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Effects of root surface debridement using Er:YAG laser versus ultrasonic scaling: a SEM study

Seyed Reza Miremadi (UGent) , Jan Cosyn (UGent) , David Schaubroeck (UGent) , Niklaus P Lang, Roeland De Moor (UGent) and Hugo De Bruyn (UGent)
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Abstract
Objective : Despite promising results of Er:YAG laser in periodontal debridement, to date there is no consensus about the ideal settings for clinical use. This experimental clinical trial aimed to determine the effects of debridement using Er:YAG laser and to compare with ultrasonic treatment. Materials and Methods : 64 teeth, were divided into two in vivo and in vitro subgroups. Each tooth received ultrasonic treatment on one side and Er:YAG laser debridement at either 60 , 100, 160 or 250mJ/pulse and at 10Hz on the other side on a random basis. All samples were morphologically analyzed afterwards under scanning electron microscope for surface changes and dentinal tubules exposure. Treatment duration(d) was also recorded. Results : Laser debridement produced an irregular, rough and flaky surface free of carbonization or meltdown while ultrasound produced a relatively smoother surface. The number of exposed dentinal tubules (n) followed an energy-dependent trend. The number of exposed tubules among the in vivo laser groups was: n60mJ=n100mJ<n160mJ<n250mJ (p<0.001). Also 160 and 250mJ lasers led to significantly more dentinal exposure than ultrasound under in vivo condition. Within the in vitro laser groups, dentinal tubules exposure was: n60mJ<n100mJ<n160mJ<n250mJ (p≤0.0015). Furthermore in vitro laser treatments at 100, 160 and 250mJ led to significantly more dentinal denudation than ultrasound. Treatment duration (d) for the in vivo groups was: d60mJ>d100mJ>dUltrasound=d160mJ>d250mJ (p≤0.046), while for the in vitro groups it was: d60mJ>d100mJ=dUltrasound=d160mJ>d250mJ (p≤0.046). Conclusions : Due to excessive treatment duration and surface damage, Er:YAG laser debridement at 60 and 250mJ/pulse, respectively, is not appropriate for clinical use. Although laser debridement at 100 and 160 mJ/pulse seems more suitable for clinical application, compared to ultrasound the former is more time-consuming and the latter is more aggressive. Using a feedback device or lower pulse energies are recommended when using laser in closed field.
Keywords
Scanning Electron Microscope, Er:YAG laser, periodontology, NONSURGICAL PERIODONTAL TREATMENT, UP SPLIT-MOUTH, IN-VITRO, SUBSTANCE REMOVAL, SUBGINGIVAL CALCULUS, DENTIN HYPERSENSITIVITY, MECHANICAL DEBRIDEMENT, CEMENTUM THICKNESS, ERYAG LASER, EFFICACY

