Comparison of Er:YAG laser and ultrasonic scaler in the treatment of moderate chronic periodontitis: a randomized clinical trial

Introduction: Periodontitis is an inflammatory periodontal disease that leads to tooth loss. Recently laser has been introduced as an alternative treatment for periodontitis. The aim of the present study was to compare the effect of Erbium-doped Yttrium Aluminum Garnet [Er:YAG] laser with ultrasonic scaler in patients with moderate chronic periodontitis

Methods: In this randomized single-blind clinical trial, 27 patients with moderate chronic periodontitis were selected. One quadrant of the patients was treated by Er:YAG laser and the other one by ultrasonic scaler. Clinical parameters, including periodontal pocket depth [PPD], papillary bleeding index [PBI] and clinical attachment level [CAL] were measured before, as well as 6 and 12 weeks after treatment. Data were analyzed by SPSS 20 software using Friedman test, paired t test, independent t test and Mann-Whitney test. The significance level was set at 0.05

Results: The means of clinical parameters in both groups were significantly improved in the first and second follow-ups [P < 0.001]. Although the means of PPD, PBI and CAL were slightly higher in the laser group than in the ultrasonic group, the differences were not statistically significant between these two groups [P > 0.05]

Conclusion: Although both ultrasonic scaler and Er:YAG laser could effectively improve clinical periodontal parameters, the results did not reveal the superiority of Er:YAG laser over ultrasonic scaler or vice versa

Effect of Nd:YAG laser irradiation on the number of open dentinal tubules and their diameter with and without smear of graphite: an in vitro study

Dentin hypersensitivity [DH] is characterized by tooth pain arising from exposure of dental roots. In this study the efficiency of neodymium yttrium-aluminum-garnet [Nd:YAG] laser in association with graphite on dentinal surface changes as the alternative to the treatment of DH was evaluated. Sixteen noncarious human third molars were collected and sectioned into 5 parts from cementoenamel junction [CEJ] to the furcation area. The prepared samples were randomly assigned into five groups [Gs] of each 16: Control [G1], treated by Nd:YAG laser at 0.5 W [G2], irradiation of Nd:YAG with a 0.25 W output power[G3], smeared with graphite and then using Nd:YAG laser at output powers of 0.5 W [G4] and 0.25 W [G5]. For all groups the parameters were 15 Hz, 60 s, at two stages and with a right angle irradiation. The number and diameter of dentinal tubules [DT] were compared and analyzed by SPSS software, One way ANOVA and Post hoc LSD tests. The number of open dentinal tubules varied significantly between all groups except among G1 with G3 and G2 with G5. Multiple comparison tests also exhibited significant differences regarding the diameter of tubules between the groups two by two except among G2 with G5. Nd:YAG laser used at 0.25 W and 0.5 W with application of graphite smear was able to reduce the number and diameter of dentinal tubules

Assessment of microleakage of class V composite resin restoration following erbium-doped Yttrium Aluminum Garnet (Er:YAG) laser conditioning and acid etching with two different bonding systems

The use of laser for cavity preparation or conditioning of dentin and enamel surfaces as an alternative for dental tissue acid-etch have increased in recent years. The aim of this in vitro study was to compare microleakage at enamel-composite and dentincomposite interfaces following Erbium-Doped Yttrium Aluminum Garnet [Er:YAG] laser conditioning or acid-etching of enamel and dentin, hybridized with different bonding systems. Class V cavities were prepared on the lingual and buccal surfaces of 50 recently extracted intact human posterior teeth with occlusal margin in the enamel and gingival margin in the dentin. The cavities were randomly assigned to five groups: group1:conditioned with laser [Energy=120mJ, Frequency=10Hz, Pulse duration=100 micro s for Enamel and Energy=80mJ, Frequency=10Hz, Pulse duration=100 micro s for Dentin] + Optibond FL, group2:conditioned with laser + etching with 35% phosphoric acid + Optibond FL, group3:conditioned with laser + Clearfil SE Bond, group 4 [control]:acid etched with 35% phosphoric acid + Optibond FL, group 5 [control]: Clearfil SE Bond. All cavities were restored using Point 4 composite resin. All samples were stored in distilled water at 37°C for 24 h, then were thermocycled for 500 cycles and immersed in 50% silver nitrate solution for 24 h. The teeth were sectioned bucco-lingually to evaluate the dye penetration. Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis. In occlusal margins, the least microleakage showed in groups 2, 4 and 5. The maximum microleakage was observed in group 3 [P=0.009]. In gingival margins, the least microleakage was recorded in group2, while the most microleakage was found in group 5 [P=0.001]. Differences between 5 study groups were statistically significant [P<0.05]. The microleakage scores were higher at the gingival margins. The use of the Er:YAG laser for conditioning with different dentin adhesive systems influenced the marginal sealing of composite resin restorations

