Caries-preventive effect of Er:YAG laser irradiation with or without water mist.

OBJECTIVE: This investigation was performed to evaluate the effect of Er:YAG laser irradiation on the acquired acid resistance of sound dental hard tissues to artificial caries formation by spectrophotometry, and the ultrastructure of lased areas was investigated by scanning electron microscopy (SEM) in vitro. BACKGROUND DATA: Although an Er:YAG laser has shown the most promise for hard tissue ablation, there have not been any dissolution studies to determine if this laser is suitable for caries preventive treatments. METHODS: An Er:YAG laser was used to irradiate the enamel and dentin samples from 20 extracted human molars at 400 mJ pulse energy with or without water mist. Samples were subjected to 2 microL of 0.1 M lactic acid solution (pH 4.8) for 24 hours at 36 degrees C. The parts per million (ppm) of calcium ion (Ca2+) dissolved in each solution was determined by atomic absorption spectrophotometry and the morphological changes were investigated by SEM. RESULTS: The lowest mean Ca2+ ppm was recorded in the samples irradiated without water mist, in those by irradiated with water mist, and in the unlased samples. SEM observation showed that the lased areas had melted and seemed to be thermally degenerated when irradiated without water mist. After acid demineralization, the thermally degenerated enamel or dentin surfaces were almost unchanged. CONCLUSIONS: The results of this study suggest that Er:YAG laser irradition with and without water mist appears to be more effective for caries prevention.     

A study on acquired acid resistance of enamel and dentin irradiated by Er,Cr:YSGG laser

OBJECTIVE: This investigation was performed to evaluate the acid resistance of lased enamel and dentin by Er,Cr:YSGG laser to artificial caries-like lesions by spectrophotometry, and the ultrastructure of lased areas was investigated by scanning electron microscopy (SEM) in vitro. BACKGROUND DATA: In recent years, many studies have been performed to evaluate the effects of Er,Cr:YSGG laser on dental hard tissues. However, there have been only a few studies to determine if this laser is suitable for caries preventive treatments. METHODS: An Er,Cr:YSGG laser was used to irradiate the enamel or dentin samples from 30 extracted human molars at 6 W (67.9 J/cm2) or 5 W (56.6 J/cm2) pulse energy, respectively, with or without water mist. Samples were subjected to 2 microl of 0.1 M lactic acid solution (pH 4.8) for 24 h at 36 degrees C. The parts per million (ppm) of calcium ion (Ca2+) dissolved in each solution was determined by atomic absorption spectrophotometery, and the morphological changes were investigated by SEM. RESULTS: The lowest mean Ca2+ ppm was recorded in the lased samples. SEM observation showed that the lased areas were melted and seemed to be thermally degenerated. After acid demineralization, the thermally degenerated enamel or dentin surfaces were almost unchanged. CONCLUSIONS: The results of this study suggested that Er,Cr:YSGG laser irradiation with and without water mist appears to be effective for increasing acid resistance.     

Acquired acid resistance of dental hard tissues by CO2 laser irradiation

OBJECTIVE: This investigation was performed to evaluate the effect of CO2 laser irradiation on the acquired acid resistance of dental hard tissues to artificial caries-like formation and the ultrastructure of lased areas was morphologically investigated in vitro. SUMMARY BACKGROUND DATA: In recent years, many studies have been carried out to evaluate the effect of the CO2 laser on the enhanced resistance to artificial caries formation of enamel. However, a limited number of papers concerning its effect on dentin have been published. METHODS: A CO2 laser of 10.6 microns wavelength was used to irradiate human enamel and dentin samples from 20 extracted human molar teeth, and samples were subjected to 2 microliters of 0.1 M lactic acid solution (pH 4.8) for 24 h at 36 degrees C. The parts per million (ppm) of calcium ion (Ca2+) dissolved in each solution was determined by atomic absorption spectrophotometry and the morphological changes were investigated by scanning electron microscopy (SEM). RESULTS: The lowest mean Ca2+ ppm was recorded in the samples irradiated at 3 W, followed by 2 W, 1 W, and unlased samples. SEM observation showed that the lased areas were melting with solidification of the smear layer. Even after acid demineralization, the lased surfaces were almost unchanged. CONCLUSIONS: The results of this study suggested that CO2 laser irradiation could sufficiently melt and solidify the enamel and dentin surfaces and thus enhance resistance to artificial caries-like formation.     

