title: Surface alterations of polished and sandblasted and acid-etched titanium implants after Er:YAG, carbon dioxide, and diode laser irradiation.
abstract: OBJECTIVE
  Laser treatment has become a popular method for resolving peri-implantitis, but the full range of its effects on implant surfaces is unknown. The purpose of the present investigation was to analyze the influence of different clinically applicable erbium:yttrium-aluminum-garnet (Er:YAG), carbon dioxide (CO2), and diode laser parameters on titanium surfaces that were either polished or sandblasted, large-grit, acid-etched (SLA).
  
  
  METHODS
  Six polished and six SLA titanium disks were irradiated at nine different power settings (n = 54 polished, 54 SLA) with Er:YAG, CO2, or diode lasers. The CO2 and diode lasers were used in continuous wave mode, and the Er:YAG laser was used in a pulsed manner. The surface of each disk was analyzed by scanning electron microscopy and confocal white light microscopy. Each disk was irradiated on six circular areas of 5 mm in diameter with the same specific laser setting for 10 seconds.
  
  
  RESULTS
  Within the chosen parameters, the CO2 and diode laser did not cause any visible surface alterations on either the polished or SLA disks. In contrast, both polished and SLA disks showed surface alterations when irradiated with the pulsed Er:YAG laser. The SLA surfaces showed alteration after 10 seconds of irradiation with Er:YAG laser at 300 mJ/10 Hz. The surfaces of the polished disks did not show alteration with the Er:YAG laser until they were irradiated at the higher energy of 500 mJ/10 Hz for 10 seconds. The results of confocal white light microscopy were in agreement with scanning electron micrographs.
  
  
  CONCLUSIONS
  In contrast to continuous-wave diode and CO2 laser irradiation, pulsed Er:YAG laser irradiation caused distinct alterations with power settings beyond 300 mJ/10 Hz on the SLA surface and 500 mJ/10 Hz on the polished surface. Thus, it is only safe to use the Er:YAG laser for implant surface irradiation with settings no higher than 300 or 500 mJ/10 Hz.
authors.affiliation: Hightech Research Center of Cranio-Maxillofacial Surgery, University of Basel, Basel, Switzerland. stefan.stuebinger@cabmm.uzh.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Stubinger
authors.forename: Christof
authors.initials: C
authors.lastname: Etter
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Miskiewicz
authors.forename: Frank
authors.initials: F
authors.lastname: Homann
authors.forename: Belma
authors.initials: B
authors.lastname: Saldamli
authors.forename: Marco
authors.initials: M
authors.lastname: Wieland
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
mesh_terms: D000134:Acid Etching, Dental; D020906:Air Abrasion, Dental; D015921:Dental Implants; D003775:Dental Polishing; D054020:Lasers, Gas; D054023:Lasers, Semiconductor; D053844:Lasers, Solid-State; D016014:Linear Models; D008855:Microscopy, Electron, Scanning; D013499:Surface Properties / Q000528:radiation effects; D014025:Titanium / Q000528:radiation effects*
chemical_list: D015921:Dental Implants; D014025:Titanium