Er:YAG Laser for Metal and Ceramic Bracket Debonding: An <i>In Vitro</i> Study on Intrapulpal Temperature, SEM, and EDS Analysis

Grzech‐Leśniak, Kinga; Matys, Jacek; Żmuda-Stawowiak, Dorota; Mroczka, K.; Dominiak, Marzena; Brugnera, Aldo; Gruber, Reinhard; Romanos, Georgios E.; Sculean, Anton

doi:10.1089/pho.2017.4412

Cited by 47 publications

(67 citation statements)

References 26 publications

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“…This study was one of the first to demonstrate the potential use of Er:YAG laser for glass fiber post removal. Er:YAG laser at 2940 wavelength used in this study selectively targets the water and residual monomer molecules in the luting cement and therefore leaves the surrounding dentin intact . This result was similar to what others have shown in removing bonded restorations from natural teeth .…”

Section: Discussionsupporting

confidence: 86%

“…Erbium–yttrium aluminum garnet (Er:YAG) laser has been used to assist in the removal of orthodontic brackets, porcelain veneers, and all‐ceramic crowns from natural teeth as well as all‐ceramic crowns from titanium implant abutments . The Er:YAG laser energy at 2940 nm wavelength targets and activates the monomer and water molecules resulting in debonding of composite resin cements.…”

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confidence: 99%

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Retrieval of Glass Fiber Post Using Er:YAG Laser and Conventional Endodontic Ultrasonic Method: An In Vitro Study

Deeb

Grzech‐Leśniak

Weaver

et al. 2019

Journal of Prosthodontics

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Purpose:To compare the times and temperatures used to remove a glass fiber post from an endodontically treated tooth using erbium-doped yttrium aluminum garnet (Er:YAG) compared to conventional endodontic ultrasonic method. Materials and Methods: Thirty-four single-root human extracted teeth were endodontically treated ex vivo. The post space was prepared to 7 mm in depth and a 11.4 mm glass fiber post was cemented using composite resin cement. Specimens were kept in 100% humidity for 24 hours and then randomly assigned to Er:YAG laser or ultrasonic methods for post removal. The removal time was recorded. Specimens with a fractured post during the removal process were excluded. The temperature on the external surface of the root was measured at the coronal, middle, and apical third portions during the laser or ultrasonic applications from 1 to 10 minutes. Data were analyzed using one-tailed t-test and paired t-test (ɑ = 0.01) for the post removal time and temperature difference, respectively. The specimen surfaces were examined using scanning electron microscopy (SEM).Results: Fifteen specimens were tested in each group. Four specimens were fractured, 2 in the laser and 1 in ultrasonic group. One post was excluded because of laser tip damage. The average removal time were 98 ± 46.1 seconds for Er:YAG laser and 538 ± 215.6 seconds or ultrasonic groups with significant difference between the groups (p < 0.001). The temperature (°C) ranges measured from 1 to 10 minutes were [24.2°, 27.3°] for laser and [33.0°, 38.0°] for ultrasonic in the cervical area, [22.1°,24.6°] for laser and [31.0°, 34.6°] for ultrasonic in the middle area, and [24.4°, 27.7°] for laser and [30.3°, 34.1°] for ultrasonic in the apical area. There were significant differences between temperatures for each treatment (p < 0.001). SEM examination showed no visible damage caused by treatment with Er:YAG laser. Conclusions: Er:YAG laser can remove posts up to 5 times faster than ultrasonic removal method. The laser causes lower temperature increase at the root surface compared to the ultrasonic removal. Er:YAG may be considered as a viable alternative to sonication for post removal.Endodontically treated teeth are often restored with post and core prior to crown or fixed restoration fabrication. Glass fiber posts have been used for over 2 decades with their annual survival rate of ß95%. 1 Glass fiber posts exhibit high flexural strength to maintain the core materials, but also elastic modululus values similar to dentin. 2-4 These mechanical properties promise the reduction in tooth fracture. 1-4 At the same time, the material translucency enhances esthetics. 5,6 The mechanical properties and retention of glass fiber posts can be further enhanced with the recently developed self-adhesive composite resin. 7,8 The application of adhesive cement may extend the longevity of an endodontically treated tooth with a glass fiber

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Section: Discussionsupporting

confidence: 86%

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confidence: 99%

Retrieval of Glass Fiber Post Using Er:YAG Laser and Conventional Endodontic Ultrasonic Method: An In Vitro Study