Dentin evaluation after Nd:YAG laser irradiation using short and long pulses

OBJECTIVE: Several reports have demonstrated the advantages of using the Nd:YAG laser to reduce dentin permeability by melting the dentin surface. A comparative study using different pulse durations can be useful to obtain further information about the laser-hard tissue interaction. MATERIALS AND METHODS: The present study pursues the evaluation of the morphological and chemical changes in human dentin surface resulting from Nd:YAG laser (lambda = 1064 nm) irradiation, with a total energy of 0.9 J distributed in 1, 2, 3, and 6 pulses with different pulse durations to promote surface melting and dentinal tubule occlusion. After irradiation, the samples were submitted to scanning electron microscopy (SEM) analysis for morphological study and energy-dispersive spectrometry (EDS) analysis for evaluation of the concentration of calcium and phosphorous in the melted layer. RESULTS: SEM analysis of the irradiated dentin surface showed surface structural changes due to laser irradiation, where the morphological changes are dependent on the laser pulse duration. EDS analysis showed an increase of calcium and phosphorous concentrations after Nd:YAG laser exposure, but no correlation with the number of pulses or pulse duration was found. CONCLUSION: Our results suggest that longer interaction times resulted in more evident effects with more melted substrate than shorter pulses, and in both cases the resultant melted layer contains a greater concentration of inorganic substances than non-irradiated dentin.     

In vitro study of the Nd:YAG laser effect on human dental enamel: optical and scanning electron microscope analysis

OBJECTIVE: The Nd:YAG laser irradiation of dental enamel was evaluated in enamel demineralization experiments in a Streptococcus mutans culture media. SUMMARY BACKGROUND DATA: Previous studies had shown that a continuous wave Nd:YAG laser at an energy of approximately 67 mJ may induce an increased acid resistance in human dental enamel when exposed to severe demineralization conditions. METHODS: Enamel windows of 3 x 4 cm in the buccal surface were irradiated with a continuous wave Nd:YAG laser at a wavelength of 1,064 microns using energy densities of from 83.75 to 187.50 J/cm2. Enamel windows of 3 x 4 cm on the lingual surface served as control (without the laser irradiation). The enamel windows were then exposed to a Streptococcus mutans culture media at a temperature of 37 degrees C for 15 and 21 days. The laser effects and demineralization were examined both by optical microscopy and scanning electron microscopy (SEM). RESULTS: A comparison between the lased and the unlased windows of enamel showed fusion and recrystalization of the enamel and increased acid-resistance in all groups irradiated with the Nd:YAG laser. On the other hand, the 3 x 4 delimited enamel surfaces from the control group (not irradiated with the Nd:YAG laser) showed 100% demineralization. CONCLUSIONS: These findings are consistent with the finding that laser irradiation of dental results in significant reduction of the effective solubility of enamel mineral.     

Study on acid resistance of human dental enamel and dentin irradiated by semiconductor laser with Ag(NH3)2F solution

OBJECTIVE: The purpose of this study was to investigate the acquired acid resistance of human dental enamel and dentin treated by 38% diamine silver fluoride [Ag(NH3)2F] solution and semiconductor (diode) laser irradiation in vitro. BACKGROUND DATA: There have been no reports on the acid-resistant effect by combined use of fluoride and semiconductor laser. METHODS: Sixty crowns of extracted human molars were divided into two groups for enamel and dentin samples, and each group was subdivided into three subgroups of 10 each. Each subgroup of enamel and dentin samples served as a control; one was treated with Ag(NH3)2F and the other was treated with Ag(NH3)2F and semiconductor laser irradiation at 2 W for 30 sec. Then all samples were immersed in 5 ml of 0.1 M lactic acid (pH 4.8) at 37 degrees C for 24 h. The concentration of calcium ion (Ca2+) dissolved in the solution was measured by atomic absorption spectrophotometry, and the samples were observed by stereoscopy and scanning electron microscopy (SEM). RESULTS: In both enamel and dentin samples, dissolved Ca2+ concentration in Ag(NH3)2F- or Ag(NH3)2F- and laser-treated group was significantly decreased compared with that in the control (p < 0.01). SEM findings showed that numerous cubic particles ranging from 0.1 to 0.5 mcirom were observed only in the combined treated groups of both enamel and dentin samples. CONCLUSIONS: A significantly decreased solubility of human enamel and dentin was acquired after treatment by Ag(NH3)2F and semiconductor laser irradiation, which suggested that this combined use has the capability of a more efficient acid-resistant effect on human dental hard tissues.     

