Evaluation of Er:YAG lasers on pain perception in pediatric patients during caries removal: a split-mouth study

Abstract

OBJECTIVE: Fear and anxiety is a major problem in the treatment of pediatric patients. The pain that occurs during the use of caries removal instruments has a strong potential of triggering dental anxiety and fear in most children and adults. This study aimed to evaluate and compare the pain perceptions of children who underwent caries removal via an Er:YAG laser and traditional rotary instruments. MATERIALS AND METHOD: Occlusal caries was removed from the permanent molar teeth of 120 pediatric patients who referred to the Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University, using an Er:YAG laser and high-and low-speed rotary instruments. All restorative procedures were performed by one clinician. The participant children were asked to choose a value or figure from the Wong-Baker FACES Pain Rating Scale, and the data were analyzed using the Wilcoxon test (α=0.05). RESULTS: A statistically significant difference was found between the groups (p<0.05). In the Er:YAG laser group, 20.83% of the participants, and in the conventional group, 6.66% of the participants selected the option 'no hurt'. The option 'hurts worst' was selected in neither of the groups. CONCLUSION: The use of Er:YAG laser for caries removal causes less or no pain during the operations, compared to traditional rotary instruments. Therefore, it can be argued that Er:YAG laser is a more comfortable and acceptable alternative for pediatric patients.

Aplicaciones del láser de alta po-tencia en odontología pediátrica

“…Se ha demostrado que elimina el esmalte y la dentina mediante un rayo láser pulsado combinado con agua pulverizada, sin un aumento notable en la temperatura de la pulpa 1,3,8 . Varios estudios han demostrado que los profesionales y pacientes están optando por el uso del láser en comparación a los instrumentos rotatorios convencionales debido a que no generan dolor, ni sensibilidad al realizar la remoción del tejido dentario prescindiendo de la colocación de anestesia 1,3,7 . Además, el láser no emite el sonido propio de los instrumentos convencionales.…”

“…Además, el láser no emite el sonido propio de los instrumentos convencionales. 7 Los aspectos anteriores hacen que su aceptación y uso en la población pediátrica sea viable. 24 .…”

“…Los láseres de Erbio son efectivos para la preparación de cavidades debido a su alta absorción por el agua y la hidroxiapatita, lo que permite el corte del tejido dental duro, con menor vibración y dolor, por tanto, un mejor confort para el paciente, que lo hace muy atractivo para la odontopediatría 5,7,8 .…”

“…5 El láser Er:YAG resulta mejor al generar menos ruido y molestia al retirar el tejido duro. 7 Los autores del estudio refieren que las diferentes intensidades del uso del láser Er:YAG son seguras para la preparación de cavidades en dientes primarios 19 .…”

Acceptance of Laser Therapy Compared to Rotary Instruments for Cavity Preparation in Pediatric Patients: A Case Control Study

“…8 Literatürde, çocuklar ve erişkin hastalarda Er:YAG lazer ile kavite preparasyonlarının subjektif kabul edilebilirliğine dair çalışmalar bulunmaktadır. 6,[9][10][11][12] Çocuk hastaların dâhil edildiği çalışmalar sonucu elde edilen kanıtların yeterli düzeyde olmamasından dolayı bu çalışmada, çürük temizleme işlemlerinde kullanılan döner aletler ve Er,Cr:YSGG lazer ile çürük temizleme tedavisinin çocuk hastalar tarafından kabul edilebilirliğinin subjektif ve objektif parametreler kullanarak karşılaştırılması amaçlanmıştır. Yirmi hastadan toplam 40 adet alt daimi 1. molar dişin çürük kavitesi (n=40), aynı hastanın bir daimi 1. molar dişi (n=20) döner aletlerle, diğer daimi 1. molar dişin çürük kavitesi (n=20) ise Er,Cr:YSGG lazer (Waterlase MD, Biolase, ABD) ile temizlenmiştir.…”