Clinical Evaluation of the Use of Er-YAG Laser in Different Hard and Soft Oral Tissues Treatment

Abstract

The recent laser technology is one of the major lines to resolve the clinical dental clinical problems. The problems in two main sections were divided, the hard tissue and the soft tissues problems. Er-YAG laser isonly one can be used for the hard and soft tissue. The performance of the mentioned laser was evaluated in hard and soft tissue in the dental clinic. Materials and methods ,The application of the Er-YAG laser (KaVoCo.) in hard tissue included 100 patients with fluences ranging between 25-30 J/ Cm2 .The patients were classified as fissure sealant (40 patients) , class I , class II , class V, (50 patients) . Bleeding pulp (10 patients) were treated with different fluences (4, 5, 6, 7, 8, 9 , and 10 J/Cm2) to stop bleeding. The patient was treated by laser in certain treatment was treated with conventional treatment in the same session to compare between two treatment. Thirty patients with oral soft tissue were Er-YAG laser treated with ranging fluences between 4-7 J/Cm2. 10 patients were treated as gingivectomy, 20 patients with different soft tissue lesions. The control measurements were depending on retrospective studies in the conventional surgery.the restrospective study were explained there are bleeding , pain postoperative , inflammation signs ,and range time consuming according to the kind of operation. Bacterial contamination of Er-YAG laser plume also evaluated. The comparative study points in hard tissue treatment were, pain through treatment and if needs anesthesia or not, duration time of the treatmentُ session. Laser knife in oral soft tissue lesions was compared with conventional surgery. The comparative points were bleeding, pain and duration operation time. The results: regarding fissure sealant, the Er-YAG laser is melting the groove in the occlusion surfaces of the teeth but the melting surfaces became not smooth. This porosity in the occlusal surfaces were good environment for microorganism. The result increased the caries incident when using instead of fissure sealant. In conservative application, the time was approximately 70% more than conventional time. There was pain through cavity preparation except the etching application. The safety precautions were highly different compared with conventional treatment. The safety precaution is much easy with conventional treatment. The Er-YAG laser is not suitable for direct pulp capping and it is contraindicated. This result is due unable of Er-YAG laser to stop of pulpal bleeding. In addition, increase laser fluences to high level developed pulpal inflammation. In laser soft tissue treatment, no need for anesthesia, take more time than conventional surgery ,no suitable in bloody area and large lesions. Due to laser knife, cutting the soft tissue layer by layer takes more time than surgical scalpel. Additionally, the bleeding in the operation site make the laser not effective in cutting due to optical properties of blood. No bacterial contamination through laser application in soft and hard oral tissue treatment were detected through laboratory examination. The detection technique called Kliglar Iron Agar test (K. I. R test) and this test based on effect of bacterial carbohydrate and hydrogen sulfide production through the growth of bacteria . The changing of color media from orange-red to yellow that due carbohydrate fermentation and the result is positive. The conclusions: Er-YAG laser is useful in, tooth conditioning instead of acid etching, Research work, Less contaminated in the laser plume than other lasers like CO2 laser. The Er-YAG laser is take more time in cavity preparation unless used Er-YAG laser working with 50-100 μs pulse width, not suitable in direct pulp capping, laser knife. In laser softtissue treatment, there is no need for injection anesthesia, take more time than conventional surgery ,no suitable in bloody area and large lesions.