Acquired acid resistance of enamel and dentin by CO2 laser irradiation with sodium fluoride solution

OBJECTIVE: The purpose of this study was to investigate the caries-preventive effect of CO2 laser irradiation with or without sodium fluoride (NaF) solution at human dental enamel and dentin in vitro. BACKGROUND DATA: The capability of caries prevention with CO2 laser irradiation has been reported in many previous studies, but few studies have been performed with regard to the combined effect of fluoride and laser. MATERIALS AND METHODS: Forty extracted human incisor teeth were used for the enamel study, and 40 molar teeth were used for the dentin study. Samples were then divided into four categories: control (no treatment); CO2 laser irradiation only; NaF treatment only; and NaF treatment followed by CO2 laser irradiation. Each sample was immersed in 2 mL of lactic acid (0.1 M, pH 4.8) solution for 24 h at 37 degrees C in 100% humidity. The parts per million (ppm) of calcium ion (Ca2+) dissolved in each solution was determined by atomic absorption spectrophotometry. The samples were also observed by stereoscopy and scanning electron microscopy (SEM). RESULTS: The lowest mean Ca2+ ppm was recorded at the enamel or dentin samples treated with NaF and laser. Statistical analysis of the data was considered significant (p < 0.01). SEM observation showed that surfaces were changed to melted, smooth, and mirror-like appearances when CO2 laser irradiation was applied with NaF solution. CONCLUSION: It can be concluded that CO2 laser irradiation with NaF solution has more caries-preventive effect than CO2 laser irradiation only at the enamel and dentin surfaces.     

Analysis of surface roughness of enamel and dentin after Er,Cr:YSGG laser irradiation.

OBJECTIVE: The purpose of this investigation was to compare the surface roughness of enamel and dentin following the Er,Cr:YSGG laser irradiation and acid etching. BACKGROUND DATA: Laser-roughened enamel or dentin surfaces have been expected to enhance restorative materials bond strength. MATERIALS AND METHODS: Er,Cr:YSGG laser irradiation was performed in one half of each polished enamel or dentin sample at 3 W (33.9 J/cm2, with air 70% and water 20%,) pulse energy for 6 sec. Then the other half was treated with 37% phosphoric acid for 30 sec. Surface roughness and morphological studies were performed. Results: It was found that surface roughness was significantly increased with the laser system. Scanning electron microscopy analysis showed that irradiated surface produces a rough surface that was completely lacking of a smear layer; there was also no cracking of enamel or dentin. CONCLUSION: Er,Cr:YSGG laser irradiation could provide an effective and alternative method to the acid etch technique.     

Removal effects of the Nd:YAG laser and Carisolv on carious dentin

OBJECTIVE: The purpose of this study was to investigate the removal effect of the Nd:YAG laser irradiation and Carisolv on carious dentin. BACKGROUND DATA: Many previous studies have reported several simple and alternative techniques, such as lasers and chemicals, for caries removal. METHODS: Carisolv was applied on the surface of 20 extracted human anterior and molar teeth for 1 min and then the Nd:YAG laser was irradiated with a continuous water spray for another 1 min. The energy densities were varied from 2 to 6W with a repetition rate of 20 pps. As caries removal progressed, the cavity was carefully assessed by DIAGNOdent. Each lesion was photographed before and after treatment, and the treated cavity was observed microscopically using a stereoscope and with scanning electron microscope (SEM). Thermal change at the time of laser irradiation was measured by thermovision. RESULTS: Our results revealed that application of Carisolv followed by Nd:YAG laser irradiation at 4-6W pulse energy effectively removed dentin caries. The total procedure was usually repeated once or twice for complete caries removal. From the SEM study, it was found that the cavity surface treated with the laser revealed various patterns of microirregularity, often accompanied by microfissure propagation. There was also no smear layer. CONCLUSIONS: It was revealed that Nd:YAG laser and Carisolv could provide an alternative technique for caries removal instead of the conventional mechanical drilling and cutting.     

