title: Effects of 2.94 microm Er:YAG laser radiation on root surfaces treated in situ: a histological study.
abstract: BACKGROUND
  Previous scanning electron microscopy (SEM) studies using extracted teeth have shown the potential of infrared Er:YAG laser radiation to remove subgingival calculus without causing severe thermal changes, e.g., charring or fusion, to the irradiated root surface. The purpose of the present study was to examine the morphologic changes on root surfaces following Er:YAG laser irradiation in situ using histological observation.
  
  
  METHODS
  The periodontal pockets of 6 premolars, canines, and incisors that remained in situ in the jaws of human corpses were irradiated with Er:YAG laser radiation at 60 mJ, 100 mJ, or 180 mJ. The pockets were treated in a similar manner to normal clinical circumstances with a total amount of either 50 or 100 laser pulses. Following laser treatment, the entire tooth, marginal gingiva, and underlying alveolar bone were removed from the jaw. The sections were embedded in methyl-methacrylate, serially cross-sectioned, stained with hematoxylin and eosin or gallamine blue, and examined under a light microscope. Additionally, the extension of the thermally changed tissue areas was determined using digital images and histometry.
  
  
  RESULTS
  The histological examination revealed two kinds of thermal changes within the laser-treated root surface. Firstly, a thin superficial layer 5 to 10 microm in width was observed. The surface of this layer showed ultrastructural irregularities. Secondly, a semicircular more deeply stained area close to the apical end of the scaling track beneath the irradiated cementum was observed. The depth of this area ranged from 255 microm to 611 microm and appeared to be independent of the radiation energy.
  
  
  CONCLUSIONS
  In contrast to previous SEM studies, the histological examination indicated thermal changes within the hard tissue bordering the periodontal pocket following Er:YAG laser irradiation.
authors.affiliation: Department of Operative Dentistry and Periodontology, Ludwig-Maximilians University, Munich, Germany. mfolwa@dent.med.uni-muenchen.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Folwaczny
authors.forename: Klaus-Ulrich
authors.initials: KU
authors.lastname: Benner
authors.forename: Barbara
authors.initials: B
authors.lastname: Flasskamp
authors.forename: Albert
authors.initials: A
authors.lastname: Mehl
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hickel
mesh_terms: D000538:Aluminum Silicates; D000539:Alveolar Process / Q000528:radiation effects; D001641:Bicuspid / Q000528:radiation effects; D002102:Cadaver; D004396:Coloring Agents; D003481:Cuspid / Q000528:radiation effects; D003739:Dental Cementum / Q000528:radiation effects; D012534:Dental Scaling / Q000379:methods*; D004871:Erbium; D005881:Gingiva / Q000528:radiation effects; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007180:Incisor / Q000528:radiation effects; D053685:Laser Therapy; D010514:Periodontal Pocket / Q000532:radiotherapy; D016613:Plastic Embedding; D019227:Tooth Apex / Q000528:radiation effects; D014092:Tooth Root / Q000528:radiation effects*; D015019:Yttrium
chemical_list: D000538:Aluminum Silicates; D004396:Coloring Agents; D015019:Yttrium; D004871:Erbium