instruments and scalers. METHODS Areas of subgingival calculus were identified on 40 freshly extracted human teeth. Each of these areas was randomly divided into 2 equal parts. The control site was treated either with scaling and root planing or with an ultrasonic instrument. The test site was cleaned using an Er:YAG laser according to the manufacturer's instructions. The end point of debridement was the inability to mechanically or visibly detect any remaining calculus. After pre- and postsurgical photographs and impressions for scanning electronic microscopic investigation, a plastic embedding technique was used to cut the undecalcified roots into 15 microm thick sections. RESULTS Clinically and histologically, scaling resulted in complete debridement at all samples, producing a smooth root surface. At the test sites, laser scaling was accompanied by an increased removal of tissue and roughened surfaces. CONCLUSIONS Laser scaling results in an increased loss of cementum and dentin, which should be taken into account in clinical situations.
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Affiliation(s)
- E Zinman
- School of Dentistry, University of California San Francisco, San Francisco, CA, USA
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Kreisler M, Al Haj H, Daubländer M, Götz H, Duschner H, Willershausen B, D'Hoedt B. Effect of diode laser irradiation on root surfaces in vitro. JOURNAL OF CLINICAL LASER MEDICINE & SURGERY 2002; 20:63-9. [PMID: 12017429 DOI: 10.1089/104454702753768034] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate possible morphological alterations of root surfaces after GaAlAs-diode laser (809 nm) irradiation under standardized in vitro conditions. MATERIALS AND METHODS Root specimens obtained from extracted periodontally diseased teeth were scaled and root planed with curettes followed by air-powder abrasive treatment prior to lasing. The variable parameters were power output (0.5-2.5 W) and exposure time (10-30 sec per specimen). Additionally, the effect of a saline solution and a human blood film on the root surface was investigated. The root segments were analyzed by means of a reflected light microscope. Photographs before and after irradiation were taken and evaluated. The scale of carbonization was quantified using a grid laid over the photographs. Specimens with distinct morphological changes were analyzed with a scanning electron microscope. RESULTS Lasing dry specimens and specimens moistened with saline resulted in no detectable alterations, irrespective of irradiation time and power output applied. Depending on different settings, irradiation caused severe damages to the root surface when segments were covered by a thin blood film. Irradiation at a power output of 1 Watt and below had barely any negative effect on the root surface, whereas lasing at 1.5, 2.0, and 2.5 Watt resulted in partial or total carbonizations of the root samples. The angle of irradiation had a significant effect on the scale of the root surface damage (Mann-Whitney U test,p < 0.05). CONCLUSION The diode laser may cause damage to periodontal hard tissues if irradiation parameters are not adequate.
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Affiliation(s)
- M Kreisler
- Department of Oral Surgery, Johannes Gutenberg University Mainz, Germany.
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Gaspirc B, Skaleric U. Morphology, chemical structure and diffusion processes of root surface after Er:YAG and Nd:YAG laser irradiation. J Clin Periodontol 2002; 28:508-16. [PMID: 11350517 DOI: 10.1034/j.1600-051x.2001.028006508.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the effects of Er:YAG and Nd:YAG lasers on morphology, chemical structure and diffusion processes of the root surface. MATERIAL AND METHODS 60 root samples were irradiated for 1 min each either with 60 mJ/p, 80 mJ/p and 100 mJ/p using Er:YAG laser or with 0.5W, 1.0W and 1.5W using Nd:YAG laser. Scanning electron microscopy (SEM) was used to determine the morphology, infrared (IR) spectroscopy to assess the alterations in chemical structure and one dimensional electron paramagnetic resonance imaging (1-D EPRI) was used to estimate the diffusion coefficients in dental root samples. RESULTS Er:YAG laser treatment resulted in deep crater formation with exposed dentin. Morphological alterations of root surface after Nd:YAG laser irradiation included cracks, crater formation, meltdown of the root mineral and resolidified porous globules formation. Er:YAG laser failed to alter the intensity of Amide peaks I, II or III. In contrast, treatment with Nd:YAG laser, using the highest power setting of 1.5W, reduced the intensity of Amide peak II and III in comparison to the control. The diffusion coefficients were increased significantly in all Er:YAG and Nd:YAG treated root samples. CONCLUSION This study demonstrated that Er:YAG laser influences only on morphology and diffusion processes of root surfaces, while Nd:YAG laser also alters the chemical structure of root proteins.