A comparative study on the effects of three types of laser irradiation at the apical stop and apical leakage after obturation

OBJECTIVE: The purposes of this study were to determine the degree of apical leakage using a dye penetration method after argon, pulsed Nd:YAG with or without black ink, or Er:YAG laser treatment and obturation, and to compare the results of three types of laser irradiation in vitro. SUMMARY BACKGROUND DATA: There have been only a few reports of the laser effect on apical leakage after laser treatment and obturation. METHODS: Seventy-five human extracted single root teeth were divided into five groups of 15 teeth each and prepared up to a #60 K-file size. One group served as the control and was not irradiated. The other four groups were irradiated with an argon laser at 0.3 W for 3 seconds at continuous mode, pulsed Nd:YAG laser at 2 W and 20 Hz for 4 seconds with or without black ink, and Er:YAG laser at 50 mJ per pulse and 4 Hz for 5 seconds. In each group, ten teeth for the apical leakage study were obturated and immersed in rhodamine B solution for 48 hours at 37 degrees C, and the others were used for the observation by scanning electron microscopy (SEM). All teeth were longitudinally bisected and observed by stereoscopy or SEM. RESULTS: After pulsed Nd:YAG laser treatment with black ink and obturation, the apical leakage degree (mean score: 0) was reduced compared to that in the control (mean score: 1.2) significantly (p < 0.05). SEM findings showed that specimens irradiated by pulsed Nd:YAG laser with black ink presented clean root canal walls with debris and smear layer evaporated, melted, fused, and recrystallized in most cases. CONCLUSION: These results suggest that pulsed Nd:YAG laser irradiation with black ink at the apical stop is useful for the reduction of apical leakage after obturation.     

In vitro study of the effects of Nd:YAG laser irradiation on the apical sealing of endodontic fillings performed with and without dentin plugs

OBJECTIVE: The aim of this study was to evaluate the effects of Nd:YAG laser irradiation on the apical sealing of root canal fillings with or without a dentin plug. BACKGROUND DATA: Previous studies have shown that Nd:YAG laser irradiation of root canal wall dentin promotes its melting, recrystallization, and therefore a less permeable surface. MATERIALS AND METHODS: Thirty extracted and endodontically treated teeth were divided into three groups. Eight specimens of each group were evaluated by means of quantitative analysis, measuring the marginal apical dye leakage. The remaining two specimens were evaluated by means of qualitative analysis, using the scanning electron microscopy (SEM). For the quantitative analysis, the samples of group I were obturated. In group II, the apical third of the samples were irradiated by the Nd:YAG laser at four exposures of 100 mJ/pulse, 1 W, 10 Hz, 3 sec, and obturated. In group III, an apical dentin plug was condensed and lased using the same parameters of group II, and the root canals were obturated. The samples evaluated by SEM were prepared as those analyzed quantitatively; however, their root canals were not filled. RESULTS: There were statistically significant differences among the groups regarding dye leakage. Group II showed the minor leakage average, followed, in order, by groups I and III. SEM analysis revealed open dentinal tubules in group I; melting and recrystallizing of the apical root dentin in group II; and melting and recrystallizing of a portion of the dentin plug in group III. CONCLUSION: The Nd:YAG laser irradiation of the root canal apical third without the presence of dentin plug significantly improved the quality of the apical sealing under the experimental conditions tested.     

