• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.15-24
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• 2003

The purpose of this study is to investigate the sterilization effect of Er:YAG laser against the intraoral acid producing bacterium, S. mutans, by irradiating the culture solution containing S. mutans KCTC 3065 with Er:YAG laser having a $650{\mu}m$ diameter beam through the non-contact method. We obtained the following results after examining the temperature changes of the culture solution, numbers of bacterial colonies, and acid-producing ability and attaching ability on teeth by measuring the amount of extracellular polysaccharide produced by S. mutans. The number of bacterial colony was decreased in $10{\mu}l$ culture solution irradiated with laser in overall compared to the control solution. The number decreased as the irradiation intensity and pulse repetition rate were larger and as the exposure time was increased. However, it did not change significantly in $100{\mu}l$ culture solution compared to the control solution. Although the acid-producing ability of S. mutans was inhibited for a certain duration after laser irradiation in 10r1 bacterial culture solution, it did not change in $100{\mu}m$ solution compared with the control solution. The amount of extracellular polysaccharide synthesized by S. mutans was partially decreased through laser irradiation in $10{\mu}m$ culture solution but did not change in $100{\mu}m$ culture solution. Based on these findings, we concluded that Er:YAG laser has an sterilization effect on S. mutans in which we presume that the mechanism is through the heat effect rather than the mechanical effect from development of ultrasound.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.457-464
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• 2005

The purpose of our study was to investigate whether the intrapulpal temperature during cavity preparation of enamel or dentin with Er:YAG laser still remained in range of safety for dental pulp protection when combined with appropriate water flow rate. The effect of different pulse repetition rates at the same pulse energy during ablation was evaluated as well. Caries-free, restoration-free extracted human molar teeth were prepared for the specimen and divided two experimental groups of enamel and dentin. Each group comprised 5 specimens and each of tooth specimens were embedded into a resin block each and measuring probe was placed on the irradiated pulpal walls. For experiments of dentin ablation, enamel layers were prepared to produce dentin specimen with a same dentin thickness of 2 mm. A pulse energy of Er:YAG laser was set to 300 mJ and three different pulse repetition rates of 20 Hz, 15 Hz and 10 Hz were employed. Laser beam was delivered with 3 seconds and less per application over enamel and dentin surfaces constant sized by $3\;mm{\times}2\;mm$ and water spray added during irradiation was a rate of 1.6 ml/min. Temperature change induced by Er:YAG laser irradiation was monitored and recorded While enamel was ablated, there was no significant difference of temperature related to pulse repetition rates(p=0.358) and temperature change at any pulse repetition rate was negligible. Significant statistical difference in temperature changes during cavity preparation in dentin existed among three different pulse groups(p=0.001). While temperature rise was noticeable when the dentinal wall was perforated, actual change of temperature due to Er:YAG laser irradiation was not enough to compromise safety of dental pulp when irradiation was conjugated with appropriate water spray. Conclusively, it can be said that cavity preparation on enamel or dentin with an Er:YAG laser is performed safely without pulp damage if appropriate volume of water is sprayed properly over the irradiated site.

• Restorative Dentistry and Endodontics
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• v.36 no.5
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• pp.409-418
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• 2011

Objectives: The purpose of this study was to compare the microshear bond strength (${\mu}$SBS) and bonding interfaces of two-step total-etching and self-etching adhesive systems to three etch types of dentin either the acid etched, laser etched or laser and acid etched. Materials and Methods: The occlusal dentinal surfaces of thirty human molars were used. They were divided into six groups: group 1, 37% $H_3PO_4$ + Single Bond 2 (3M ESPE); group 2, Er:YAG laser (KEY Laser 3, KaVo) + Single Bond 2; group 3, Er:YAG laser + 37% $H_3PO_4$ + Single Bond 2; group 4, Clearfil SE Primer + Bond (Kuraray); group 5, Er:YAG laser + Clearfil SE Bond; group 6, Er:YAG laser + Clearfil SE Primer + Bond. The samples were subjected to ${\mu}$SBS testing 24 hr after bonding. Also scanning microscopic evaluations were made on the resin-dentin interfaces of six specimens. Results: The ${\mu}$SBS of group 2 was significantly lower than that of groups 1 and 3 in Single Bond 2 (p < 0.05). There were significant differences among the uSBS of groups 4, 5, and 6 in Clearfil SE Bond (p < 0.05). Very short and slender resin tags were observed in groups 2 and 5. Long and slender resin tags and lateral branches of tags were observed in groups 3 and 6. Conclusions: Treatment of dentin surface using phosphoric acid or self-etching primer improved the adhesion of Er:YAG lased dentin.