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Affiliation(s)
- B Gaspirc
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Slovenia.
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Folwaczny M, Mehl A, Aggstaller H, Hickel R. Antimicrobial effects of 2.94 microm Er:YAG laser radiation on root surfaces: an in vitro study. J Clin Periodontol 2002; 29:73-8. [PMID: 11846852 DOI: 10.1034/j.1600-051x.2002.290111.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This in vitro study investigated the antimicrobial effects of 2.94 microm Er:YAG laser radiation on root surfaces. MATERIALS AND METHODS The study used 125 extracted teeth which were divided into 2 groups (A, B) of 40 teeth and 3 groups of 15 teeth (C, D, E). A defined and similarly-sized area of the root surface was inoculated with an aliquot of 7 microl of a bacterial suspension of Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923), Actinobacillus actinomycetemcomitans (ATCC 43719), Eikenella corrodens (ATCC 51724), or Peptostreptococcus micros (ATCC 33270). Subsequently, the samples from each group were further divided into subgroups which have been irradiated either with 55, 75, and 105 (group A, B) or 55 and 75 (group C, D, E) laser pulses. 1 subgroup of each group was left untreated as control. The source of laser radiation was an Er:YAG laser emitting pulsed infrared radiation at a wavelength of 2.94 microm. The number of bacteria was determined using the surface spread plate technique. The statistical analysis was performed using ANOVA followed by the Scheffé-test. RESULTS Depending on the number of laser pulses the bacterial load in the E. coli group was reduced by the Er:YAG laser radiation after exposure to 105 laser pulses to 5.5% of the initial count and that in the Staph. aureus group to 15.1%. The number of bacteria in case of A. actinomytemcomitans was reduced to 8.3%, in case of E. corrodens to 3.0% and in case of P. micros to 22.0% after application of 75 laser pulses. CONCLUSION Besides the selective removal of plaque and calculus, the 2.94 microm Er:YAG laser radiation causes reduction in bacteria on root surfaces.
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Affiliation(s)
- Matthias Folwaczny
- Department of Operative Dentistry and Periodontology, Ludwig-Maximilians-University, Munich, Germany.
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Kreisler M, Meyer C, Stender E, Daubländer M, Willershausen-Zönnchen B, d'Hoedt B. Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: an in vitro study. J Periodontol 2001; 72:1312-7. [PMID: 11699471 DOI: 10.1902/jop.2001.72.10.1312] [Citation(s) in RCA: 161] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The present study is part of a basic research program investigating the cellular effects of an 810 nm GaAlAs-diode laser on human periodontal tissues. The aim of the investigation was to evaluate the effects of laser treatment of root surface specimens on the attachment of periodontal ligament (PDL) cells in vitro. METHODS Root specimens were prepared from periodontally diseased teeth. PDL cells were obtained from human third molar ligaments. Cells were cultured under simple, standardized, and reproducible experimental conditions. One hundred fifty root specimens were scaled and root planed with curets followed by air-powder abrasive treatment; 75 were then lased and 75 served as controls. The irradiation time was 20 seconds at a power output of 1 W. The root segments were placed into culture dishes, covered with a solution of PDL cells, and incubated for 72 hours. The specimens were then washed with phosphate buffer to remove cells not attached to the surface, and the adherent cells were stained with methylene blue. Cells were counted using a reflected light microscope and the cell density per mm2 was calculated. RESULTS The analysis of 150 specimens revealed no significant differences between the groups (P = 0.347, Wilcoxon test). The cell numbers, however, were slightly higher on laser specimens. The mean was 66 cells/mm2 in the laser group and 63.7 cells/mm2 in the control group. CONCLUSIONS The application of the diode laser at the parameters used did not have a substantially positive effect on the new attachment of PDL cells on the tooth specimens. It remains to be investigated whether the difference detected is really clinically relevant.
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Affiliation(s)
- M Kreisler
- Department of Oral Surgery, Johannes Gutenberg-University Mainz, Germany.