Ablation depths and morphological changes in human enamel and dentin after Er:YAG laser irradiation with or without water mist

OBJECTIVE: This investigation was performed quantitatively to determine the ranges of ablation and to evaluate the morphological changes in human enamel and dentin irradiated by Er:YAG laser with or without water mist. SUMMARY BACKGROUND DATA: Recently, several infrared lasers have been introduced in the dental clinic to remove carious dental hard tissues in anticipation of replacing the high-speed dental drill. Among them, the Er:YAG laser has shown the most promise for hard tissue ablation. METHODS: An Er:YAG laser was used to ablate human dental hard tissues using a pulse energy that ranged from 100 to 400 mJ at a frequency of 2 Hz for 5 seconds. Ablation rates with or without water mist at different pulse energies were measured, and the morphological changes on enamel and dentin were also investigated by stereomicroscopy and scanning electron microscopy (SEM). RESULTS: The relationship between ablation depths and energies was almost linear at both enamel and dentin samples. The irradiation with water mist reduced the ablation depths, but only minimally, when compared to those irradiated without water mist. Morphological findings by SEM indicated that Er:YAG laser irradiation with water mist could produce the cavities without signs of thermal damage to the surrounding enamel and dentin. CONCLUSIONS: The results of this study suggest that addition of a fine water mist directed at the ablation sites does not greatly decrease the ablation, and does not cause any carbonization and melting in the surrounding dental hard tissues.     

Comparison between the removal effect of mechanical, Nd:YAG, and Er:YAG laser systems in carious dentin.

OBJECTIVE: The purpose of this study was to compare the effectiveness of carious dentin removal by using an Er:YAG laser irradiation and Nd:YAG laser under a continuous water spray with that of the conventional mechanical treatment in vitro. BACKGROUND DATA: Lasers are being considered as a potential replacement of conventional mechanical systems to remove diseased and healthy dental hard tissues. METHODS: First, one half of the 10 carious lesions were treated with the round steel bur and then removed. The other half were treated with the Er:YAG laser at 200-mJ pulse energy at 2 Hz. After that, one half of another set of 10 teeth was subjected to the round steel bur in which the other half was removed using the Nd:YAG laser at 6-W output power, 20 pps, and under a continuous water spray (120 mL/min). Thermal change during each treatment and the time required for carious dentin removal was determined, and the surface characteristic was observed using the scanning electron microscopic (SEM). RESULTS: The Er:YAG or Nd:YAG laser irradiation time was almost two or three times longer than the bur treatment, respectively. From the SEM study, it was found that the lased cavity surface revealed various patterns of microirregularity, and there was also no smear layer. CONCLUSIONS: It can be suggested that under adequate water spray and with a careful irradiation technique, cavities without sign of thermal damage to the surrounding tissues as well as dental pulp could be produced with the Er:YAG and Nd:YAG laser.     

Treatment of cervical dentin hypersensitivity by various methods using pulsed Nd:YAG laser

OBJECTIVE: The purpose of this study was to evaluate the results of two irradiated regions, the cervical and apical, for cervical dentin hypersensitivity treatment using pulsed a Nd:YAG laser with or without black ink. SUMMARY BACKGROUND DATA: There has been no reports on the irradiated area(s) except the cervical region for dentin hypersensitivity treatment using pulsed Nd:YAG laser. METHODS: A total of 180 teeth diagnosed with cervical dentin hypersensitivity in 54 (39 females, 15 males, aged 21 to 73) healthy adult patients were included in this study, and teeth were randomly divided into four groups of 45 each. Sensitivity was rated using a blast from a fully depressed air syringe on a four-grade scale both before and up to 2 months after laser treatment. The effectiveness was evaluated on the change in the degree of hypersensitivity after laser treatment. The tooth surfaces in groups 1 and 2 were observed by the replica model method using scanning electron microscopy (SEM). RESULTS: The methods of irradiation at the cervical regions were better than those at the apical regions except for the period 2 months later. The laser effect was enhanced by black ink at both areas. The effective (excellent and good) rate was decreased depending on the time in every group. SEM observation at the tooth surfaces from group 2 showed that dentinal tubules were occluded or narrowed after laser irradiation. CONCLUSIONS: These results show that the method of irradiation by a pulsed Nd:YAG laser at cervical regions with black ink is the most effective for cervical dentin treatment of hypersensitivity and recurrence by this method is less than in other methods.     

