Removal of Composite Restoration from the Root Surface in the Cervical Region Using Er: YAG Laser and Drill—In Vitro Study

Abstract

<jats:p>Background: Recently, the defects of the tooth surface in the cervical region are often restored using composite filling materials. It should meet the needs of the patients regarding esthetics and material stability. The aim of the study was to analyze the tooth root surface at the cervical region after the removal of the composite filling material by means of the Erbium-doped Yttrium Aluminium Garnet (Er: YAG) laser or drill using the scanning electron microscopy (SEM) and fluorescence microscopy. Materials and Methods: For the purposes of this study, 14 premolar teeth (n = 14) were removed due to orthodontic reasons. The rectangular shape cavities with 3 mm in width and 1.5 mm in height were prepared with a 0.8 mm bur on high-speed contra-angle in the tooth surface just below cemento-enamel junction (CEJ) and filled with the composite material. The composite material was removed with the Er: YAG laser at a power of 3.4 W, energy 170 mJ, frequency 20 Hz, pulse duration 300 μs, tip diameter 0.8 mm, air/fluid cooling 3 mL/s, and time of irradiation: 6 sec, at a distance from teeth of 2 mm (G1 group, n = 7) or a high-speed contra-angle bur (G2 group, n = 7). After the removal of composite material, the surfaces of teeth were examined using the scanning electron microscopy (SEM) and fluorescence microscopy. Results: The Er: YAG irradiation allowed to remove completely the composite material from the tooth cavity. The study confirmed, that the ends of collagen fibers were only partially denatured after the Er: YAG laser application. Conclusion: It has been proved that using the Er: YAG laser is an effective and safe method of composite removal for the dentin surface.</jats:p>

Dental Aerosol as a Hazard Risk for Dental Workers

“…That can indicate additional benefit in using erbium family lasers compared to CO 2 in terms of decreasing biohazard in the dental office [ 42 ]. Although the laser works through the water components vaporization in the target tissue, the explosion effect has a limited range; thus, the aerosol formed during this process is lower in contrast to traditional methods of caries removal [ 21 ]. This is a possible explanation of lower aerosol formation obtained during caries removal with the Er:YAG laser.…”

“…The positive effect of lasers in dentistry has been proven in the scientific literature regarding different treatment modality and eliminating the virus, bacteria, and fungi [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Some lasers produce an aerosol or induce a bubble formation in fluids (cavitation effect) [ 19 , 20 , 21 , 22 , 23 ]. The erbium lasers are widely used for different dental procedures, including caries removal, endodontic irrigation, periodontal and implant treatment or orthodontic brackets, or prosthetic crown debonding [ 19 , 24 , 25 , 26 , 27 ].…”

The Effect of Er:YAG Laser on a Shear Bond Strength Value of Orthodontic Brackets to Enamel—A Preliminary Study

“…One of the main problems that are still present in restorative dentistry is the achievement of an attachment between the composite materials and the enamel surface durable enough to maintain the long-term tightness of fillings and also reduces the risk of bacterial microleakage [ 8 , 10 ]. Composite bonds to the enamel surface as a result of shear bond strength that depends primarily on the type of the enamel surface, which can be modified in many ways.…”

“…The use of erbium family lasers has many advantages in conservative dentistry. These lasers allow cavity preparation (caries removal), caries prevention, a decrease of dentin hypersensitivity, decontaminate the tooth after caries removal, and are less painful during caries treatment [ 8 ]. In conservative dentistry, one of the alternative methods of modifying the enamel prismatic structure is using Er:YAG lasers [ 8 ].…”

“…These lasers allow cavity preparation (caries removal), caries prevention, a decrease of dentin hypersensitivity, decontaminate the tooth after caries removal, and are less painful during caries treatment [ 8 ]. In conservative dentistry, one of the alternative methods of modifying the enamel prismatic structure is using Er:YAG lasers [ 8 ]. By using erbium lasers, it is possible to prepare the tooth by creating the photothermal effect (vaporization) by heating up water contained in the tooth tissues.…”