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Journal of Prosthetic Dentistry

Using an Er,Cr:YSGG laser to remove lithium disilicate restorations: A pilot study

      Abstract

      Statement of problem

      The use of lasers is growing widely in dentistry. Despite its clinical implications, most information and clinical data related to the removal of ceramic restorations with the aid of a laser is either anecdotal or in the form of clinical reports.

      Purpose

      The purpose of this in vitro study was to establish a parameter on the removal of lithium disilicate crowns with a laser and conduct an in vitro trial of crown removal based on the wattage and time of application.

      Material and methods

      Twenty extracted molars were prepared to accommodate a lithium disilicate disk specimen, which was cemented with resin cement. An erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser was applied at different wattages (3, 3.5, 4, and 5 W) to determine the optimal wattage for the removal of the lithium disilicate specimens. Once the optimal wattage was established, 25 extracted teeth were mounted in stone, then prepared to receive milled lithium disilicate computer-aided design/computer-aided manufacturing complete coverage crowns. The crowns were cemented with a dual-polymerizing resin cement. The groups comprised 3.5 and 4 W output with 30-, 60-, and 90-second application time (n=5), and 5 crowns were removed using traditional handpiece and electric handpiece with coarse grit diamond rotary instruments. The results and time required to remove the crown were recorded. The chi-square test was performed to assess any significant differences in removing the crown with the laser according to wattage or time of application (α=.05).

      Results

      Laser application at 3.5 and 4 W was best for removing crowns conservatively. Eight crowns (40%) of 20 specimens were successfully removed at the first attempt. The majority of the crowns came off during the second attempt. The chi-square test revealed no significant difference between the combination of wattage and time of application (P= .92). The mean time to remove the lithium disilicate crown with a diamond rotary instrument was 6 minutes, and removal required 1.8 instruments on the average.

      Conclusions

      An Er,Cr:YSGG laser can safely remove lithium disilicate crowns with the settings used this study.
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      References

        • van As G.
        Erbium lasers in dentistry.
        Dent Clin N Am. 2004; 48: 1017-1059
        • Gimbel C.B.
        Hard tissue laser procedures.
        Dent Clin N Am. 2000; 4: 931-953
        • Meister J.
        • Franzen R.
        • Forner K.
        • Grebe H.
        • Stanzel S.
        • Lampert F.
        • et al.
        Influence of water content in dental enamel and dentin on ablation with erbium YAG and erbium YSGG lasers.
        J Biomed Opt. 2006; 11: 30430
        • Wigdor H.
        Basic physics of laser interaction with vital tissue.
        Alpha Omegan. 2008; 101: 127-132
        • Baldissara P.
        • Catapano S.
        • Scotti R.
        Clinical and histological evaluation of thermal injury threshold in human teeth: a preliminary study.
        J Oral Rehabil. 1997; 24: 791-801
        • Dostalova T.
        • Jelinkova H.
        • Krejsa O.
        • Hamal K.
        • Kubelka J.
        • Prochazka S.
        • et al.
        Dentin and pulp response to erbium:YAG laser ablation: a preliminary evaluation of human teeth.
        J Clin Laser Med Surg. 1997; 15: 117-121
        • Rizoiu I.
        • Kohanghadosh F.
        • Kimmel A.I.
        • Eversole L.R.
        Pulpal thermal responses to an erbium,chromium:YSGG pulsed laser hydrokinetic system.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 86: 220-223
        • Glockner K.
        • Rumpler J.
        • Ebeleseder K.
        • Stadtler P.
        Intrapulpal temperature during preparation with Er:YAG laser compared to the conventional burr: an in vitro study.
        J Clin Laser Med Surg. 1998; 16: 153-157
        • Pelagalli J.
        • Gimbel C.B.
        • Hansen R.T.
        • Sweet A.
        • Winn D.W.
        Investigational study of the use of Er:YAG laser versus dental drill for caries removal and cavity preparation—phase I.
        J Clin Laser Med Surg. 1997; 15: 109-115
        • Cavalcanti B.N.
        • Lage-Marques J.L.
        • Rode S.M.
        Pulpal temperature increases with Er:YAG laser and high-speed handpieces.
        J Prosthet Dent. 2003; 90: 447-451
        • Basaran E.
        • Ayna E.
        • Basaran G.
        • Beydemir K.
        Influence of different power outputs of erbium, chromium:yttrium-scandium-gallium-garnet laser and acid etching on shear bond strengths of a dual-cure resin cement to enamel.
        Laser Med Sci. 2011; 26: 13-19
        • Schelle F.
        • Polz S.
        • Haloui H.
        • Braun A.
        • Dehn C.
        • Frentzen M.
        • et al.
        Ultrashort pulsed laser (USPL) application in dentistry: basic investigations of ablation rates and thresholds on oral hard tissue and restorative materials.
        Lasers Med Sci. 2013; 29: 1775-1783
        • Rosenstiel S.F.
        • Land M.F.
        • Crispin B.J.
        Dental luting agents: A review of the current literature.
        J Prosthet Dent. 1998; 80: 280-301
        • Feldon P.J.
        • Murray P.E.
        • Burch J.G.
        • Meister M.
        • Freedman M.A.
        Diode laser debonding of ceramic brackets.
        Am J Orthod Dentofac Orthop. 2010; 138: 458-462
        • Oztoprak M.O.
        • Nalbantgil D.
        • Erdem A.S.
        • Tozlu M.
        • Arun T.
        Debonding of ceramic brackets by a new scanning laser method.
        Am J Orthod Dentofac Orthop. 2010; 138: 195-200
        • Dostalova T.
        • Jelinkova H.
        • Sulc J.
        • Nemec M.
        • Jelinek M.
        • Fibrich M.
        • et al.
        Ceramic bracket debonding by Tm:YAP laser irradiation.
        Photomed Laser Surg. 2011; 29: 477-484
        • Oztoprak M.O.
        • Tozlu M.
        • Iseri U.
        • Ulkur F.
        • Arun T.
        Effects of different application durations of scanning laser method on debonding strength of laminate veneers.
        Lasers Med Sci. 2012; 27: 713-716
        • Broome P.J.
        Utilization of an Er,Cr:YSGG laser for the removal of all-ceramic restorations.
        Pract Proced Aesthet Dent. 2007; 19: 23-25
        • Toledano M.
        • Osorio R.
        • Osorio E.
        • Aguilera F.
        • Yamauti M.
        • Pashley D.
        • et al.
        Durability of resin-dentin bonds: effects of direct/indirect exposure and storage media.
        Dent Mater. 2007; 23: 885-892