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Kreisler M, Daubländer M, Willershausen-Zönnchen B, d'Hoedt B. Effect of diode laser irradiation on the survival rate of gingival fibroblast cell cultures. Lasers Surg Med 2001; 28:445-50. [PMID: 11413556 DOI: 10.1002/lsm.1072] [Citation(s) in RCA: 142] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE The present study is part of a basic research program investigating the cellular effects of the GaAlAs-diode laser with a wavelength of 810 nm on human periodontal tissues. The aim of the investigation was to evaluate the effects of the laser treatment on the survival rate of human gingival fibroblasts (HGF) in monolayer cell culture at different power settings and durations. STUDY DESIGN/MATERIALS AND METHODS HGF were obtained from a human gingival connective tissue explant. Cells were cultured on 24-well tissue culture plates. One hundred and thirty multi well cell cultures were laser treated. The variable parameters were power output (0.5-2.5 W) and exposure time (60-240 seconds per well). The cultures were analyzed by means of trypan blue staining, and the cell numbers counted under a light microscope. Photographs before and after irradiation were taken and evaluated. RESULTS Depending on different settings, the laser irradiation caused significant (P < 0.05, t-test) reductions of cell numbers. Exposure time was more relevant to this phenomenon than the power output. Linear regression analysis revealed no unambiguous correlation between power output and cell death, when exposure time was kept constant. CONCLUSIONS When used for periodontal pocket decontamination, the laser beam may cause damage to collateral periodontal tissues, if the power setting and the duration of the treatment are not adequate. Further investigation, especially with regard to the effects on hard tissue and microorganisms, are needed to give a secure recommendation for irradiation parameters at pocket decontamination.
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Affiliation(s)
- M Kreisler
- Department of Oral Surgery, Johannes Gutenberg-University, Mainz, Germany.
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Kimura Y, Yu DG, Kinoshita J, Hossain M, Yokoyama K, Murakami Y, Nomura K, Takamura R, Matsumoto K. Effects of erbium, chromium:YSGG laser irradiation on root surface: morphological and atomic analytical studies. JOURNAL OF CLINICAL LASER MEDICINE & SURGERY 2001; 19:69-72. [PMID: 11443792 DOI: 10.1089/104454701750285386] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the morphological and atomic changes on the root surface by stereoscopy, field emission-scanning electron microscopy (FE-SEM), and energy dispersive X-ray spectroscopy (SEM-EDX) after erbium, chromium:yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation in vitro. SUMMARY BACKGROUND DATA There have been few reports on morphological and atomic analytical study on root surface by Er,Cr:YSGG laser irradiation. METHODS Eighteen extracted human premolar and molar teeth were irradiated on root surfaces at a vertical position with water-air spray by an Er,Cr:YSGG laser at the parameter of 5.0 W and 20 Hz for 5 sec while moving. The samples were then morphologically observed by stereoscopy and FE-SEM and examined atomic-analytically by SEM-EDX. RESULTS Craters having rough but clean surfaces and no melting or carbonization were observed in the samples. An atomic analytical examination showed that the calcium ratio to phosphorus showed no significant changes between the control and irradiated areas (p > 0.01). CONCLUSIONS These results showed that the Er,Cr:YSGG laser has a good cutting effect on root surface and causes no burning or melting after laser irradiation.
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Affiliation(s)
- Y Kimura
- Department of Endodontics, Showa University School of Dentistry, Tokyo, Japan.
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Moritz A, Schoop U, Goharkhay K, Schauer P, Doertbudak O, Wernisch J, Sperr W. Treatment of periodontal pockets with a diode laser. Lasers Surg Med Suppl 2000; 22:302-11. [PMID: 9671997 DOI: 10.1002/(sici)1096-9101(1998)22:5<302::aid-lsm7>3.0.co;2-t] [Citation(s) in RCA: 179] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study is to examine the long-term effect of diode laser therapy on periodontal pockets with regard to its bactericidal abilities and the improvement of periodontal condition. STUDY DESIGN/MATERIALS AND METHODS Fifty patients were randomly subdivided into two groups (laser-group and control-group) and microbiologic samples were collected. There have been six appointments for 6 months following an exact treatment scheme. After evaluating periodontal indices (bleeding on probing, Quigley-Hein) including pocket depths and instruction of patients in oral hygiene and scaling therapy of all patients, the deepest pockets of each quadrant of the laser-group's patients were microbiologically examined. Afterwards, all teeth were treated with the diode laser. The control-group received the same treatment but instead of laser therapy were rinsed with H2O2. Each appointment also included a hygienic check-up. After 6 months the final values of the periodontal indices and further microbiologic samples were measured. The total bacterial count as well as specific bacteria, such as Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis, were assessed semiquantitatively. RESULTS The bacterial reduction with diode laser therapy was significantly better than in the control group. The index of bleeding on probing improved in 96.9% in the laser-group, whereas only 66.7% in the control group. Pocket depths could be more reduced in the laser group than in the control group. CONCLUSION The diode laser reveals a bactericidal effect and helps to reduce inflammation in the periodontal pockets in addition to scaling. The diode laser therapy, in combination with scaling, supports healing of the periodontal pockets through eliminating bacteria.