Characterization of enamel and dentin response to Nd:YAG picosecond laser ablation

OBJECTIVE: We investigated the main characteristics of human dental tissue under Nd:YAG picosecond laser ablation. SUMMARY BACKGROUND DATA: The use of ultrashort laser pulses for teeth ablation prevents overheating and is an alternative for mechanical material removal; it also minimizes the volume of damaged material. METHODS: Laser pulses of picosecond at 15 Hz repetition rates from a Q-switched and mode-locked Nd:YAG laser were focused on sound human molars for 30 seconds. Variation of light intensity in the pulse train allowed us to obtain drilled holes with different characteristics. Enamel and dentin surfaces were examined by optical and scanning electron microscope (SEM). The samples consisted of three sound human molars. The ablation rate was determined after taking an average of all samples. RESULTS: Images from the SEM showed an interesting contrast between the morphology of the ablated enamel and dentin regions. In enamel, the ablated region appears to be more superficial than in dentin. The dentin fragility normally causes cracks that originate in the ablated region. The ablation rates in both enamel and dentin demonstrate a saturation behavior as the laser intensity increases. Furthermore, the ablation rate in dentin is about eight times greater than in enamel for the same laser fluence. CONCLUSION: Our results show an important correlation between the surface morphology and the pulsed laser fluence, which is compatible to the ablation mechanisms presented when ultrashort laser pulses are used.     

The bactericidal effect of Ho:YAG laser irradiation within contaminated root dentinal samples.

OBJECTIVE: This in vitro study investigates the bactericidal effect of pulsed Ho:YAG laser irradiation in the depth of contaminated dentin specimens. BACKGROUND DATA: Previous studies have shown the effectiveness of laser irradiation in bacterial reduction of infected root canal. METHODS: Root dentin of bovine teeth were sliced longitudinally in 180 samples of 100 microm, 300 microm, and 500 microm thickness, sterilized, dried, and inoculated on one side, with 1 microL of Enterococcus faecalis suspension. The opposite side's were irradiated four times for 5 seconds each with Ho:YAG laser irradiation, a wavelength of 2.10 microm, using four different energy settings: 1 W/5 Hz; 1 W/10 Hz; 1.5 W/5 Hz, and 2.0 W/5 Hz through a 320-microm quartz fiber at an angle of approximately 5 degrees. In addition, two control groups were investigated, the first was inoculated and not submitted to any treatment, the second was inoculated and treated with NaOCl and H2O2. The remaining bacteria from each dentin sample in a transport media were removed by vibration, serially diluted, and plated out on culture dishes selective for Enterococcus faecalis. RESULTS: When compared with the untreated control group or even with the group treated with NaOCl plus H2O2, counting of colonies forming units (CFU) from the laser-treated samples revealed a high significant bacterial elimination with a maximum of 98.46% and a minimum of 83.65%. CONCLUSIONS: Our findings demonstrate a significant decrease of the bacterial population in depth, suggesting that the Ho:YAG laser irradiation could be effective to eliminate the microorganisms harbored within dentin or contaminated canals.     

Nd:YAG laser effects on the microleakage of composite resin restorations.

OBJECTIVE: This study evaluated microleakage of composite restorations submitted to marginal treatment with Nd:YAG laser and surface sealant. BACKGROUND DATA: Previous studies have demonstrated that Nd:YAG-lased enamel melted and became recrystallized with a morphologic appearance similar to lava, and has been used clinically in the sealing of enamel pits and fissures. METHODS: Class V cavities in enamel of human premolars were restored with composite resin (Z100, 3M) and randomly divided in six groups: G1, control; G2, surface sealant marginal treatment; G3 to G6, were treated with pulsed Nd:YAG laser (1.064 microm) marginal treatment, contact fiberoptic (300 microm), air cooling, for 30 seconds, powers of 1.2-2 W, repetition rates of 20-30 Hz, energies of 40-100 mJ. Teeth were impermeabilized, immersed in a rhodamine dye, sectioned, and evaluated under stereomicroscope microscopy with scores. RESULTS: There were significant differences between marginal treatments; there were no differences between groups 1, 2, and 4, and 3,5, and 6; lower values of microleakage were at groups 3, 5, and 6 (Kruskal-Wallis,p = 0.05). CONCLUSION: Nd:YAG laser showed improved marginal sealing and decreased microleakage of composite resins restorations.     