• Journal of Oral Medicine and Pain
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• v.24 no.4
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• pp.411-420
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• 1999

과거 수십년간 여러 가지 다른 레이저를 이용한 치아경조직에 대한 몇 가지의 생체외적 실험이 이루어졌다. 그러나 그 결과는 좋지 못하였다. 그러한 주 문제는 열작용이었다. 미국 식품의약국(FDA)에서 사용하도록 허가된 Er:YAG 레이저는 인간의 생체 치아를 삭제할 수 있는 최초의 레이저이다. 치아 삭제가 열작용의 원리에 의해 이루어지기는 하지만, 경조직의 미세폭발에 의하기 때문에 주변의 경조직과 연조직에 미치는 열작용은 거의 없다. 본 연구에서는 최근 국내에서 최초로 개발된 Er:YAG 레이저를 사용하여, 상아질과 법랑질에 일회 조사시 다양한 에너지 수준에 따른 삭제율을 연구하였다. 건조된 10개의 치아가 선택되었으며, 각각은 에폭시 레진에 포매되어 경화되었다. 그 후 다섯 개의 치아는 저속회전 다이아몬드 휠로써 교합면 삭제를 통해 상아질이 노출되었으며, 나머지 다섯 개의 치아는 협측 혹은 설측을 삭제하여 평평한 표면의 법랑질을 만들도록 하였다. 준비된 상아질과 법랑질 치아의 표면은 각각의 에너지 수준의 레이저를 조사할 6개의 구획으로 나누어 표본으로 삼았다. 상아질과 법랑질 표본은 에너지 수준에 따른 5개의 실험군(40 mJ, 80 mJ, 120 mJ, 160 mJ, 200 mJ)으로 나누어 그 삭제율을 분석하였다. 삭제된 부피는 삼차원 영상 표면분석기로 측정하였으며, 통계적으로 분석하였으며, 그 결과는 다음과 같다. 1. 상아질과 법랑질간의 삭제율의 차이는 통계적으로 유의한 차이가 있었다(p<0.0001). 2. 에너지 수준에 따른 삭제율의 차이는 통계적으로 유의한 차이가 있었다(p<0.0001). 3. 각각의 에너지 수준에서 상아질과 법랑질간의 삭제율의 차이는 통계적으로 유의한 차이가 있었으나(p<0.05), 40 mJ과 80 mJ에서는 유의한 차이를 보이지 않았다. 4. 상아질에서 각각의 에너지 수준 간의 삭제율이 유의한 차이를 보였으나(p<0.01), 160 mJ과 200 mJ간에는 삭제율의 유의한 차이가 없었으며, 법랑질에서도 각각의 에너지 수준 간의 삭제율이 유의한 차이를 보였으나(p<0.01), 120 mJ, 160 mJ, 200 mJ 간에 유의한 차이를 보이지 않았다. 본 연구에서는 건조된 치아에 다양한 에너지 수준의 Er:YAG 레이저를 적용했을 경우 상아질과 법랑질의 삭제 부피를 연구하여 정량화 및 통계적 분석을 하였다. 그 결과, Er:YAG 레이저는 치아경조직의 삭제에 매우 유용하였으며, 앞으로도 이를 임상적으로 널리 이용하기까지 좀더 다양하고 심화된 연구가 필요할 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• v.30 no.3
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• pp.375-381
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• 2005

