[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to screen CO(2) laser (10.6 μm) parameters to increase enamel resistance to a continuous-flow erosive challenge.
A new clinical CO(2) laser providing pulses of hundreds of microseconds, a range known to increase tooth acid-resistance, has been introduced in the market. Methods: Different laser parameters were tested in 12 groups (n=20) with varying fluences from 0.1 to 0.9 J/cm(2), pulse durations from 80 to 400 μs and repetition rates from 180 to 700 Hz. Non-lased samples (n=30) served as controls. All samples were eroded by exposure to hydrochloric acid (pH 2.6) under continuous acid flow (60 μL/min). Calcium and phosphate release into acid was monitored colorimetrically at 30 sec intervals up to 5 min and at 1 min intervals up to a total erosion time of 15 min. Scanning electron microscopic (SEM) analysis was performed in lased samples (n=3). Data were statistically analysed by one-way ANOVA (p<0.05) and Dunnett's post-hoc tests.
Calcium and phosphate release were significantly reduced by a maximum of 20% over time in samples irradiated with 0.4 J/cm(2) (200μs) at 450 Hz. Short-time reduction of calcium loss (≤1.5 min) could be also achieved by irradiation with 0.7 J/cm(2) (300μs) at 200 and 300 Hz. Both parameters revealed surface modification.
A set of CO(2) laser parameters was found that could significantly reduce enamel mineral loss (20%) under in vitro erosive conditions. However, as all parameters also caused surface cracking, they are not recommended for clinical use.
Photomedicine and laser surgery 03/2012; 30(6):331-8. DOI:10.1089/pho.2011.3175 · 1.58 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this paper we describe a novel, erbium laser-assisted whitening method, TouchWhiteTM, which pertains to chemical strategies for removing tooth stains by means of laser-activated aqueous gels or pastes. The TouchWhiteTM method makes use of the fact that the Er:YAG laser wavelength has a water absorption peak in the vicinity of 3 μm. Since water is the major component of the aqueous bleaching gels, this eliminates the need for any additional absorbing particles in the bleaching gels. More importantly, taking into account thermal burden considerations, the TouchWhiteTM procedure represents the most effective and least invasive laser-assisted tooth whitening method possible. Due to its high absorption in bleaching gels, the Er:YAG laser beam is fully absorbed in the gel and does not penetrate to the hard tissue or the pulp. All of the laser energy is thus effectively used for the heating of the gel. There is no direct heating of the dental tissue and the pulp, as is the case with other laser-assisted whitening methods. As a consequence, the procedure can be performed with a minimal undesirable thermal burden on the tooth, and the tooth whitening speed can be safely increased by 5 - 10 times.
[Show abstract][Hide abstract] ABSTRACT: The success of endodontic treatment depends on the effective elimination of microorganisms from the root canal, and lasers provide more effective disinfection than conventional treatment using rinsing solutions. The objective of this in vitro study was to determine the bactericidal effect of laser irradiation in dentine of various depths at a wavelength of 1,064 nm and pulse durations of 15 and 25 ms. A total of 90 dentine slices were cut from bovine incisors and divided into two groups (45 slices each) of thickness 500 and 1,000 μm. All were inoculated with a suspension of Enterococcus faecalis (5.07 × 10(9) bacteria/ml). Based on the clinically accepted dose (approximately 300 J/cm(2)), the following laser settings were chosen for this study: 1.75 W, 0.7 Hz for 4 s, three repetitions. The two groups were divided into two subgroups of 15 slices each to be irradiated with pulse durations of 15 and 25 ms. The remaining 15 slices per group were not irradiated to serve as a control. After irradiation, the colony-forming units (CFU) were counted and evaluated. To determine the bactericidal effect of irradiation with different pulse durations, the results in the different groups were compared statistically. For all irradiated subgroups a bactericidal effect was observed at pulse durations of 15 and 25 ms (p=0.0085 and p<0.0001). The corresponding average log kills were 0.29 (15 ms) and 0.52 (25 ms) for 500 μm and 0.15 and 0.3 for 1,000 μm, respectively. The results of this in vitro study showed that Nd:YAG laser irradiation with a pulse duration of 15 ms eliminated an average of 49% and 29% of E. faecalis at dentine depths of 500 μm and 1,000 μm, respectively, and irradiation with a pulse duration of 25 ms eliminated 70% (500 μm) and 50% (1,000 μm). However, these values are lower than those achieved with the established protocol using microsecond pulses.
