SEM evaluation of the morphological changes in hard dental tissues prepared by Er: YAG laser and rotary instruments

Effective ablation of dental hard tissues by means of the erbium:yttrium-aluminum garnet (Er: YAG) laser has been reported recently, and its application to caries removal and cavity preparation has been expected. However, few studies have investigated the morphological changes in hard dental tissues after Er: YAG laser caries treatment. In the present study the morphological changes in hard dental tissues after Er: YAG laser caries ablation in vitro was compared with that of conventional mechanical treatment. Thirty extracted human teeth with caries were used. Ten tooth was treated with the Er: YAG laser, and the other was treated with a conventional steel and diamond burs. Laser treatment was performed by means of a non-contact irradiation modes with cooling water spray, with a new Er: YAG laser (LiteTouch). Conventional bur treatment was conducted by means of a low-speed micromotor and air turbine with water cooling. Scanning electron microscope (SEM) observations were performed for each treatment. The Er: YAG laser ablated carious dentin effectively with minimal thermal damage to the surrounding intact dentin, and removed infected and softened carious dentin to the same degree as the burtreatment. In addition, a lower degree of vibration was noted with the Er: YAG laser treatment. The SEM examination revealed characteristic micro-irregularities of the lased dentin and enamel surfaces with potential benefits for adhesive restorations. Our results show that the Er: YAG laser is promising as a new technical modality for caries treatment