title: Achieving Dental Analgesia with the Erbium Chromium Yttrium Scandium Gallium Garnet Laser (2780 nm): A Protocol for Painless Conservative Treatment.
abstract: OBJECTIVE
  The aim of this research is to evaluate those techniques and optimal parameters of Erbium Chromium Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser use in delivering predictable painless (or with very limited discomfort) restorative cavity preparation without the aid of injected local anesthesia.
  
  
  METHODS
  This study was conducted on 30 patients (26 adults and 4 youth 9-16 years old; average age, 37) treated in a private practice. For each patient, a single cavity was prepared using the Er,Cr:YSGG laser (2780 nm). An Electric Pulp Tester (EPT) was used to monitor the changes in pulp sensibility threshold. The patient experience was tested before and after the treatment using a modified Visual Analogue Scale (VAS) and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) to evaluate pain and anxiety.
  
  
  RESULTS
  Pain analysis indicated that 80% of patients (24 out of 30) felt no pain and no discomfort, or only a very slight sensation. None of the 30 patients requested anesthesia. EPT was found to be unreliable in evaluating pulpal pain threshold levels. A tendency was noted wherein greater discomfort was felt by anxious patients. On average, the older the patient, the less discomfort was felt. The factors that have a greater tendency to promote discomfort were: posterior teeth, greater caries depth, greater use of higher power levels and ablation time.
  
  
  CONCLUSIONS
  Using the Er,Cr:YSGG laser, it was possible to avoid local anesthesia during cavity preparation with a bur. The treatment was effective in a high number of cases (80%), leading to reduction in the anxiety frequently associated with dental care.
authors.affiliation: Department of Surgical Sciences and Integrated Diagnostics, University of Genoa , Genoa, Italy .
authors.forename: Riccardo
authors.initials: R
authors.lastname: Poli
authors.affiliation: Department of Surgical Sciences and Integrated Diagnostics, University of Genoa , Genoa, Italy .
authors.forename: Steven
authors.initials: S
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia; D002648:Child; D003737:Dental Cavity Preparation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy; D008297:Male; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D055815:Young Adult