Lasers in Medical Science 01/2011; 26(1):95-101. DOI:10.1007/s10103-010-0826-5 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: For medical applications, erbium lasers are usually equipped with articulated mirror arms or special glass fibers. However, only with mirror arms is it so far possible to transmit high average powers or pulse energies in the region of 1 J to achieve suitable energy densities for fast tissue preparation. An alternative to the glass fiber systems mentioned above are liquid-core light guides. An extremely flexible liquid-core light guide was used to connect a dental Er:YAG laser system to an especially adapted dental laser applicator. The core liquid was continuously circulated during laser irradiation to transmit pulse energies up to 1.1 J. A modified laser handpiece was used for exemplary clinical treatment. The experimental setup with the highly flexible light guide was completed successfully, and its ease of handling for a dental surgeon was demonstrated in the clinical treatment of leukoplakia of the oral cheek mucosa. Complete ablation of the epithelium with the laser was performed. One year postoperatively, the patient remains disease-free. This article describes the technical realization of a liquid-core light guide system for medical applications. We report about the first successful clinical treatment of oral hyperkeratosis using this new light guide technology.
Lasers in Medical Science 09/2010; 25(5):669-73. DOI:10.1007/s10103-010-0782-0 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The use of an erbium:YAG laser in arthroscopic surgery has the advantage of a precise treatment of soft tissue. Due to the high absorption in water, the laser energy is perfectly matched to smoothing the hydrous, fibrillated articular cartilage surface. In minimal invasive surgery, the workspace is filled with aqueous liquids for enlargement. This appears contrary to the absorption characteristics of erbium:YAG laser radiation in water. The purpose of this study was to evaluate the ablated volume per pulse of cartilage lesions and the potential side effects including thermal damage and tissue necrosis.
Twenty-four osteochondral specimens of porcine knee joints were irradiated with an Er:YAG laser completely submerged in water, with distances to the cartilage surface of 1, 3 and 5 mm and pulse durations of 75 and 100 microseconds. To keep a constant peak power of approximately 6 kW, pulse energies of 450 and 580 mJ were used at a pulse repetition rate of 15 Hz. After a histological preparation, ablated volumes, depths, and widths of the cuts were investigated. Additionally, laser protocols were correlated with different markers of cartilage tissue damage and apoptosis.
Ablation could be observed for every measurement. The influence of the distance showed a statistical significance (P < 0.001) for the volume, depth, and width of the cuts. For the pulse duration, statistical significance (P < 0.001) was found only for the volume and the depth. We observed no loss of proteoglycan or collagen type II. The total cell number, cell morphology, and number of apoptotic cells in an area close to the cutting edge and in a corresponding unaffected area of the same specimens revealed no differences regardless of the applied protocol.
The use of an Er:YAG laser demonstrates the successful application in liquid environments for cartilage removal without any damage of the surrounding tissue.
Lasers in Surgery and Medicine 11/2009; 41(9):674-85. DOI:10.1002/lsm.20848 · 2.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to determine the amount of intra-canal dentine removed with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser using different endodontic tips and different power settings. Ninety intact extracted bovine teeth were selected as samples. After sectioning the roots and preparing the testing cylinders, we divided the samples into three main groups (A, B, C), with further subdivision of each group to be irradiated with three different powers (1500 mW, 1750 mW and 2000 mW). An Er,Cr:YSGG laser system (2.78 microm, 140 micros, 20 Hz and 65% water to 35% air ratio) was used for irradiation, and the loss of intra-canal dentine mass was calculated by the difference between the initial and final sample masses. Data were analysed with Kolmogorov-Smirnov, analysis of variance (ANOVA) and Tukey tests. At a significance level of alpha = 1%, the results showed statistically significant differences (P < 0.0001) between different tip groups, regarding both the ablation rate and the ablation efficiency criteria. With regard to the three irradiation power settings, statistically significant difference were recorded only between groups C and A, for the ablation rate criteria. The intra-canal ablation ability of the Er,Cr:YSGG laser improved with increasing power and/or tip diameter. The latter exhibited a stronger influence on ablation rate and efficiency. Laser intra-canal ablation is an important addition to the field of endodontics; nevertheless, further investigations and system improvements are required.
