yttrium, aluminum, garnet (Nd:YAG) laser using a 320 micron contact optic fiber handpiece with an energy setting of 80 mJ at 10 pulses per second for one minute.The fiber was held perpendicular to the root surface. An attempt was made to cover the entire root surface equally during the one minute of exposure. This was confirmed in a subsequent pilot study using lased, non-diseased root segments.A pilot study using photoacoustic spectroscopy on a iii laser charred root surface revealed the presence of a charged ion of ammonium and an altered phosphate to carbonate ratio as compared to a non-lased root segment.The presence of this charged ion of ammonium may have

The purpose of this study was to evaluate the effects of Nd:YAG laser treatment on root surfaces in vitro when used alone or in combination with conventional scaling and root planing. The study population consisted of 18 unerupted third molars, each with a 3 mm diameter treatment site outlined on the root surface. Three specimens were randomly assigned to each of 6 different treatment groups: 1) untreated control; 2) root planed only; 3) laser treated only using 1.25 W of energy; 4) laser treated only using 1.50 W of energy; 5) laser treated with 1.25 W of energy followed by root planing; and 6) laser treated with 1.50 W of energy followed by root planing. Following their respective treatment, all specimens were prepared for evaluation by scanning electron microscopy. Specimens from Group 2, root planed only, exhibited a smear layer of scale-like texture with parallel instrument tracks resulting from curet use. Specimens treated by laser only, Groups 3 and 4, featured various surface changes not observed in controls such as charring and carbonization of the cementum surface, randomly distributed pitting and crater formation, and melting of the root mineral phase with subsequent resolidification as porous globules. Those specimens treated by laser followed by root planing, Groups 5 and 6, exhibited surface characteristics similar to those noted in Group 2 specimens. Further, there were areas of exposed dentinal tubules resulting from a "peeling" of the cementum layer. The results of this in vitro study suggest that laser use during root preparation, even at relatively low energy levels, will result in physical changes to the root surface.(ABSTRACT TRUNCATED AT 250 WORDS)

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Accurate and reliable detection of subgingival calculus is a difficult skill which relies on subjective tactile sensations for determinations. This one year retrospective study examined the interrater agreement among a large, generalized pool of clinical examiners who scored residual subgingival calculus after student scaling. Four thousand one hundred and sixty tooth surfaces were analyzed for examiner agreement. Interrater reliability for all paired clinical ratings was low (Kappa = .33). A second, companion study evaluated accuracy and reliability using raters' assessments about the existence of simulated calculus on the root surfaces of manikin teeth. In the second study interrater reliability also was low (Kappa = .34); the true positive and true negative ratios were 49 percent and 88 percent respectively, while the false positive and false negative ratios were 12 percent and 51 percent. These data suggest that there is a need in periodontics for effective examiner calibration methodologies and objective subgingival calculus detection techniques.