Clinical evaluation of the efficacy of neodymium-doped Yttrium Aluminium Garnet [Nd: YAG] laser therapy and Sensikin[Registered] in treatment of dentine hypersensitivity

Dentine hypersensitivity [DH] is characterized by a short sharp pain arising from the exposed dentine, in response to a thermal, evaporative, tactile, osmotic or chemical stimulus. The aim of this study was to evaluate the efficacy of Nd:YAG laser therapy and desensitizing gel [Sensikin[Registered], Laboratorios Kin S.A., Barcelona, Spain] in treatment of dentine hypersensitivity. A total of 20 patients with at least 6 hypersensitive teeth were selected and divided randomly into three groups: Nd:YAG laser [10 HZ, 1W, 60 S, two times] treated group, Sensikin[Registered] treated group and a control group. Subjects were asked to apply the gel at home for the next week and 3 times a day as they were instructed. Assessment of the pain was performed by visual analyzing scale [VAS] after stimulation of the teeth by compressed air at 6 intervals: before treatment, immediately after treatment, one week, one, three and six months later. The data obtained were analyzed using the SPSS software, one way ANOVA and repeated measurement ANOVA tests. VAS scores did not show any significant differences between the three groups prior to treatment [P value>0.05], but in all groups after treatment VAS scores differed significantly in comparison to VAS scores before treatment [Pvalue<0.05]. This statistically significant difference in the control group demonstrated a placebo effect. However, the efficacy between the three groups was not significantly different. An overall comparison indicated no significant differences at various time intervals. Nd:YAG laser and desensitizing gel effectively reduce DH. However, we found no significant statistical differences between these two groups compared with the control group

Removal of smear layer by two endodontic irrigation solutions and erbium: yttrium, aluminum, garnet [Er:YAG] laser: a scanning electron microscope [SEM] study

The purpose of the present study was to determine the effect of 17% Ethylene, di-amine, tetra-acetic acid [EDTA], 6% phosphoric acid and Erbium: Yttrium, Aluminum, Garnet [Er:YAG] Laser in removing the smear layer by scanning electron microscopy. In this study, 80 single-rooted human teeth were selected. Instrumentation was done by use of hand files and step-back technique up to file #40 at apical and file #80 at coronal area. During instrumentation, 1ml of 5.25% sodium hypochlorite [NaOCl] was used as irrigation between each file. The teeth were randomly divided into four groups with different methods of smear removal.17% Ethylene, di-amine, tetra-acetic acid was used in group 1, 6% Phosphoric acid in group 2, Erbium: Yttrium, Aluminum, Garnet laser in group 3, and no intervention in group 4 [as control]. Roots were then longitudinally sectioned and prepared for scanning electron micrograph in cervical, middle and apical areas. Data were analyzed by Kruskal-Walis, Mann-Whitney, Friedman and Wilcoxson tests [P<0.05]. The results showed a significant difference in smear layer removal between three methods in favor of the EDTA [P<0.001] and Phosphoric groups [P<0.001] with no significant difference between them [P=0.49]. Although Er:YAG laser showed some limited ability to remove the smear layer, the effectiveness was not significantly different from the control group [P=0.157]. Based on the findings of this study, EDTA and Phosphoric acid were effective methods to remove smear layer from the root canal walls but Er:YAG laser showed less efficacy compared to the other experimental groups