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Affiliation(s)
- A Moritz
- Department of Conservative Dentistry, Dental School of the University of Vienna, Austria
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Folwaczny M, Mehl A, Haffner C, Benz C, Hickel R. Root substance removal with Er:YAG laser radiation at different parameters using a new delivery system. J Periodontol 2000; 71:147-55. [PMID: 10711604 DOI: 10.1902/jop.2000.71.2.147] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The recently introduced Er:YAG laser radiation appears to be a promising alternative in treating dental hard tissue due to its thermo-mechanical ablation properties and the lack of thermal side effects. The present in vitro study attempted to evaluate the use of Er:YAG laser radiation in combination with a specially developed delivery system in removing calculus from root surfaces. METHODS Fifty extracted anterior teeth, premolars and molars, were divided into 2 groups of 25 each with (group A) and without (group B) subgingival calculus. Source of radiation was an Er:YAG laser device with a wavelength of 2.94 microm, in the infrared optical spectrum, a pulse duration of 250 ns, and a pulse repetition rate of 15 pps. In each group, 6 teeth were irradiated with 300 laser pulses either at 60 mJ, 80 mJ, 100 mJ, or 150 mJ. The samples were continually moved linearly using a computer numeric controlled device. The volumetric evaluation of root substance removal was performed with a 3-dimensional laser scanning system (100,000 surface points per sample, accuracy: 5 microm) and special image analyzing software. A scanning electron microscopic (SEM) observation was performed to assess the laser induced ultrastructural changes on the root surfaces. Statistical analysis was carried out with ANOVA followed by the Scheff*e test and with regression analysis according to Pearson-Bravais at a level of significance of 5% (P <0.05). RESULTS The linear measurement of substance removal on calculus samples (group A) revealed average depths between 174.38 (+/-16.13) microm and 501.85 (+/-111.01) microm. Defect depths on the teeth without calculus (group B) ranged from 37.78 (+/-14.03) microm to 484.44 (+/-80.63) microm. The SEM observation of laser-treated root surfaces revealed no signs of thermal damage; e.g., melting, fusion, or cracking. CONCLUSIONS The results of the present study showed that a substance removal with Er:YAG laser radiation at lower energy densities is comparable, in effect, to that after conventional root surface instrumentation with curets. The results seem to indicate that calculus removal can be selectively done using lower radiation energies. Considering the favorable results of the SEM investigation, the use of the Er:YAG laser in periodontal therapy may be possible in the future.
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Affiliation(s)
- M Folwaczny
- Department of Operative Dentistry and Periodontology, Ludwig-Maximilians-University, Munich, Germany.
