Fluorescence-controlled Er:YAG laser for caries removal in permanent teeth: a randomized clinical trial.
The aim of this randomized clinical study was to compare the efficacy of a fluorescence-controlled erbium-loaded yttrium aluminum garnet (Er:YAG) laser with conventional bur treatment for caries therapy in adults. Twenty-six patients with 102 carious lesions were treated using either the Er:YAG laser, at threshold levels of 7, 8, 9, and 10 [U], or rotary burs. Both techniques were applied to each lesion at separate locations. After treatment, dentine samples were obtained using a carbide bur. The viable counts of Streptococcus mutans (SM) and lactobacilli (LB) [expressed as colony-forming units (log10 CFUs)], treatment time, pain, vibration, and sound intensity were determined. The median numbers of CFUs for SM and LB were not statistically different between laser and bur treatment at threshold levels 7 and 8 [U]. At threshold levels 9 and 10 [U], the median number of CFUs for LB [1.11 (range: 0.00-2.04)] were significantly higher following laser treatment than following bur treatment [0.30 (range: 0.00-0.60)]. The results indicate that treatment with a fluorescence-controlled Er:YAG laser at threshold levels of 7 and 8 removed caries to a level similar to that achieved using conventional bur treatment, with clinically irrelevant amounts of remaining bacteria. Although more time consuming, laser treatment provided higher patient comfort than bur treatment.
Dommisch
Henrik
H
Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany. Henrik.Dommisch@ukb.uni-bonn.de
Peus
Katja
K
Kneist
Susanne
S
Krause
Felix
F
Braun
Andreas
A
Hedderich
Jürgen
J
Jepsen
Søren
S
Eberhard
Jörg
J
D000328:Adult; D015169:Colony Count, Microbial; D003731:Dental Caries / Q000382:microbiology / Q000628:therapy*; D003732:Dental Caries Activity Tests; D003737:Dental Cavity Preparation / Q000295:instrumentation* / Q000379:methods; D003755:Dental High-Speed Technique; D003804:Dentin; D005260:Female; D005453:Fluorescence; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000302:isolation & purification; D013997:Time Factors