title: Evaluation of blood cell attachment on Er: YAG laser applied root surface using scanning electron microscopy.
abstract: BACKGROUND
  Periodontal regeneration is dependent on the uninterrupted adhesion, maturation and absorption of fibrin clots to a periodontally compromised root surface. The modification of the root surface with different agents has been used for better fibrin clot formation and blood cell attachment. It is known that Er:YAG laser application on dentin removes the smear layer succesfully.
  
  
  OBJECTIVE
  The aim of this study is to observe blood cell attachment and fibrin network formation following ER:YAG laser irradiation on periodontally compromised root surfaces in comparison to chemical root conditioning techniques in vitro.
  
  
  METHODS
  40 dentin blocks prepared from freshly extracted periodontally compromised hopeless teeth. Specimens were divided in 5 groups; those applied with PBS, EDTA, Citric acid and Er:YAG. They were further divided into two groups: those which had received these applications, and the control group. The specimens were evaluated with scanning electron microscope and micrographs were taken. Smear layer and blood cell attachment scoring was performed.
  
  
  RESULTS
  In the Er:YAG laser applied group, smear layer were totally removed. In the blood applied specimens, better fibrin clot formation and blood cell attachment were observed in the Er:YAG group. In the group that had been applied with citric acid, the smear layer was also removed. The smear layer could not be fully removed in the EDTA group.
  
  
  CONCLUSIONS
  Er:YAG laser application on the root dentin seems to form a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies to support these results are necessitated.
authors.affiliation: Istanbul University Faculty of Dentistry Department of Periodontology, 34093 Capa Istanbul, Turkey. cekici@istanbul.edu.tr
authors.forename: Ali
authors.initials: A
authors.lastname: Cekici
authors.forename: Ilay
authors.initials: I
authors.lastname: Maden
authors.forename: Sercan
authors.initials: S
authors.lastname: Yildiz
authors.forename: Tangul
authors.initials: T
authors.lastname: San
authors.forename: Gulden
authors.initials: G
authors.lastname: Isik
mesh_terms: D001773:Blood Cells / Q000528:radiation effects / Q000648:ultrastructure; D002448:Cell Adhesion / Q000528:radiation effects; D021982:Cell-Matrix Junctions / Q000187:drug effects / Q000528:radiation effects; D003804:Dentin / Q000254:growth & development / Q000648:ultrastructure; D004871:Erbium / Q000737:chemistry; D005337:Fibrin / Q000378:metabolism; D006801:Humans; D053844:Lasers, Solid-State; D008855:Microscopy, Electron, Scanning; D012038:Regeneration; D014092:Tooth Root / Q000254:growth & development* / Q000528:radiation effects / Q000648:ultrastructure
chemical_list: D004871:Erbium; D005337:Fibrin
keywords: Erbium yag laser; In vitro; Periodontal regeneration; Scanning electron microscopy.