Janka Ohlasova: Evaluation of Er:YAG Efficacy in Carious Cavity Decontamination - Clinical Study
Modern procedures in dentistry have a tendency to be less invasive and more patient-friendly. LASER cavity preparation offers a significant reduction in pain and a lack of vibration, providing a significant advantage.
Objective: The aim of this study was to compare the efficacy, duration and pain perception of Er:YAG laser with a conventional burr for cavity decontamination and removal of carious dentin.
Materials and Methods: A comparable in vivo study was performed on 40 cavities in permanent premolars and molars. Cavities were divided in two groups of 20. In the laser Group L, enamel and dentin were ablated by Er:YAG (250 mJ, 20 Hz 100 ms / 150 mj, 12 Hz, 300 ms / 70 mJ, 10 Hz, 300 ms with water/air cooling). In Group B, the enamel was removed with diamond abrasive and the dentin was excavated with low-speed carbide bur. Cavity decontamination was verified using a fluorescent caries detection system (FACE®). MALDI-Tof analysis was used to identify the species of Genus Lactobacillus.
Results: Microbiological semi-qualitative analysis showed a higher growth reduction of the cariogenic bacteria Streptococcus mutans and Lactobacillus spp. in group L. No growth of bacteria colonies was observed in group L in 14 cavities (p-value = 0.0170) out of 20. In all 20 cavities (p-value = 0.0035) of group B, there was bacteria growth after cavity excavation. The growth of bacteria before and after removal of carious dentin was more abundant in group B. MALDI-tof identification distinguished Lactobacillus paracasei.
Conclusion: The average reduction of cariogenic bacteria Streptococcus mutans and Lactobacillus spp. was higher after the laser treatment. Laser preparation lasted almost twice as long but was more pleasant for the patients.
