Equivalence of Er:YAG Laser and Ultrasonic Scaling for Calculus Removal
Vaderhobli R, White JM, Barr R, Pinzon LObjectives: To compare the effectiveness of calculus removal using ER:YAG laser with ultrasonic scaling on extracted teeth. Methods: 7 extracted teeth with heavy deposits of supra and subgingival calculus were randomly treated using ultrasonic scaling or ER:YAG laser (Lares Research, Chico, CA). The laser parameters were 35 mJ with 50 Hz, and 12 J/cm2 with 600 μm diameter contact tip and air/water spray (15 ml/min). Time required to remove calculus was recorded for ultrasonic scaling and laser. Optical microscope images (2x-4x) captured before and after treatment were graded by three calibrated blinded independent examiners for presence of calculus, removal of calculus, and surface alteration using standard indices (J Clin Perio, 1997:4:77-91). The treated root surfaces were embedded in resin and cross-sectioned (30 microns) and polished (n=21). Sections were examined under optical microscope (2x and 4 x) and graded based on presence of calculus, cementum and surface alteration. Time required to remove calculus were statistically compared using t-test and the treated surfaces were rank ordered non-parametrically. Results: There was no statistical difference in time between the two groups in removal of calculus (p=0.39). The average laser calculus removal time was 154 ± 40 seconds and ultrasonic scaling was 185 ± 78 seconds. Of the 7 laser samples tested, all had calculus removed, all had cementum remaining and 6/7 had no surface alteration with 1/7 having a surface alteration of 1 (minimal surface roughness areas with no obvious instrument marks). Of the 7 ultrasonic samples tested, all had calculus removed, all had cementum remaining and 5/7 had no surface alteration with 2/7 having a surface alteration of 1. Conclusion: Er:YAG laser calculus removal is equivalent to ultrasonic scaling for calculus removal, surface alteration and presence of cementum. This work is supported by research agreement with Lares Research, Chico, CA