Morpho-structural aspects of Er:YAG-prepared class V cavities

OBJECTIVE: The aim of this study was to evaluate the ability of an Er:YAG laser (2960nm) to prepare class V cavities as compared with rotary instruments. MATERIALS AND METHODS: Twenty-six freshly extracted human molars were selected and randomly distributed in two groups. Non standardized class V cavities were prepared using (group 1) a diamond bur for enamel, plus a tungsten bur for dentin with water irrigation and (group 2) an Er:YAG laser (output parameters, enamel: 1000 mJ, 12Hz, dentin: 500 mJ, 20Hz) with a continuous flow of water. RESULTS: The SEM examination revealed characteristic micro-irregularities of the lased samples as compared with the conventional prepared cavities: group 1, the walls of the cavities were slightly curved and a smear layer plus muds covered peripheric walls as well as the depth of the cavity; rare dentinal tubules were opened; linear and circular surface irregularities were observed on the dentin; and group 2, the walls of the cavities were irregular, jagged; photo-ablation creates a real cleavage of hydroxyapatite prisms with respect to the enamel prism pathway; an homogeneous dentin with opened dentinal tubules covered the depth of the cavities; intertubular dentin is selectively more ablated than Er-YAG the peritubular dentin. CONCLUSIONS: Jagged outline as well as opened dentinal tubules are the main characteristics of the Er-YAG prepared class V cavities. Further investigations (ulstrastructural, histochemical properties of the lased dentin, resistance to traction of bonded resins) should be conducted.     

Morphological study of dentin irradiated by solid-state ultraviolet lasers: a comparison of wavelength and repetition rate

OBJECTIVE: In this study, we examined the surface morphology of dentin after being ablated by the third, fourth, and fifth harmonics of the Nd:YAG laser. The influences of the repetition rate with respect to the wavelength were also investigated. BACKGROUND DATA: Typically, excimer lasers have been used as the primary sources of ultraviolet (UV) laser wavelengths to investigate laser ablation of dentin. In the past decade, developments in nonlinear optical technology have given rise to higher conversion efficiencies of the fourth and fifth harmonics of the Nd:YAG laser. To this end, sufficient energy densities of the fourth and fifth harmonics of the Nd:YAG laser have been generated to ablate dentin. MATERIALS AND METHODS: Thin dentin samples (typically 1 mm) were irradiated by the third, fourth, and fifth harmonics of the Nd:YAG laser. Ablation occurred at repetition rates of 1, 5, 10, and 20 Hz, using similar energy densities for each laser wavelength. An environmental scanning electron microscope was used to assess the resultant surface morphology. RESULTS: Dentine surfaces after 355-nm ablation exhibited plugging at each repetition rate. Similar surfaces were exhibited after 266-nm ablation. "Plugging" over dentine tubules was less obvious after 213-nm laser ablation. The results may highlight the impact of different absorption characteristics of each wavelength. CONCLUSION: Solid-state UV laser ablation of dentin exhibits similar properties to excimer laser ablation. At similar energy densities, the deeper UV laser wavelengths exhibit less "plugging" of dentin tubules, suggesting a lower thermal impact.     

Experimental studies of the applications of the holmium laser in dentistry

The purpose of this study is to evaluate the possibility of using a pulsed Ho:YLF laser for endodontic surgery access, preparation of cavities, etching of dental enamel, and treatment of dental caries. Specimens were irradiated with a prototype of pulsed Ho:YLF laser (2,065 microns). Laser energies in the range of 120-750 mJ per pulse were used. The study of morphological changes on enamel and dentine was conducted on light and scanning electron microscopes. Perforation of approximately 4 mm depth with homogeneous and smooth aspect of its wall surfaces was obtained. There was no carbonization. Irradiation with low energy results in melted and recrystalized surface with small and shallow pits. In accordance with our results the Ho:YLF laser produces surfaces that are white in appearance in contrast to the Nd:YAG modified enamel and dentine surfaces, that were darkened. These are indications that the holmium laser may be useful for dentistry in the future.