• 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.

• The Journal of the Korean dental association
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• v.49 no.11
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• pp.660-669
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• 2011

Er: YAG laser irradiation utilizing the newly developed RCLase side-firing spiral tip was used for the cleansing of root canals following their bio-mechanical preparation with ProTaper Ni-Ti files. The distal and palatal roots of 20 freshly extracted molar teeth were instrumented to size F3 with ProTaper files. In the experimental group (10 teeth) the pulp chamber and the root canals were filled with EDTA 17% and the root canals were lased for 30 s using the Er: YAG laser irradiation at 600 mJ per pulse and a frequency of 12 Hz. In the control group (10 teeth) the root canals were not lased. Scanning electron microscope analysis showed clean wall surfaces of the lased root canals with open dentinal tubules, free of smear layer and debris. In the scanning electron microscope photographs of the walls of the non-lased root canals a considerable amount of debris could be detected. It appears that an efficient cleansing of the root canal system can be achieved by using the Er: YAG laser irradiation with the RCLase Side-firing Spiral Tip following bio-mechanical preparation of the root canal with Ni-Ti Taper files.

• 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.

• The Journal of Advanced Prosthodontics
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• v.4 no.4
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• pp.192-196
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• 2012

PURPOSE. The purpose of this study was to evaluate the effect of provisional cement removal by different dentin cleaning protocols (dental explorer, pumice, cleaning bur, Er:YAG laser) on the shear bond strength between ceramic and dentin. MATERIALS AND METHODS. In total, 36 caries-free unrestored human third molars were selected as tooth specimens. Provisional restorations were fabricated and cemented with eugenol-free provisional cement. Then, disc-shaped ceramic specimens were fabricated and randomly assigned to four groups of dentin cleaning protocols (n = 9). Group 1 (control): Provisional cements were mechanically removed with a dental explorer. Group 2: The dentin surfaces were treated with a cleaning brush with pumice Group 3: The dentin surfaces were treated with a cleaning bur. Group 4: The provisional cements were removed by an Er:YAG laser. Self-adhesive luting cement was used to bond ceramic discs to dentin surfaces. Shear bond strength (SBS) was measured using a universal testing machine at a 0.05 mm/min crosshead speed. The data were analyzed using a Kolmogorov Smirnov, One-way ANOVA and Tukey HSD tests to perform multiple comparisons (${\alpha}$=0.05). RESULTS. The dentin cleaning methods did not significantly affect the SBS of ceramic discs to dentin as follows: dental explorer, pumice, cleaning bur, and Er:YAG laser. CONCLUSION. The use of different cleaning protocols did not affect the SBS between dentin and ceramic surfaces.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.396-405
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• 2010

Purpose: This study was performed to find out the effects of the Er:YAG laser (Key Laser) & Er,Cr:YSGG laser (Water Laser) on inflammatory tissues. Materials and Methods: It was performed on about 20 g, 6 weeks male ICR mouses. They were grouped into the control (negative), the inflammation induced 'control'(positive), Er,Cr:YSGG laser exposured group after inducing inflammation, Er:YAG lasere exposured group after inducing inflammation each 15 mouses. The mouses were applicated 0.5% DNFB 1 cc on ear skin twice a day for 4 days until symptom expression. After laser exposure, ear tissues were extracted and defined gene expression by RT-PCR. Then, tissue staining, lymphocytes observation, electromicroscophic laboratory were carried out. Results: Interleukin-$1{\beta}$ was expressed much less in the A-laser exposed group. Interleukin-$1{\beta}$ & Tumor Necrosis Factor-${\alpha}$ were expressed 7 times lesser in the A-laser exposed group. The number of Lymphocytes related to inflammation was decreased rapidly in the A-laser exposed group in vivo. he number of cavity recovered normal was a little bigger in the A-laser exposed group after 5 days Conclusion: The expression of IL-$1{\beta}$ & TNF-${\alpha}$, hitologic change, observation with electron microscope shows that Erbium laser exposure causes lesser inflammation with A-laser rather than B-laser.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.232-237
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• 2012

Background : Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. Methods : Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Posttreatment evaluations were performed 1 month after the fourth treatment session. Results : All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. Conclusions : This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.32-44
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• 2001