Lasers in Medical Science 07/2009; 25(6):835-40. DOI:10.1007/s10103-009-0701-4 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The desire for perfect and white teeth can be accomplished in aesthetical dentistry by modern tooth bleaching methods. Within the scope of a clinical study, laser assisted in-office bleaching was applied to the teeth of 20 individual patients with a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (lambda = 1.064 microm, average power 4 W, pulse repetition rate 10 Hz, pulse duration 320 micros). The treatment was carried out in a split-mouth design, each patient having two appointments with 1 week in between. Laser activation of the bleaching agent was performed on teeth 14-11 and 34-31 per session, with a total irradiation time of 30 s per tooth. The initial and the final color of the teeth were ascertained by VITA Colorsticks and the dental chromatometer ShadeEye NCC. Whitening was detected in the laser-activated and in the non-activated quadrants. Statistical evaluation showed that the additional activation of the bleaching agent by the Nd:YAG laser had produced no significant influence on the whitening (P > 0.05). The results achieved in this study should be scrutinized critically. They give cause for one to reconsider the treatment conditions or the laser parameters used, or even to query the application of the Nd:YAG laser in general during in-office bleaching.
Lasers in Medical Science 05/2009; 25(4):503-9. DOI:10.1007/s10103-009-0675-2 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although CO(2) laser irradiation can decrease enamel demineralisation, it has still not been clarified which laser wavelength and which irradiation conditions represent the optimum parameters for application as preventive treatment. The aim of the present explorative study was to find low-fluence CO(2) laser (lambda = 10.6 microm) parameters resulting in a maximum caries-preventive effect with the least thermal damage. Different laser parameters were systematically evaluated in 3 steps. In the first experiment, 5 fluences of 0.1, 0.3, 0.4, 0.5 and 0.6 J/cm(2), combined with high repetition rates and 10 micros pulse duration, were chosen for the experiments. In a second experiment, the influence of different pulse durations (5, 10, 20, 30 and 50 micros) on the demineralisation of dental enamel was assessed. Finally, 3 different irradiation times (2, 5 and 9 s) were tested in a third experiment. In total, 276 bovine enamel blocks were used for the experiments. An 8-day pH-cycling regime was performed after the laser treatment. Demineralisation was assessed by lesion depth measurements with a polarised light microscope, and morphological changes were assessed with a scanning electron microscope. Irradiation with 0.3 J/cm(2), 5 micros, 226 Hz for 9 s (2,036 overlapping pulses) increased caries resistance by up to 81% compared to the control and was even significantly better than fluoride application (25%, p < 0.0001). Scanning electron microscopy examination did not reveal any obvious damage caused by the laser irradiation.
Caries Research 05/2009; 43(4):261-8. DOI:10.1159/000217858 · 2.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Seit nunmehr fast 20 Jahren werden Neodymium-Laser sowohl in der dentalen Praxis als auch in der Zahntechnik eingesetzt. In diesem Artikel werden die technisch-physikalischen Aspekte dieser Geräteklasse vorgestellt. Unter anderem werden die chemischen Eigenschaften des Laserkristalles und das allgemeine Funktionsprinzip beschrieben. Des Weiteren werden Lichtübertragungssysteme wie z. B. Fasern oder Spiegelgelenkarme sowie die zugehörigen Handstückausführungen erörtert.
[Show abstract][Hide abstract] ABSTRACT: This preliminary study was to investigate in vitro the Er,Cr:YSGG laser ablation capability, both range (enlargement aspects of laser tips corresponded to conventional endodontic files) and quality (removing of smear layer and opening of dentinal tubules) to clean and shape the root canal for final obturation step. The crowns of 15 extracted multi-rooted posterior human teeth were resected, and then 15 canals were prepared by an Er,Cr:YSGG laser up to 1.5 W (actual power output) using the step-back technique, while the other 15 canals (control) were enlarged conventionally by K-flex file. The results revealed that posterior root-canal preparation could be achieved by laser beam transmitted to the canal using endodontic tips. At a chosen significance level of alpha = 1%, the results showed no significant statistical difference between the two groups (P > 0.01). Considering the results of this current study, laser-based root-canal preparation still shows certain limitations, and further improvements are mandatory for higher achievement and better preparation outcomes.
Lasers in Medical Science 12/2007; 24(1):7-12. DOI:10.1007/s10103-007-0507-1 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this in vitro study was to evaluate the depth of effectiveness of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation on microorganism reduction. From human roots, dentin slices of 100 microm to 1,000 microm thickness were prepared. These specimens were sterilized and then inoculated with 1 microl of Enterococcus faecalis suspension. The backs of the specimens were then irradiated with Er,Cr:YSGG radiation at a pulse energy of 3.13 mJ, delivered at an incidence angle of 5 degrees to the dentin slice surface. A control group was left without irradiation. The remaining bacteria were collected in 1 ml sterilized NaCl solution, serially diluted and seeded in Columbia-Agar plates. Despite the low pulse energy of 3.13 mJ, the Er,Cr:YSGG laser irradiation resulted in significant bacterial reduction up to a dentin thickness of 500 microm (P < 0.05). Scanning electron microscopy (SEM) micrographs of the contaminated and irradiated surfaces showed the absence of a smear layer and opened dentinal tubules.
