J Periodontal Implant Sci.  2014 Oct;44(5):227-234. 10.5051/jpis.2014.44.5.227.

A comparative evaluation of CO2 and erbium-doped yttrium aluminium garnet laser therapy in the management of dentin hypersensitivity and assessment of mineral content

• Belal MH
• Yassin A

• KMID: 2027820
• DOI: http://doi.org/10.5051/jpis.2014.44.5.227

Abstract

PURPOSE
Dentin hypersensitivity is a potential threat to oral health. Laser irradiation may provide reliable and reproducible treatment but remains controversial. The present study aimed to evaluate the effects of CO2 or erbium-doped yttrium aluminium garnet (Er:YAG) laser therapy, and to assess mineral content.
METHODS
Eighteen human single-rooted teeth affected with advanced periodontitis were obtained. Buccal and lingual surfaces were planed to form 36 specimens. Ethylenediaminetetraacetic acid gel (24%) was applied to remove the smear layer and simulate hypersensitive teeth. The experimental groups were: group 1, control (no irradiation); group 2, CO2 laser (repetitive pulsed mode, 2 W, 2.7 J/cm2); and group 3, Er:YAG laser (slight contact mode, 40 mJ/pulse and 10 Hz). To evaluate dentinal tubule occlusion, six specimens per group (2-mm thickness) were prepared and observed using scanning electron microscopy (SEM) for calculation of the occlusion percentage. To evaluate the mineral content, six specimens per group (0.6-mm thickness) were used, and then the levels of Ca, K, Mg, Na, and P were measured by inductively coupled plasma-atomic emission spectrometry. In addition, the surface temperature of the specimens during laser irradiation was analyzed by a thermograph.
RESULTS
The SEM photomicrographs indicated melted areas around exposed dentinal tubules and a significantly greater percentage of tubular occlusion in the CO2 and Er:YAG laser groups than the control, and in the Er:YAG group than the CO2 laser group. In addition, no significant differences were noted among the experimental groups for the mineral elements analyzed. The CO2 laser group showed an evident thermal effect compared to the Er:YAG group.
CONCLUSIONS
CO2 and Er:YAG laser are effective in treating dentin hypersensitivity and reducing its symptoms. However, the Er:YAG laser has a more significant effect; thus, it may constitute a useful conditioning item. Furthermore, neither CO2 nor Er:YAG lasers affected the compositional structure of the mineral content.

Keyword

Dentin; Hypersensitivity; Laser; Minerals

MeSH Terms

Dentin
Dentin Sensitivity*
Edetic Acid
Humans
Hypersensitivity
Laser Therapy*
Lasers, Gas
Microscopy, Electron, Scanning
Minerals
Oral Health
Periodontitis
Smear Layer
Spectrum Analysis
Tooth
Yttrium*
Edetic Acid
Minerals
Yttrium

Figure

• 

  Figure 1 Scanning electron microscopy image of the root surfaces for the different experimental groups: (A-C) Group 1: control, clearly showed openings of the dentinal tubules with wide and funnel shaped orifices; (D and E) Group 2: the CO2 laser group, which generally showed a reduction in open dentinal tubules and reduced diameters when compared to the controls (×350 and ×700).

• 

  Figure 2 Scanning electron microscopy image of the root surfaces of group 3, which was treated by erbium-doped yttrium aluminium garnet laser. Narrowing of the orifices and a reduction in open dentinal tubules (A and B) as well as melting of the tubule orifices (C and D) can be noted (×350 and ×700).

• 

  Figure 3 Pie chart of the mean percentage of occluded tubules among the experimental groups. Er:YAG, erbium-doped yttrium aluminium garnet laser.

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