Er:YAG laser has been considered a promising alternative to dental drill and many researches indicate that adjustment to variable parameters, including water flow rate, pulse energy and pulse repetition rate, can be made to improve ablation ability and efficiency of the laser. Of these parameters, addition of water spray during irradiation has been thought to ablate dental hard tissue more rapidly and safely. The purpose of this study was to investigate tooth ablation amount by Er:YAG laser irradiation as related to varied water flow rates added and, ultimately to find the most effective water flow rate for ablation. In addition, the temperature change of pulp chamber during irradiation was also monitored on the irradiated and opposite pulpal walls, respectively. An Er:YAG laser with contact mode was employed. Extracted human molars were split into two pieces for ablation experiment. Pulse energies of 200 and 300 mJ with a pulse repetition rate of 20 Hz and 5 water flow rates (1.6, 3.0, 5.0, 7.0, and 10.0 ml/min) were applied. Each irradiation was performed for 3 seconds. According to these parameters, experimental groups were divided into 10 subgroups which consisted of 5 specimens. For temperature experiment, another 5 tooth-specimens were prepared in the manner that pulp chamber was open through access cavity preparation and two temperature-measuring probes were placed respectively on the irradiated and the opposite walls of pulp chamber. From the experiment on ablation amount related to different water flow rates, it was shown that the least water flow rate of 1.6 ml/min ablated more than any other water flow rates (p<0.000). When the irradiation for 3 seconds, combined with the pulse repetition time of 20Hz and the water flow rate of 1.6 ml/min was done to tooth specimen, the temperature rise was not noticeable both on the irradiated and the opposite pulpal walls (less than 3$^{\circ}C$) and there was no significant difference in temperature rise between the two pulse energies, 200 and 300 mJ. From the results of this study, it is suggested that tooth ablation with Er:YAG laser can be done effectively and safely at a energy between 200 and 300 mJ/pulse and a pulse repetition rate of 20 Hz when the lasing is conjugated with the water flow rate of 1.6ml/min.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.223-229
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• 2006

The objectives of this study was to investigate the amount of tooth ablation and the change of intrapulpal temperature by Er:YAG laser as it relates to pulse energy and pulse repetition rate at the identical power and, thereby, to reveal which of the two parameters strongly relates with ablation efficiency and intrapulpal temperature. Extracted healthy human molar teeth were sectioned into two pieces and each specimen was irradiated within the combination of pulse energy and pulse repetition time at the same power of 3W; $300mJy{\times}10Hz$ group, $200mJy{\times}15Hz$ group, and $150mJy{\times}20Hz$ group. Each specimen comprised ten tooth specimens. A laser beam with conjunction of a water flow rate of 1.6 ml/min was applied over enamel surfaces of the specimens during 3 seconds and the ablation amount was determined by difference in weight before and after irradiation. To investigate the temperature change in the pulp according to the above groups, another five extracted healthy human molar teeth were prepared. Each tooth was embedded into resin block and the temperature-measuring probes were kept on the irradiated and the opposite walls in the dental pulp during lasing. When the power was kept constant at 3W, ablation amount increased with pulse energy rather than pulse repetition rate (p=0.000). Although intrapulpal temperature increased with pulse repetition rate, there were no significant differences among the groups and between the irradiated and the opposite pulpal walls, except at a condition of $150y{\times}20Hz$ (p=0.033). Conclusively, it is suggested that ablation efficacy is influenced by pulse energy rather than pulse repetition rate.

• The korean journal of orthodontics
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• v.39 no.4
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• pp.213-224
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• 2009

Objective: The aim of this study was to find out whether Er:YAG laser can aid in debonding ceramic brackets, and to see what kind of method will be the most appropriate for debonding. Methods: One hundred and ninety teeth, monocrystalline brackets ($MISO^{TM}$, HT, Ansan-Si, Korea), polycrystalline brackets ($Transcend^{TM}$ series 6000, 3M Untek, Monrovia, CA, USA) and the KEY Laser3 (KavoDental, Biberach, Germany) were used. Experimental groups were classified according to the type of ceramic brackets, and the amount of laser energy (0, 140, 300, 450, 600 mJ). After applying laser on the bracket at two points at 1 pulse each, the shear bond strength was measured. The effect of heat caused by laser was measured at the enamel beneath the bracket and pulp chamber. After measuring the shear bond strength, adhesive residue was evaluated and enamel surface was investigated using SEM. Results: All ceramic bracket groups showed a significant decrease in shear bond strength as the laser energy increased. The greatest average temperature change was $3.78^{\circ}C$ on the enamel beneath the bracket and $0.9^{\circ}C$ on the pulp chamber. Through SEM, crater shape holes caused by the laser was seen on the enamel and adhesive surfaces. Conclusions: If laser is applied on ceramic brackets for debonding, 300 - 450 mJ of laser energy will be safe and efficient for monocrystalline brackets ($MISO^{TM}$), and about 450 mJ for polycrystalline brackets ($Transcend^{TM}$ series 6000).