Graphite application and different powers of neodymium-doped yttrium aluminium garnet [Nd:YAG] laser on dentin surface changes: a scanning electron microscopy study

Various methods have been used for the treatment of dentine hypersensitivity such as dentifrices, sealants and different types of lasers. The aim of this study was to evaluate the effect of Neodimium:Yttrium-Aluminium-Garnet [Nd:YAG] laser in association with graphite on the dentin morphologic changes. In this experimental in vitro study, 16 freshly extracted third molars were selected. 5 specimens with the dimensions of 2×2×1 mm from root trunk were prepared. Specimens were randomly divided into five groups: group 1 [control, no laser irradiation]. Group 2, 3 irradiated by Nd:YAG laser 0.5 and 1W, output power respectively. Group 4, 5 smeared with graphite and then irradiated by Nd: YAG laser 0.5 and 1W output power. Samples were prepared for scanning electron microscopy. Number and diameter of dentinal tubules were determined in different groups and analyzed with the Kruskal-wallis and Mann-Whitney tests [SPSS 16]. The number of tubules had significant difference between all groups [P<0.001], except group 1 in comparison with group 2 [P> 0.05], and group 3 in comparison with group 4 [P> 0.05]. Micro-cracks and rupture of melted dentin materials were seen in group 4 and 5. According to the findings of this study, smearing with graphite on dentin surface increase the absorption of Nd:YAG laser energy and reduced the diameter and number of open dentinal tubules

Effect of xanthan-based CHLO-SITE chlorhexidine gel with scaling and root planing on the treatment of periodontitis

Nowadays, various antibiotics and antiseptics are used as locally delivered adjuncts to scaling and root planing [SRP] in the treatment of periodontitis. The aim of this study was to evaluate the clinical efficacy of xanthan-based CHLO-SITE gel [xan-CHX] as a local adjunctive therapy to SRP in the treatment of moderate-to-severe periodontitis. In this controlled clinical trial, 6 patients with moderate-to-severe chronic periodontitis were selected. Each subject had at least three pockets 4-7 mm deep. Twenty-eight randomly selected pockets were assigned to the control group and 44 pockets were assigned to the test group. Scaling and root planing [SRP] procedures were carried out in all the pockets. In the test group, in addition to SRP, xan-CHL gel was injected into the pockets. Clinical indices [PPD, CAL, BOP, PI] before and three months after treatment were measured and evaluated by paired t-test, chi-squared and Kruskal- Wallis tests using SPSS software. At baseline, there were no significant differences between the control and experimental sites in relation to the indices measured. After 3 mouths, means of PPD and BOP in the experimental sites were significantly lower compared to control sites [p value

[Evaluation of the implant-bone interface integration using PRGF in the dog jaw]

It has been demonstrated that use of plasma rich in growth factors produces a dynamic surface on the implants, which accelerates the healing process. This study undertook a histologic and histomorphometric evaluation of the effect of platelet-rich growth factors [PRGF] on the amount of bone regeneration around dental implants. In this animal-intervention study, two systemically healthy Persian mix-breed dogs were selected. Three months after extraction of the dogs' mandibular premolars on both sides, 12 implants were selected from the OIC system with a length of 10 mm and a diameter of 5 mm. Six implants were placed in the osteotomy cavities using growth factors and 6 others were placed in the osteotomy cavities without PRGF. After 12 weeks, all the implants were removed along with the surrounding bone using Trephine bur. The samples were evaluated under a light microscope subsequent to sectioning. Data were analyzed with t-test and Mann-Whitney test [? = 0.05]. The results of the present study indicated that histologically, there was a significant increase in the amount of regenerated bone around the implants; moreover, thickness and maturity of bony trabeculae were not different in the samples containing PRGF in comparison with the control samples. According to the results, implant-bone interface integration rate around dental implants coated with PRGF was higher compared to the control group