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MLA
Miremadi, Seyed Reza et al. “Effects of Root Surface Debridement Using Er:YAG Laser Versus Ultrasonic Scaling: a SEM Study.” INTERNATIONAL JOURNAL OF DENTAL HYGIENE 12.4 (2014): 273–284. Print.
APA
Miremadi, S. R., Cosyn, J., Schaubroeck, D., Lang, N. P., De Moor, R., & De Bruyn, H. (2014). Effects of root surface debridement using Er:YAG laser versus ultrasonic scaling: a SEM study. INTERNATIONAL JOURNAL OF DENTAL HYGIENE, 12(4), 273–284.
Chicago author-date
Miremadi, Seyed Reza, Jan Cosyn, David Schaubroeck, Niklaus P Lang, Roeland De Moor, and Hugo De Bruyn. 2014. “Effects of Root Surface Debridement Using Er:YAG Laser Versus Ultrasonic Scaling: a SEM Study.” International Journal of Dental Hygiene 12 (4): 273–284.
Chicago author-date (all authors)
Miremadi, Seyed Reza, Jan Cosyn, David Schaubroeck, Niklaus P Lang, Roeland De Moor, and Hugo De Bruyn. 2014. “Effects of Root Surface Debridement Using Er:YAG Laser Versus Ultrasonic Scaling: a SEM Study.” International Journal of Dental Hygiene 12 (4): 273–284.
Vancouver
1.
Miremadi SR, Cosyn J, Schaubroeck D, Lang NP, De Moor R, De Bruyn H. Effects of root surface debridement using Er:YAG laser versus ultrasonic scaling: a SEM study. INTERNATIONAL JOURNAL OF DENTAL HYGIENE. 2014;12(4):273–84.
IEEE
[1]
S. R. Miremadi, J. Cosyn, D. Schaubroeck, N. P. Lang, R. De Moor, and H. De Bruyn, “Effects of root surface debridement using Er:YAG laser versus ultrasonic scaling: a SEM study,” INTERNATIONAL JOURNAL OF DENTAL HYGIENE, vol. 12, no. 4, pp. 273–284, 2014.
@article{4375591,
  abstract     = {{Objective : Despite promising results of Er:YAG laser in periodontal debridement, to date there is no consensus about the ideal settings for clinical use. This experimental clinical trial aimed to determine the effects of debridement using Er:YAG laser and to compare with ultrasonic treatment.
Materials and Methods : 64 teeth, were divided into two in vivo and in vitro subgroups. Each tooth received ultrasonic treatment on one side and Er:YAG laser debridement at either 60 , 100, 160 or 250mJ/pulse and at 10Hz on the other side on a random basis. All samples were morphologically analyzed afterwards under scanning electron microscope for surface changes and dentinal tubules exposure. Treatment duration(d) was also recorded.
Results : Laser debridement produced an irregular, rough and flaky surface free of carbonization or meltdown while ultrasound produced a relatively smoother surface. The number of exposed dentinal tubules (n) followed an energy-dependent trend. The number of exposed tubules among the in vivo laser groups was: n60mJ=n100mJ<n160mJ<n250mJ (p<0.001). Also 160 and 250mJ lasers led to significantly more dentinal exposure than ultrasound under in vivo condition. Within the in vitro laser groups, dentinal tubules exposure was: n60mJ<n100mJ<n160mJ<n250mJ (p≤0.0015). Furthermore in vitro laser treatments at 100, 160 and 250mJ led to significantly more dentinal denudation than ultrasound. Treatment duration (d) for the in vivo groups was: d60mJ>d100mJ>dUltrasound=d160mJ>d250mJ (p≤0.046), while for the in vitro groups it was: d60mJ>d100mJ=dUltrasound=d160mJ>d250mJ (p≤0.046). 
Conclusions : Due to excessive treatment duration and surface damage, Er:YAG laser debridement at 60 and 250mJ/pulse, respectively, is not appropriate for clinical use. Although laser debridement at 100 and 160 mJ/pulse seems more suitable for clinical application, compared to ultrasound the former is more time-consuming and the latter is more aggressive. Using a feedback device or lower pulse energies are recommended when using laser in closed field.}},
  author       = {{Miremadi, Seyed Reza and Cosyn, Jan and Schaubroeck, David and Lang, Niklaus P and De Moor, Roeland and De Bruyn, Hugo}},
  issn         = {{1601-5029}},
  journal      = {{INTERNATIONAL JOURNAL OF DENTAL HYGIENE}},
  keywords     = {{Scanning Electron Microscope,Er:YAG laser,periodontology,NONSURGICAL PERIODONTAL TREATMENT,UP SPLIT-MOUTH,IN-VITRO,SUBSTANCE REMOVAL,SUBGINGIVAL CALCULUS,DENTIN HYPERSENSITIVITY,MECHANICAL DEBRIDEMENT,CEMENTUM THICKNESS,ERYAG LASER,EFFICACY}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{273--284}},
  title        = {{Effects of root surface debridement using Er:YAG laser versus ultrasonic scaling: a SEM study}},
  url          = {{http://dx.doi.org/10.1111/idh.12074}},
  volume       = {{12}},
  year         = {{2014}},
}

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