The purpose of this study was to investigate the effects of Er : YAG laser on cutting efficacy and temperature changes of dentin. We used the dentin specimens of human premolars and molars which contain the physiologic saline and maintain the pulpal pressure in dentinal tubules. Each specimen was exposed to Er : YAG laser with non-contact handpiece type delivery system under different treatment condition of irradiation energy, pulse repetition rate, and exposure time. Two procedures were conducted by the presence of water flow during lasing. The specimens were grouped by thickness of dentin. We investigated the cavity pattern, volume, and temperature change of dentin specimen to determine the cutting efficacy and temperature rise of Er : YAG laser, and obtained following results. 1. Cutting volume of dentin was increased by increasing the irradiation energy, pulse repetition rate, and exposure time(P<0.05). 2. Margins of abulated cavities were sharp and clean and floors of cavities were conical in shape and showing smooth surfaces. Upper diameter of abulated cavities were increasing as laser parameter of irradiation energy, pulse repetition rate, and exposure time were increased. A few cracks were observed on abulated surfaces under treatment condition of laser parameter with 150mJ, 5Hz, and 5sec. 3. Temperature was increased as laser parameter of irradiation energy, pulse repetition rate, and exposure time were increased, and temperature rise was decreased as dentin thickness was increased(P<0.05). 4. Temperature rise was decreased under water flow compared with no water flow during laser exposure(P<0.05). From these results, we think that the method of using a Er:YAG laser would be effective and safe in cutting dentin for clinical application.

• 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 Periodontal and Implant Science
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• v.41 no.3
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• pp.135-142
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• 2011

Purpose: The present study was performed to evaluate the effect of erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser irradiation on sand-blasted, large grit, acid-etched (SLA) implant surface microstructure according to varying energy levels and application times of the laser. Methods: The implant surface was irradiated by the Er:YAG laser under combined conditions of 100, 140, or 180 mJ/pulse and an application time of 1 minute, 1.5 minutes, or 2 minutes. Scanning electron microscopy (SEM) was used to examine the surface roughness of the specimens. Results: All experimental conditions of Er:YAG laser irradiation, except the power setting of 100 mJ/pulse for 1 minute and 1.5 minutes, led to an alteration in the implant surface. SEM evaluation showed a decrease in the surface roughness of the implants. However, the difference was not statistically Significant. Alterations of implant surfaces included meltdown and flattening. More extensive alterations were present with increasing laser energy and application time. Conclusions: To ensure no damage to their surfaces, it is recommended that SLA implants be irradiated with an Er:YAG laser below 100 mJ/pulse and 1.5 minutes for detoxifying the implant surfaces.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.101-105
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• 2013

Purpose: The present study aimed to measure root surface roughness in teeth with periodontitis by a profilometer following root planning with ultrasonic and hand instruments with and without erbium-doped yttrium aluminium garnet (Er:YAG) laser irradiation. Methods: Sixty single-rooted maxillary and mandibular teeth, extracted because of periodontal disease, were collected. The crowns and apices of the roots were cut off using a diamond bur and water coolant. The specimens were mounted in an acrylic resin block such that a plain root surface was accessible. After primary evaluation and setting a baseline, the samples were divided into 4 groups. In group 1, the samples were root planned using a manual curette. The group 2 samples were prepared with an ultrasonic scaler. In group 3, after scaling with hand instrumentation, the roots were treated with a Smart 1240D plus Er:YAG laser and in group 4, the roots were prepared with ultrasonic scaler and subsequently treated with an Er:YAG laser. Root surface roughness was then measured by a profilometer (MahrSurf M300+RD18C system) under controlled laboratory conditions at a temperature of $25^{\circ}C$ and 41% humidity. The data were analyzed statistically using analysis of variance and a t-test (P<0.05). Results: Significant differences were detected in terms of surface roughness and surface distortion before and after treatment. The average reduction of the surface roughness after treatment in groups 1, 2, 3, and 4 was 1.89, 1.88, 1.40, and 1.52, respectively. These findings revealed no significant differences among the four groups. Conclusions: An Er:YAG laser as an adjunct to traditional scaling and root planning reduces root surface roughness. However, the surface ultrastructure is more irregular than when using conventional methods.