title: Caries removal in deciduous teeth using an Er:YAG laser: a randomized split-mouth clinical trial.
abstract: OBJECTIVE
  The aim of the present clinical randomized split-mouth study was to evaluate the effectiveness and efficiency of an Er:YAG laser for caries removal in primary molars, microbiological dentin analysis, and clinical restorations after 1 year in 29 children.
  
  
  METHODS
  The children's teeth were randomized into two groups: (I) an Er:YAG laser group and (II) a bur preparation group. The efficiency of the treatments (the time necessary for the removal of carious tissue) was evaluated based on the time spent on caries removal in the deciduous molars. The effectiveness (caries removal capacity) of the caries removal was determined by means of a blind test in which the examiner performed a tactile and visual examination of the dentin. Microbiological analysis was performed by counting the Streptococcus mutans and Lactobacillus sp in the remaining dentin. Clinical analysis of restorations was performed using the USPHS method in combination with photographs of restored teeth, 7 days after the restorative procedure and again after 1 year. All cavities were restored with the Adper Single Bond 2/Filtek Z350 system. The obtained data were analyzed with a significance level of 5 %.
  
  
  RESULTS
  The Er:YAG laser was less effective and had the same efficacy as bur preparation during caries removal at the pulpal wall of deciduous molars. In the surrounding walls, bur preparation was the more effective method. Regardless of the method employed, the affected dentin in the pulpal wall had similar amounts of S. mutans and Lactobacillus sp. The restorations were clinically accepted by the USPHS method over a 1-year period.
  
  
  CONCLUSIONS
  It can be concluded that caries removal with an Er:YAG laser has no influence on the clinical behavior of restorations.
  
  
  CONCLUSIONS
  Irradiation with an Er:YAG laser is appropriate for caries removal in primary teeth.
authors: Clinical Pediatric Dentistry Department, Ribeirão Preto School of Dentistry/ São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. roavalerio@hotmail.com.
authors: Rodrigo Alexandre
authors: RA
authors: Valério
authors: Clinical Pediatric Dentistry Department, Ribeirão Preto School of Dentistry/ São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. borsatto@forp.usp.br.
authors: Maria Cristina
authors: MC
authors: Borsatto
authors: Restorative Dentistry Department, Ribeirão Preto School of Dentistry/ São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. mcserra@forp.usp.br.
authors: Monica Campos
authors: MC
authors: Serra
authors: Clinical Pediatric Dentistry Department, Ribeirão Preto School of Dentistry/ São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. silvanapolizeli@hotmail.com.
authors: Silvana Aparecida Fernandes
authors: SA
authors: Polizeli
authors: Clinical Pediatric Dentistry Department, Ribeirão Preto School of Dentistry/ São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. marianaalencar@usp.br.
authors: Mariana Alencar
authors: MA
authors: Nemezio
authors: Department of Dental Materials and Prosthodontics, Araraquara Dental School, State Sao Paulo University, Humaitá, 1680 Street, Centro, Araraquara, SP, 14801-903, Brazil. rogallo@usp.br.
authors: Rodrigo
authors: R
authors: Galo
authors: School of Pharmaceutical Sciences of Ribeirão Preto, São Paulo University, Café Avenue, s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. airescp@fcfrp.usp.br.
authors: Carolina Patrícia
authors: CP
authors: Aires
authors: School of Pharmaceutical Sciences of Ribeirão Preto, São Paulo University, Café Avenue, s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. carolinarenan@hotmail.com.
authors: Ana Carolina
authors: AC
authors: Dos Santos
authors: Restorative Dentistry Department, Ribeirão Preto School of Dentistry/ São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil. silmaracorona@forp.usp.br.
authors: Silmara Aparecida Milori
authors: SA
authors: Corona
mesh_terms: D002648:Child; D003188:Composite Resins; D003731:Dental Caries / Q000382:microbiology / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000379:methods*; D003738:Dental Cements; D003793:Dental Restoration, Permanent; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D014094:Tooth, Deciduous; D016896:Treatment Outcome
chemical_list: C554641:Adper single bond 2; D003188:Composite Resins; D003738:Dental Cements; C533204:filtek Z350
keywords: Deciduous tooth; Dental caries; Effectiveness; Efficiency; Lasers; Microbiological