Lasers in Medical Science 12/2007; 24(1):75-80. DOI:10.1007/s10103-007-0522-2 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Different ideas have been presented to describe the mechanism of augmented laser ablation of dental enamel with different shapes by adding water to the working environment. In this study, the influence of water-laser interaction on the surface of enamel during ablation was investigated at a wavelength of 2.94 microm with different distances between the laser tip and the enamel surface. A motion-control system was used to produce linear incisions uniformly on flat enamel surfaces of bovine anterior teeth, with free-running Er:YAG laser very short pulses (pulse length = 90-120 micros, repetition rate = 10 pulses per second). Four different output energies (100, 200, 300 and 400 mJ) were radiated on samples under distilled water from different distances (0.5, 0.75, 1, 1.25, 1.75 and 2.00 mm). The tooth slices were prepared with a cutting machine, and the surfaces of the ablated areas were measured with software under a light microscope. The average and standard deviation of all cut areas in different groups were reported. There was no significant difference when using a different pulse ablation speed (cm(3)/J) and a water-layer thickness between the tip and enamel surface of 0.5-1.25 mm with energy densities of 30-60 J/cm(2) (200-400 mJ). However, using an output energy of 15 J/cm(2) (100 mJ) and a thicker water layer than 1 mm, a linear ablation did not take place. This information led to a clearer view of the efficiency of Er:YAG laser in the conditions of this study. There are several hypotheses which describe a hydrokinetic effect of Er,Cr:YSGG. These basic studies could guide us to have a correct attitude regarding hydro-mechanical effects of water, although the wavelength of 2.78 microm has a better absorption in hydroxyl branch of water molecules. Therefore, our results do not directly interrupt with the series of investigations done with Er,Cr:YSGG. Water propagation and channel formation under water are investigated during the ablation of tooth enamel with the Er:YAG laser from different distances. Comparing the results of this study with the same research done with water/air spray concludes that the bubble formation and channel propagation in water with this wavelength leads to a more symmetric (linear) ablation process with cavity-preparation-recommended parameters.
Lasers in Medical Science 11/2007; 23(4):451-7. DOI:10.1007/s10103-007-0508-0 · 2.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Die Dioden- oder Halbleiter-Laser haben sich als festes Therapieinstrument in der Endodontie, Parodontologie und der Chirurgie etabliert. Im Rahmen dieser Artikelserie werden die tech- nisch-physikalischen Aspekte dieser Geräteklasse vorgestellt und die Unterschiede eines Halbleiters zu einem Isolator und zu einem Leiter erörtert. Dazu erfolgt eine allgemeine Beschreibung des Funktionsprinzips. Die unterschiedlichen Betriebsarten von Dioden-Lasern werden beschrieben und ein neues Therapieverfahren zur Diskussion gestellt. Fermi energy, optical HF-surgery, Nomenclature
The diode or semiconductor lasers have been established as therapeutic instruments in endodontics, periodontics and surgery. Within the scope of this series of articles the techni- cal-physical aspects of this device class are introduced and the differences of a semiconductor to insulator and metal are discussed. In addition, a general description of the functio- nal principle is given. The different modes of operation of diode lasers are described and a new therapeutic procedure is discussed.
[Show abstract][Hide abstract] ABSTRACT: Seit nunmehr fast 20 Jahren werden Erbium-Laser in der dentalen Praxis eingesetzt. In diesem Artikel werden die technisch-physikalischen Aspekte dieser Geräteklasse vorgestellt. Unter an- derem werden die chemischen Eigenschaften der verschiedenen Laserkristalle und das allge- meine Funktionsprinzip beschrieben. Des weiteren werden Lichtübertragungssysteme wie Fasern, Hohlwellen oder Spiegelgelenkarme, sowie die zugehörigen Handstückausführungen erörtert. Das räumliche und das zeitliche Strahlprofil werden vor dem Hintergrund der biophy- sikalischen Abtragsprozesse diskutiert. Summary
For almost 20 years Erbium lasers are being used in dental offices around the world. In this article the technical and physical aspects of this group of laser systems are introdu- ced. The chemical properties of the various laser crystals and the general laser principle in these solid-state lasers is outlined. Light transmission systems like fibers, hollow wave guides, and articulated mirror arms as well as the corres- ponding handpieces are described. The spatial and tempo- ral laser beam profiles are discussed against the background of the biophysical tissue removal processes.
