Erbium laser‐assisted ceramic debonding: a scoping review

Abstract

Purpose Removal of ceramic restorations and appliances can be time consuming, invasive, and inconvenient. Erbium lasers offer an alternative noninvasive method for debonding of ceramic appliances. This paper aims to provide a comprehensive review of current literature on the effectiveness of erbium lasers for removal of ceramic restorations and appliances from natural teeth and dental implants. Methods A comprehensive search of 7 databases, including Medline (Ovid), Embase, Dentistry and Oral Sciences Source (DOSS), Web of Science, Cochrane Library, and ProQuest Dissertations and Theses was performed. The inclusion and exclusion criteria were agreed prior to the literature search. Two reviewers independently screened the title and abstract. A third reviewer then broke the tie, if any. The selected articles then underwent full text review and the data was extracted. Results The search identified 4117 unique articles published through June 10, 2021. Studies were assessed and categorized based on the type of restoration/appliance, type of abutment, type of laser, laser settings, efficacy of debonding, and pulpal temperature rise. Thirty‐eight full‐text articles were reviewed for inclusion. Time for ceramic debonding varies depending on the type of restorations and materials. Removal of zirconia crowns from teeth and implant abutments requires a longer period of time compared to lithium disilicate crowns. Temperature increases were reported as 5.5 degrees or less. Laser setting and laser type affect the debonding time and the increase in temperature. Examinations of debonded ceramics demonstrated no known structural damages resulting from laser applications. Conclusions Erbium lasers are effective noninvasive tools to remove all ceramic restorations/appliances from natural teeth and implant abutments without causing harm to abutments. Laser‐assisted debonding should be considered as a viable alternative to rotary instrumentation for ceramic crowns; however, clinical studies of erbium‐assisted ceramic retrieval are needed.

Evaluation of Er,Cr:YSGG laser technique for fiber post removal of endodontically treated teeth using micro‐computed tomography

“…As it was mentioned before, Er,Cr:YSGG laser emits at 2780 nm and selectively targets the water and residual monomer molecules in the resin cement. This was the reason that in previous studies this laser wavelength was used for removing bonded restorations from natural teeth (Deeb et al, 2022; Giraldo‐Cifuentes et al, 2020). It is important to note that dentin damage during post removal procedure can also be a result of temperature rise at the area of application.…”

Evaluation of the effectiveness and practicality of erbium lasers for ceramic restoration removal: A retrospective clinical analysis

“…In most cases, local anesthesia was not required for the removal of the prosthetics. However, local anesthesia was administered if cutting of the prosthesis for natural tooth abutments was deemed necessary [7,[11][12][13][14][15].…”

“…If the prosthesis was not dislodged, the laser irradiation was continued. The removal protocol was standardized based on established methodologies from several previous studies [11][12][13][14][15][16].…”

“…This leads to the thermomechanical ablation of the cement, causing its vaporization [13,14,22]. Both Er,Cr:YSGG and Er:YAG lasers can be utilized for ceramic restoration debonding, although the Er:YAG laser generally demonstrates greater effectiveness [14,15]. Due to the laser energy primarily being absorbed by water and monomer molecules in the luting cement, as well as the presence of water coolant during the debonding process, scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDX) analyses have revealed no significant surface or chemical damage to natural teeth, implant abutments, or debonded ceramic restorations [7,[11][12][13][14].…”

“…Due to the laser energy primarily being absorbed by water and monomer molecules in the luting cement, as well as the presence of water coolant during the debonding process, scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDX) analyses have revealed no significant surface or chemical damage to natural teeth, implant abutments, or debonded ceramic restorations [7,[11][12][13][14]. Importantly, the temperature changes resulting from laser applications do not appear to have any adverse effects on the dental pulp, implants, or surrounding bone [7,[11][12][13][14][15].…”