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Quintessence Publishing: Journals: JOLA


The Journal of Oral Laser Applications

Edited by Prof Dr Andreas Moritz and Prof G. Lynn Powell

Official publication of the European Society for Oral Laser Applications

ISSN (print) 1473-7809 • ISSN (online) 1867-5611

Fall 2006
Volume 6 , Issue 3

Pages: 181-186
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Efficiency and Effectiveness of Er:YAG Laser on Carious Tissue Removal

Messias, Danielle Cristine Furtado / de Souza-Gabriel, Aline Evangelista / Palma-Dibb, Regina Guenka / Rodrigues, Antonio Luiz / Serra, Monica Campos

Purpose: The aim of this study was to assess the efficiency (time necessary for carious tissue removal) and effectiveness (caries removal capacity) of the Er:YAG laser using different pulse repetition rates. Materials and Methods: Fifty-two slabs of carious human dentin were selected, fixed, and a 3-mm2 circular area was delimited. According to a randomized complete block design, specimens were assigned to 4 groups (n = 13): Er:YAG laser at three pulse repetition rates (2, 3, and 4 Hz) and carbide bur at low speed (control). Time to remove carious tissue was recorded, and 5 calibrated examiners checked the cavities through tactile and visual analysis. Results: Concerning the efficiency, Kaplan-Meier analysis demonstrated that the bur was faster than Er:YAG laser, regardless of the frequency. The Kruskal-Wallis test showed a significant difference among groups (p = 0.0001). The Wilcoxon test verified that all frequencies were significantly different from the mechanical bur (p < 0.0001) and that 2 Hz differed significantly from 4 Hz (p = 0.0042). In the analysis of efficacy, medians from five examiners’ judgments were used. Interexaminer agreement (Kappa) varied from 0.24 (fair) to 0.75 (substantial). The Student’s t-test did not demonstrate a significant difference between 4 Hz and carbide bur (p = 1.0000), but both presented greater effectiveness in carious tissue removal than 2 and 3 Hz. Conclusion: Mechanical drilling was more efficient than Er:YAG laser, regardless of the pulse repetition rate used. Er:YAG laser irradiation with 4 Hz presented similar effectiveness to the carbide bur in a low-speed handpiece.

Keywords: Er:YAG laser, carious dentin, caries removal, pulse repetition rate, efficiency, effectiveness

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