Deeb

Grzech‐Leśniak

Weaver

et al. 2019

Journal of Prosthodontics

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“…9 High-energy pulsed erbium lasers, such as erbium-doped yttrium aluminum garnet (Er:YAG) with 2940 nm wavelength and Er,Cr:YSGG with 2780 nm wavelength, have been used to remove fixed prostheses. 9,10 Laser irradiation activates water and monomer molecules in luting cement between the abutment and crown, and consequently disrupts the cement structure. [11][12][13] The peak absorption range of the water curve lies in the mid-infrared spectrum.…”

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confidence: 99%

“…11 This range is not absorbed by ceramic 11,12 or titanium materials of implant abutments or crowns. 11 Therefore, Er:YAG laser has been successfully used to debond various dental restorations and appliances, 14 including veneer restorations, 12 orthodontic brackets, 10 and crowns from natural teeth without damaging the restoration or causing excess thermal disturbance to the dental pulp. 15,16 However, limited information is available about the removal time or temperature changes when Er:YAG is used to remove a lithium disilicate crown 17 from a titanium implant abutment.…”

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In Vitro Examination of the Use of Er:YAG Laser to Retrieve Lithium Disilicate Crowns from Titanium Implant Abutments

Grzech‐Leśniak

Bencharit

Dalal

et al. 2019

Journal of Prosthodontics

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Purpose Removal of cement‐retained implant crowns can be difficult and often requires sectioning of the prosthesis by rotary instruments. This study aimed to measure how much time is required in crown removal and the temperature changes when erbium‐doped yttrium aluminum garnet (Er:YAG) laser was used to retrieve lithium disilicate crowns from titanium implant abutments luted with composite resin (CR) cement and resin‐modified glass ionomer (RMGI). Materials and Methods Forty identical lithium disilicate crowns were fabricated for prefabricated titanium abutments. CR and RMGI cements were used to lute the crowns, 20 specimens for each cement. Specimens were kept in 100% humidity for 48 hours. Er:YAG laser was then used to facilitate the crown retrieval. The retrieval time was recorded. The temperature changes at the abutment level for each type of cement were recorded during irradiation of 10 specimens for each type of cement from 1 to 10 minutes. Data were analyzed using t‐test (ɑ = 0.01) and paired t‐test (ɑ = 0.05). The surfaces of the crown and the abutment were further examined using scanning electron microscopy (SEM). Results The average times of crown removal from titanium abutments were 196.5 seconds for CR and 97.5 seconds for RMGI groups with statistical significance (p < 0.001). The temperatures measured from 1 to 10 minutes of irradiation ranged from 18° to 20.8° for CR and 18° to 23° for RMGI at the abutment surface, and 22.1° to 24.6° for CR and 22° to 24.8° for RMGI at the crown surface. No statistical differences were observed between temperature changes at the abutment or the crown for each cement (p = 0.63); however, there was a statistically significant difference between the temperatures at the abutment and crown for both cements (p < 0.001). SEM examination showed no visible damage caused by treatment with Er:YAG laser. Conclusions It is faster to remove lithium disilicate crowns from titanium implant abutments when luted with RMGI compared to CR cement. The temperature rise was higher in the crown compared to the abutment. The type of cement had no effects on temperature changes. Heat generated from Er:YAG irradiation does not appear to be high enough to have any adverse effect on implant osseointegration.

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“…The wide range of laser employment in orthodontics includes, e.g., soft tissue surgery [18,19], hard tissue surgery [20], orthodontic mini-implants insertion [21], accelerating of tooth movement [20], and bracket debonding [22]. Low-level laser therapy (LLLT) is adopted for the relief of pain in orthodontic treatment [23].…”

Section: Introductionmentioning

confidence: 99%

Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch—a randomized clinical controlled trial

Matys

Jaszczak²,

Flieger³

et al. 2019

Lasers Med Sci

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The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm 2 , power density per second 1.59 W/cm 2 , dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

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Er:YAG Laser for Metal and Ceramic Bracket Debonding: An In Vitro Study on Intrapulpal Temperature, SEM, and EDS Analysis

Abstract: Er:YAG laser-assisted debonding causes a minor increase in the pulp temperature and reduced the risk of enamel damage compared with conventional bracket removal.

Cited by 47 publications

References 26 publications

Retrieval of Glass Fiber Post Using Er:YAG Laser and Conventional Endodontic Ultrasonic Method: An In Vitro Study

Retrieval of Glass Fiber Post Using Er:YAG Laser and Conventional Endodontic Ultrasonic Method: An In Vitro Study

In Vitro Examination of the Use of Er:YAG Laser to Retrieve Lithium Disilicate Crowns from Titanium Implant Abutments

Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch—a randomized clinical controlled trial

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