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Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium–aluminum–garnet laser irradiation. A scanning electron microscopy study

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Abstract

The purpose of this study was to evaluate the effect of erbium:yttrium–aluminum–garnet (Er:YAG) laser (2.94 μm) irradiation on the removal of root surface smear layer of extracted human teeth and to compare its efficacy with that of citric acid, ethylenediamine tetra-acetic acid (EDTA), or a gel containing a mixture of tetracycline hydrochloride (HCl) and citric acid, using scanning electron microscopy (SEM). Thirty human dentin specimens were randomly divided into six groups: G1 (control group), irrigated with 10 ml of physiologic saline solution; G2, conditioned with 24% citric acid gel; G3, conditioned with 24% EDTA gel; G4, conditioned with a 50% citric acid and tetracycline gel; G5, irradiated with Er:YAG laser (47 mJ/10 Hz/5.8 J/cm2/pulse); G6, irradiated with Er:YAG laser (83 mJ/10 Hz/10.3 J/cm2/pulse). Electron micrographs were obtained and analyzed according to a rating system. Statistical analysis was conducted with Kruskal–Wallis and Mann–Whitney tests (P < 0.05). G1 was statistically different from all the other groups; no statistically significant differences were observed between the Er:YAG laser groups and those undergoing the other treatment modalities. When the two Er:YAG laser groups were compared, the fluency of G6 was statistically more effective in smear layer removal than the one used in G5 (Mann–Whitney test, P < 0.01). Root surfaces irradiated by Er:YAG laser had more irregular contours than those treated by chemical agents. It can be concluded that all treatment modalities were effective in smear layer removal. The results of our study suggest that the Er:YAG laser can be safely used to condition diseased root surfaces effectively. Furthermore, the effect of Er:YAG laser irradiation on root surfaces should be evaluated in vivo so that its potential to enhance the healing of periodontal tissues can be assessed.

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Acknowledgments

This work is attributed to the Center for Lasers and Applications, IPEN, São Paulo, Brazil, and Master in Lasers in Dentistry, IPEN/FOUSP, São Paulo, Brazil. The authors gratefully acknowledge Dr. Marie Oshiiwa from the Technology School (FATEC), Marilia, SP, Brazil, for data management, and Dr. Stephen Enrico Fucini, from the USA, for assistance in translating the paper.

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Authors and Affiliations

  1. Center for Lasers and Applications, Laboratory of Biophotonics Center for Lasers and Applications IPEN - CNEN/SP, Av. Lineu Prestes, 2242 Cidade Universitária- USP CEP, São Paulo, SP, 05508-000, Brazil

    Letícia Helena Theodoro & Denise Maria Zezell

  2. University Center of Education Foundation of Barretos (UNIFEB), Barretos, SP, Brazil

    Letícia Helena Theodoro

  3. Division of Periodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, SP, Brazil

    Valdir Gouveia Garcia, Maria José Hitomi Nagata & Juliano Milanezi de Almeida

  4. Division of Restorative Dentistry, Dental School of São Paulo, University of São Paulo (USP), São Paulo, SP, Brazil

    Patrícia Haypek & Carlos de Paula Eduardo

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  1. Letícia Helena Theodoro
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  2. Denise Maria Zezell
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  3. Valdir Gouveia Garcia
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Correspondence to Letícia Helena Theodoro.

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Theodoro, L.H., Zezell, D.M., Garcia, V.G. et al. Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium–aluminum–garnet laser irradiation. A scanning electron microscopy study. Lasers Med Sci 25, 485–491 (2010). https://doi.org/10.1007/s10103-009-0665-4

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