Effects of Er:YAG laser in caries treatment:A clinical pilot study

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Abstract
Various lasers have been suggested for cavity preparation. Pain reduction is expected as a potential benefit of laser usage. Among the systems studied in vitro, the Er:YAG laser offers a distinct combination of high ablation efficiency and low thermal side effects. Animal studies demonstrated that pulp damage can be avoided when appropriate laser parameters are used. The present prospective clinical study was intended to test the practical applicability of the system and to investigate the patient's response. The study population consisted of 67 teeth on 33 subjects. Patient's reaction to pain was documented in four categories: no pain, little pain (like a brief pressure to the tooth), medium pain (like needle sticks), and strong pain (like a thermal shock test). For superficial cavities 200 pulses (SD: 114) were needed. At a pulse repetition rate of 2 Hz, the preparation time was 1.6 min (SD: 2.1 min). Deeper cavities required 391 pulses (SD: 251), or approximately 3.3 min (SD: 2.1 min). No loss in pulp vitality was observed. In 36% of the laser-treated teeth, no pain was felt, and in 57%, little pain was reported. With one exception, no local anesthesia was needed. On the basis of this study, we suggest that the Er:YAG: laser can provide caries removal and cavity preparation in an adequate preparation time with minimal patient discomfort.