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Misra V, Mehrotra KK, Dixit J, Maitra SC. Effect of a carbon dioxide laser on periodontally involved root surfaces. J Periodontol 1999; 70:1046-52. [PMID: 10505808 DOI: 10.1902/jop.1999.70.9.1046] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this in vitro study was to evaluate the effect of CO2 laser on the periodontally involved root surface, and to compare its efficacy with citric acid, EDTA and hydrogen peroxide in removal of root surface smear layer after root planing. METHODS The study was conducted on 50 periodontally involved single rooted human teeth with poor prognosis. Immediately after extraction the teeth were scaled and root planed with Gracey curets; 50 specimens were obtained from the proximal side of each tooth which were assigned randomly to 1 of the 4 groups. Group A (35 specimens) was divided into 7 subgroups of 5 specimens each and irradiated with CO2 laser using a defocused mode at 3-watt power for 0.2, 0.4, 0.6, 0.8, 1.0, 1.2, or 1.4 seconds, respectively. Groups B, C, and D (5 specimens each) were treated with 6% hydrogen peroxide, EDTA solution (pH 7.4), or saturated citric acid solution (pH 1), respectively for 3 minutes. The specimens were then fixed and scanned using SEM. RESULTS It was observed that surface smear layer was present on root surfaces of teeth that were root planed; the CO2 laser was not able to remove the smear layer on the sites that were irradiated for 0.2, 0.4 or 0.6 seconds at 3W power. Irradiation time of 0.8 seconds at 3W power was able to remove the smear layer, but the dentinal tubules were partially exposed. The surface irradiated for 1 second showed a flat appearance with many clear orifice of dentinal tubules. No change in diameter of exposed dentinal tubules was observed and their diameter was nearly equal that of normal dentinal tubules. Irradiation time of 1.2 and 1.4 seconds produced surface charring and carbonization and was totally ineffective in exposing the dentinal tubules; 6% hydrogen peroxide did not remove the smear layer completely and the exposed dentinal tubules orifice was not clear. EDTA (pH 7.4) and citric acid (pH 1) were found to be effective in removing the smear layer and exposing the dentinal tubules, which showed funnel shaped widening. CONCLUSIONS Surface smear layer was present on root surfaces of teeth that were root planed. Laser irradiation of 1 second at 3W completely removed the smear layer with minimal change in the diameter of the dentinal tubules. EDTA and citric acid were also effective in removing smear layer, but the exposed dentinal tubules showed funnel-shaped widening.
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Affiliation(s)
- V Misra
- Department of Periodontics, Faculty of Dental Sciences, King George's Medical College, Lucknow, U.P. India
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Spencer P, Cobb CM, Wieliczka DM, Glaros AG, Morris PJ. Change in temperature of subjacent bone during soft tissue laser ablation. J Periodontol 1998; 69:1278-82. [PMID: 9848538 DOI: 10.1902/jop.1998.69.11.1278] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In tissues that closely approximate bone, sufficient heat may be transferred to the bone during laser surgery to cause damage and/or necrosis. To date, there have been few studies examining the temperatures elicited at the bone surface as a result of laser application to the overlying soft tissues. The purpose of this investigation was to determine, under in vitro conditions, temperature changes at the bone/soft tissue interface during laser ablation with CO2 and Nd:YAG lasers used with and without (w/wo) air/water coolant. Experimental specimens consisted of 5 mandibles from freshly sacrificed hogs; laser treatment sites were the buccal and lingual attached gingiva of the molars and the lingual keratinized mucosa of the incisor region. CO2 and Nd:YAG lasers were used w/wo coolant at power settings of 4 to 8 W and 5 to 9 W, respectively. Temperature changes were measured with a copper constant thermocouple contained within a 21 gauge hypodermic needle. In comparing the lasers at comparable energy densities w/wo coolant, temperature increases at the bone/soft tissue interface ranged from 8.0 to 11.1 degrees C with the Nd:YAG and 1.4 to 2.1 degrees C with the CO2. Similarly, in comparing the times required for the interface to return to baseline temperature following removal of the laser, values ranged from approximately 143 to 205 and approximately 119 to 139 seconds for the Nd:YAG and CO2, respectively. Results from this study suggest that, at energy densities equal or above those reported here, the increase in temperature at the bone surface as a result of periodontal soft tissue surgery with the Nd:YAG laser could be damaging, especially if the exposure is prolonged.
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Affiliation(s)
- P Spencer
- Department of Periodontology, University of Missouri-Kansas City School of Dentistry, 64108, USA
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Wilder-Smith P, Nguyen A, Lin S, Berns MW. Effects of cavity preparation using a nanosecond-pulsed Nd-YAG laser on tooth-restoration interface. Lasers Med Sci 1997. [DOI: 10.1007/bf02763917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Allen EP, Bayne SC, Donovan TE, Hansson TL, Klooster J, Kois JC. Annual review of selected dental literature. J Prosthet Dent 1996; 76:56-93. [PMID: 8814636 DOI: 10.1016/s0022-3913(96)90347-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- E P Allen
- Baylor College of Dentistry, Dallas, Tex., USA
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