[Show abstract][Hide abstract] ABSTRACT: Der Kohlendioxid- oder auch CO2-Laser hat sich als chirurgisches Instrument in der Zahn- heilkunde etabliert. Auch bei der Behandlung von Leukoplakien hat sich dieser Lasertyp als ide- ales Therapieinstrument erwiesen. So werden auch im Rahmen dieses Themenheftes die tech- nisch-physikalischen Aspekte dieser speziellen Geräteklasse erläutert. Die unterschiedlichen technischen Realisierungsmöglichkeiten werden vorgestellt und das allgemeine Funktions- prinzip der klassischen Laserröhre beschrieben. The carbon diode laser had been established as a surgical instrument in dentistry as well as the tool of choice when removing leukoplakia. In the scope of this article the tech- nical-physical aspects of this class of lasers is explained. Different technical realizations of carbon dioxide lasers are introduced and the general principle of function within a classic laser discharge tube is described.
[Show abstract][Hide abstract] ABSTRACT: We apply a genetic algorithm to optimize the pump cavity of a complex miniaturized diode-pumped laser to find a balance between the efficient energy transfer of the pump light and the homogeneous illumination of the laser crystal. These two points are in contradiction to each other, whereby a complex optimization situation is given. The genome determines the geometry of the internal optical elements of the pump cavity in which a laser rod is placed. After optimization of the internal optical elements, a homogeneous illumination over the crystal length and a coupling efficiency of 59% were achieved. The results showed that genetic algorithms can find solutions and blueprints for laser pump cavities of consistent quality.
[Show abstract][Hide abstract] ABSTRACT: The theory of the ablation of dental hard tissue with erbium lasers is based on a process of thermomechanical interaction, which is explained by the absorption of the radiation in the water component of the tissue. The abrupt evaporation of the water is the cause of tissue fragments being blasted out of the tooth structure. The aim of this study is to examine the effect of the water contained in dental hard tissues on the efficiency of ablation. 192 specimens of both bovine dental enamel and bovine dentin are irradiated with an Er:YAG and an Er,Cr:YSGG laser. Half of the specimens are dehydrated beforehand. Irradiation is carried out in subgroups: without water spray and with water spray at flow rates of 0.8 and 3 mls. The ablated volume is determined following histological preparation. Only in dentin, and then only with irradiation with the Er:YAG laser, is the water contained in the tissue found to have a significant influence (p < 0.0001) on the ablated volume. The water content has no effect on the efficiency of laser ablation in any of the other test groups. In contrast, the externally supplied water always has a significant influence on the effectiveness of the ablation process.
[Show abstract][Hide abstract] ABSTRACT: The thermal rise threshold of an 810-nm semi-conductor diode laser on the root surface when used in root canals in vitro for laser assisted root canal treatment is investigated in this study. A total of 50 human single-rooted extracted teeth were included. For this study, the canals were enlarged up to an apical size of ISO#50 file. Laser irradiation was performed with six different settings. Specimens were irradiated at 0.6-1 W output power at the distal end of the fiber and about 1-1.5 W output power in the continuous mode (CW) as two groups. In the third group, 0.6-1 W output power, 10 ms pulse length (PL) and 10 ms interval duration (ID) were selected. In three other groups 1-1.5 W output power were used with different PL and ID as following: PL 10 and ID 10 ms, PL 10 and ID 20 ms and PL 20 and ID 20 ms. The total irradiation time was from 5 to 20 s per canal with a 200 mum in diameter and 25 mm long tip. After laser treatment, the temperature changes at the outer root surface were registered by means of NiCr-Ni measuring sensors and a T 202 thermometer. The safe temperature threshold for applying this diode laser in root canal is considered as 7 degrees C increase. To avoid increasing the temperature changes at the outer root surface related to this threshold, following total irradiation times were found: 0.6-1 W output power (10 ms PL/10 ms ID): 20 s (s), 1-1.5 W output power (10 ms/10 ms and 20 ms/20 ms): 15 s, 0.6-1 W output power CW and 1-1.5 W output power (20 ms PL/10 ms ID): 10 s and 1-1.5 W output power CW: 5 s. In the first three groups, 5 s irradiation and 5 s rest period avoided a temperature increase above the threshold of 7 degrees C).
Lasers in Medical Science 10/2005; 20(2):99-103. DOI:10.1007/s10103-005-0347-9 · 2.42 Impact Factor