• Proceedings of the Optical Society of Korea Conference
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• 2003.02a
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• pp.130-131
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• 2003

수술용으로 쓰이는 치과용 레이저로는 Nd：YAG, $CO_2$, Er：YAG 레이저들이 있다. 치료 부위에 따라 두 가지 응용으로 나눌 수 있다. 잇몸의 절개 등은 주로 $CO_2$나 Nd：YAG 레이저를 이용하여 정밀하게 그리고 출혈을 최소로 하는 레이저의 장점을 살리면서 시술하고 있다. $CO_2$레이저의 경우 강한 열적 손상작용 때문에 출력 조사 시간을 짧게 하여 사용하며, 열적 손상력이 낮은 Nd：YAG 레이저는 화이버를 접촉식으로 하여 화이버의 작은 면적의 높은 광밀도를 이용하여 시술하고 있다. (중략)

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.131-140
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• 2005

The purpose of this study was to examine the ablation rate of Er: YAG laser irradiation on dentin and enamel and to observe the microscopic structures of cavities formed after ablation of enamel and dentin in using a bur and cavities formed after ablation using laser. Er:YAG laser irradiated at 200 mJ, 250mJ, 300mJ at the frequency of 20Hz, 15Hz. The following results were obtained : 1. The ablation rate of dentin groups at power of 3 W-6 W was about $1.103{\sim}2.639mm^3/sec$ and there were no significant differences between power of 4.5 W$\sim$6 W. 2. The ablation rate of enamel groups at power of 3 W-6 W was about $0.413{\sim}0.969mm^3/sec$ and there were no significant differences between power of 4 W$\sim$6 W. 3. With SEM examination of the cavity surface treated with the conventional high speed bur revealed relatively flat appearance almost covered with a debris like smear layer. 4. With SEM examination of the lased surface of dentin groups revealed no smear layer and no debris and openings of dentinal tubules were clearly opened. But the lased surfaces of the groups over 3 W were irregular and particles were loosely attached on it. 5. With SEM examination of the lased surface of enamel groups revealed severely destructed surface at the 6 W group and melting drop materials at the 3 W group. But the lased surface of 4 W group revealed clearly ablated surface. Therefore when cutting teeth using Er:YAG laser, the lasing power which can make effective ablation rate and minimize the thermal effect could be 3W at dentin and 4W at enamel. But, further studies and additional data collection will be necessary for appropriate lasing condition of Er:YAG laser.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.4
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• pp.954-967
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• 1996

Laser application to modify healthy permanent dentin to improve microhardness and caries resistence has been previously reported but the physical modification and ablation thresholds of carious and sclerotic dentin has yet to be identified. This study determined the energy density required by modify (physical modification threshold, PMT) and remove (ablation threshold, AT) infected carious, affected and selerotic dentin compared to healthy permanent dentin. $1{\pm}0.25mm$ thick dentin sections(n=272) from extracted human teeth were used. Smear layer was removed 0.5M EDTA for 2 minutes. Utilizing three pulsed fiberopitc delivered contact lasers with different emission wavelengths($1.06{\mu}m$=Nd : YAG, $2.10{\mu}m$=Ho : YAG and $2.94{\mu}mEr$ : YAG). The energy density($J/cm^2$) was incrementally increased and the resulting tissue interaction classified on a scale from 0-6. A minimum of 5 repetitions/energy density were completed. Light microscopy(10-25X) was used to verify the physical modification(scale=3) and ablation thresholds(scale=4) of the various forms of dentin and the data were analyzed by logistic regression at the 95 % confidence interval. PMT and AT by the laser and the dentin types were: PMT and AT was lower in infected dentin than in sound dentin for all lasers. PMT and AT induced by Nd : YAG>Ho : YAG>Er : YAG for all forms of dentin. Microhardness was increased in sound dentin at PMT. Morphology of crater examined by light microscopy showed Nd : YAG was safe and effective for removing carious dentin and Er: YAG was effective for removing sound dentin. The PMT and AT for YAG lasers are different as a function of dentin type which may be utilized for selective modification and removal of dentin.