Laser-aided ceramic bracket debonding: a comprehensive review

Different techniques have been introduced for the removal of ceramic brackets. Since the early 1990s, lasers have been used experimentally for debonding ceramic brackets. The goal of this study is to give a comprehensive literature review on laser-aided ceramic bracket debonding. PubMed and Google Scholar databases were used to identify dental articles with the following combination of key words: Ceramic brackets, Debonding, and Laser. Sixteen English articles from 2004 to 2015 were selected. The selected studies were categorized according to the variables investigated including the intrapulpal temperature, shear bond strength, debonding time, enamel damage and bracket failure. Most articles reported decreased shear bond strength and debonding time following laser irradiation without any critical and irritating increase in pulpal temperature. There were no reports of bracket failure or enamel damage. Laser irradiation is an efficient way to reduce shear bond strength of ceramic bracket and debonding time. This technique is a safe way for removing ceramic bracket with minimal impact on intrapulpal temperature and enamel surface and it reduces ceramic bracket failure

Surface treatment by different parameters of erbiumryttrium-aluminum-garnet [ENYAG] laser: scanning electron microscope [SEM] evaluation

Introduction: This study aimed to assess the Scanning Electron Microscope [SEM] analysis of tooth surface irradiated by erbium:yttrium-aluminum-garnet [EnYAG] laser with various parameters

Methods: Number of 25 extracted human third molars free of caries were used in this study.

The teeth were put into 5 groups for laser irradiation as follows: group 1 [power: 0.5 W, Energy: 50 mj]; group 2 [power: 1 W, Energy: 100 mj]; group 3 [power: 1.5 W, Energy: 150 mj]; group 4 [power: 2 W, Energy: 200 mj]; group 5 [power: 2.5 W, Energy: 250 mj]. All samples were prepared by repetition rate of 10 Hz and duration of 230 us, using a non-contact handpiece at a distance of 4 mm. Then, the samples were prepared for SEM examination

Results: SEM evaluation of every 25 samples, treated by EnYAG, showed that all groups had exposed dentinal tubules without any melted area or cracks

Conclusion: In this study we used SEM to investigate ablated dentine with different parameters of EnYAG laser energy. Our findings support these conclusions. All powers of laser below 3 W are proper for ablation, and make no cracks

Laser treatment of peri-implantitis: a literature review

Peri-implantitis is a state defined as an inflammatory reaction around osseointegrated implants, leading to progressive loss of supporting bone. Various treatment methods are suggested in the treatment of peri-implantitis and clinicians have to choose a method over a large number of treatment protocols. Lasers have shown promising therapeutic effect in treatment of peri-implantitis. However, some controversies have been found in clinical outcomes after using lasers. Therefore, we aimed to review the current literature over the past ten years for the use of lasers in treatment of peri-implantitis, via the Pubmed electronic database of the US National Library of Medicine. Fifteen human studies were reviewed. Er:YAG [Erbium-Doped Yttrium Aluminum Garnet], CO2[Carbon Dioxide Laser] and Diode lasers were used. Despite inconsistencies and disharmonies among studies in terms of study design, positive treatment outcomes were obvious among the majority of them. However, short period of follow-ups and poor control of plaque index, as a critical confounding factor, were the major problems which these studies suffered from. It seems that one session laser therapy is not adequate for achieving optimal clinical outcome. Further studies with longer periods of follow-ups, intense control of plaque index, and various sessions of laser treatments are needed to clearly illustrate the clinical privilege of laser therapy

Pyogenic granuloma: surgical treatment with Er:YAG laser

Pyogenic granuloma [PG] is a common tumor-like growth of the oral cavity, considered to be of non-neoplastic nature, often caused by constant low-grade trauma as well as poor oral hygiene and maybe due to hormonal disturbances. Surgical excision, and removal of underlying cause in some cases, is the preferred method of treatment as it is only a benign lesion. In order to remove this lesion, scalpel, cryosurgery and laser are used. Currently different lasers, with adequate parameters, are used for the surgery of PG, which include CO2 [Carbon Dioxide Laser], Nd:YAG [Neodymium-Doped Yttrium Aluminium Garnet], Diode and Er Family amongst others. In this present case, due to the proximity of the lesion with dental hard tissue, Er:YAG [Erbium-Doped Yttrium Aluminum Garnet] laser appears to be the more appropriate laser. The application of Laser is also a newly recommended technique. The aim of this study is to assess the stages of treatment, recovery and recurrence of PG when the Er:YAG laser is used. Furthermore this study aims to also evaluate the friendliness of this method with regards to the surgeon [therapist]. A 24-year-old female was referred to the Laser Research Center of Dentistry of Tehran University of Medical Sciences with a complaint of gingival overgrowth and bleeding. This lesion was in the buccal and palatal side of the 5 and 6 maxillary teeth. Treatment plan included an excisional biopsy of the lesion using Er:YAG laser [3W, 300mJ, 10Hz, Short pulse, with contact headpiece]. The bones were then cleaned of soft tissue before being smoothed using a curette. The excised specimen was preserved and sent for histopathological examination. The patient reported no pain after surgery and did not use any systemic antibiotics. The patient was satisfied after the surgery. Chlorhexidine mouthwash was given to the patient. Pathology results confirmed Pyogenic granuloma. After 2 weeks, complete healing was observed. The 9-month follow-up was also carried out in order to check the process of healing as well as the recurrence. Excisional surgery is the preferred treatment method for PG. The application of laser can be considered as an effective and safe technique for excision of this lesion with minimal invasion and many clinical advantages such as less intra-operative bleeding, hemostasis and reduced pain and times of healing