The bleaching efficiency of KTP and diode 810 nm lasers on teeth stained with different substances: An in vitro study

Effectiveness of KTP lasers in tooth bleaching, by comparing tooth color change after bleaching with KTP, Nd:YAG, Er:YAG, and diode laser system: A systematic review

This systematic review evaluated the role of Potassium-titanyl-phosphate (KTP) lasers in dental bleaching by comparing tooth color change and rise in intrapulpal temperature after bleaching with KTP, Neodymium-doped yttrium aluminum garnet (Nd:YAG), Er:YAG, and diode laser system. Following were the inclusion criteria: in vitro studies in English available in full text. Articles published between 2000 and 2021 were selected. The search for was conducted on PubMed, Cochrane library/CENTRAL, Wiley online library, ProQuest, Science Direct, and Hand searching/specialized registers. Keywords were used: "Lasers" [Mesh] and "Tooth bleaching" [Mesh] using Boolean operators. A total of four articles fulfilled the inclusion criteria. The quality assessment of studies included was undertaken independently as part of data extraction process. KTP lasers demonstrated more effectiveness in attaining color change in stained teeth and showed the lowest rise in intrapulpal temperature. Based on the data obtained in the present review, the choice of bleaching treatment is directly related to the type of discoloration, activation of the bleaching agent, and esthetic requirement. Although all bleaching procedures were effective in color change, the KTP laser showed better results when compared to other laser activation. The bleaching treatment protocol is directly related to the type of discoloration, activation of the bleaching agent, and esthetic requirement. It has been demonstrated that a faster change in color can be obtained when bleaching is performed in combination with a light source, i.e., power bleaching aiming for a more in-depth change of color.

Spectrophotometric evaluation of the effectiveness of Er,Cr:YSGG laser-assisted intracoronal tooth bleaching treatment using different power settings

BACKGROUND

Non-vital tooth discoloration is a common condition in dental practice. The aim of this in vitro study was to evaluate the efficacy of intracoronal bleaching treatments of non-vital teeth either activated or not by Er,Cr:YSGG laser (2780 nm) operating at 1.25 or 2.5 W.

METHODS

Twenty four human canines were artificially stained after implementation of root canal treatment. Subsequently, the teeth were randomly divided into three groups (n = 8): Group 1 (control) received intracoronal bleaching treatment with a bleaching gel containing 35 % hydrogen peroxide for 40 min, Group 2 received the same treatment assisted with Er,Cr:YSGG laser (2780 nm) operating at 1.25 W average power for 30 s and Group 3 received the same treatment with Group 2, but the average power was adjusted to 2.5 W. The bleaching treatments repeated after one week. Spectrophotometric analysis of tooth color change (ΔE) was implemented 7 days after both bleaching sessions.

RESULTS

The results of two-way ANOVA revealed that there was a tendency of no significant difference in color change between the three experimental groups (p = 0.063). However, the between-group comparisons showed that laser 2.5 W group had significantly higher ΔE than the control group after the first bleaching session. Moreover, a significant interaction between bleaching treatment and number of applications was detected (p = 0.026).

CONCLUSIONS

Er,Cr:YSGG laser irradiation significantly increased ΔE only after the first bleaching session when operating at 2.5 W. After the second bleaching session ΔE was not different compared to the control group, irrespectively of the laser power settings.

KTP and Er:YAG laser dental bleaching comparison: a spectrophotometric, thermal and morphologic analysis

The aim of this study was to compare the results, in terms of temperature, colour change and morphology, of two different laser wavelengths with two different concentrations of hydrogen peroxide (HP). The lasers used were KTP (potassium-titanyl-phosphate) laser (λ = 532 nm (PD = 1.98 W/cm2)) and Er:YAG laser (λ = 2940 nm (PD = 2.54 W/cm2)). The bleaching gels used were PolaOffice 35% HP gel and PolaOffice+ 6% HP gel (SDI, Australia). Thirty-six extracted human teeth were selected and divided into two groups. For the 35% HP treatment, 18 teeth were randomly assigned to three subgroups: (1) HP gel without laser irradiation vs. HP gel + KTP laser irradiation; (2) HP gel without laser irradiation vs. HP gel + Er:YAG irradiation; and (3) HP gel + KTP laser irradiation vs. HP gel + Er:YAG irradiation. The same protocol was used for the 6% HP bleaching treatment. The bleaching results were analysed by a spectrophotometer, the thermal elevation by K thermocouples and the enamel surface by a scanning electron microscope (SEM). The Kruskal-Wallis test and the Mann-Whitney test were performed, and the data were analysed using the software StatView and the free Web statistics tool BiostaTGV. The thermal elevation of the Er:YAG groups was higher than KTP, while only the group 35% HP gel vs. 35% HP gel + Er:YAG showed significant colour differences (p < 0.05). SEM photographs showed slight enamel surface morphologic alterations after bleaching treatment. The Er:YAG laser may improve the bleaching results of 35% HP even if it increases the gel temperature, when compared to the KTP laser.

Laser teeth bleaching: evaluation of eventual side effects on enamel and the pulp and the efficiency in vitro and in vivo

Light and heat increase the reactivity of hydrogen peroxide. There is no evidence that light activation (power bleaching with high-intensity light) results in a more effective bleaching with a longer lasting effect with high concentrated hydrogen peroxide bleaching gels. Laser light differs from conventional light as it requires a laser-target interaction. The interaction takes place in the first instance in the bleaching gel. The second interaction has to be induced in the tooth, more specifically in the dentine. There is evidence that interaction exists with the bleaching gel: photothermal, photocatalytical, and photochemical interactions are described. The reactivity of the gel is increased by adding photocatalyst of photosensitizers. Direct and effective photobleaching, that is, a direct interaction with the colour molecules in the dentine, however, is only possible with the argon (488 and 415 nm) and KTP laser (532 nm). A number of risks have been described such as heat generation. Nd:YAG and especially high power diode lasers present a risk with intrapulpal temperature elevation up to 22°C. Hypersensitivity is regularly encountered, being it of temporary occurrence except for a number of diode wavelengths and the Nd:YAG. The tooth surface remains intact after laser bleaching. At present, KTP laser is the most efficient dental bleaching wavelength.