• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.683-693
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• 2001

The purpose of this study was to evaluate the effects of Er:YAG laser on cutting efficacy and its histologic findings. Dentin specimens of human premolars and molars were used and irradiated by Er:YAG laser with noncontact handpiece type delivery system under different treatment condition of irradiation time. Cavity pattern and volume were evaluated to determine the cutting efficacy and following results were obtained. 1. Cutting volume of sound dentin was getting larger with time immersed in water increase 2. With the condition of irradiation (150mJ, 10Hz, 30sec), surface irregularity was more increased in sound dentin comparing to carious dentin. For the light microscopic examination, dentinal tubules were opened and ash flecks and cracks were noted with inconsistence of dentinal tubules. 3. In case of 30 sec. irradiation in carious dentin, dark zone was limited to small focus whereas 1 min. irradiation, more wider, and cracks were noted in the perpendicular to direction of dentinal tubules. For the 2 min. irradiation, cavity was the widest and more cracks were found.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.374-382
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• 2001

The purpose of this study was to investigate the surface morphology and measure shear bond strength of Er : YAG lased enamel. To determine the most effective energy density of laser for improving bonding strength of human enamel, 24 specimen were lased from 30mJ to 150mJ at 1Hz used focused, defocused beam. After irradiation, the lased specimen were observed scanning electron microscope. To determine the resin shear bond strength of Er : YAG lased enamel, the 90 specimen were divided into 3 groups. The Control group was etched with 37% phosphoric acid for 15seconds and rinsed. Group 1 was only laser irradiaton(60mJ, 10Hz), Group 2 was irradiated as Group 1 regimen, followed 37% phosphoric acid etching. The following results were obtained: 1. In both focused and defocused Er : YAG lased enamel surface are similar to acid-etched enamel more than 60mJ in SEM evaluation. 2. The more increased laser energy, the more observed fissuring surface. 3. The highest mean shear bond strength value was observed in control group with the statistical significance(p<0.05) between all the other groups and the shear bond strength in group 1 was the lowest with significant difference among the other groups.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.211-221
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• 2006

Purpose The aims of this study were to evaluate micro-tensile bond strength of composite resin bonded to dentin following high-speed rotary handpiece preparation or Er:YAG laser preparation with two different adhesive systems and to assess the influence of different Er:YAG laser energies on the micro-tensile bond strength. Materials and Methods In this study, 40 third morlars were used. Flat dentin specimans were obtained and randomly assigned to eight groups. Dentin surfaces were prepared with one of four cutting types: carbide bur, Er:YAG laser (2 W, 3 W and 4 W) and conditioned with two bonding systems, Scotchbond Multipurpose Plus (SM), Clearfil SE bond (SE) and composite resin-build ups were created. After storage for 24 hours, each specimen was serially sectioned perpendicular to the bonded surface to produce more than thirty slabs in each group. Micro-tensile bond strength test was performed at a crosshead speed of 1.0 mm/min. Micro-tensile bond strengths (${\mu}TBS$) were expressed as means$\pm$SD. Data were submitted to statistical analysis using two-way ANOVA, one-way ANOVA, Student-Newman-Keuls' multiple comparison test and t-test. Results and Conclusion 1. Regardless of bonding systems, the ${\mu}TBS$ according to cutting types were from highest to lowest : 3 W, 2 W, Bur, and 4 W. In addition, there was no significant difference between Bur and 4 W (p<0.001). 2. Regardless of cutting types, SM showed significantly higher ${\mu}TBS$ than SE (p<0.001). 3. Bonding to dentin conditioned with SM resulted in higher ${\mu}TBS$ for 3 W compared to Bur, 2 W, and 4 W. There was no significant difference between 2 W and Bur (p<0.001). 4. Bonding to dentin conditioned with SE resulted in higher ${\mu}TBS$ for 3 W compared to 2 W, 4 W, and Bur. Bur exhibited significant lower ${\mu}TBS$ than all other cutting types. There were no significant differences between 3 W, 2 W and between 4 W and Bur (p<0.001). 5. The ${\mu}TBS$ of laser cutting groups were shown in order from highest to lowest: 3 W, 2 W and 4 W in two bonding systems. There was no significant difference between 2 W and 3 W in SE (p<0.001). : The ${\mu}TBS$ of composite resin bonded dentin was significantly affected by interaction between the cutting type and bonding system. In the range of 2 W-3 W, cavity preparation of the Er:YAG laser seems to supply good adhesion of composite resin restoration no less than bur preparation. In particular, if you want to use the self-etching system, including Clearfil SE bond for the purpose of a simplification of the bonding procedures and prevention of adverse effects by excessive etching, an Er:YAG laser may offer better adhesion than a bur.

• 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 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.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.569-578
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• 2007

This study was performed to compare the shear bond strength of self etching system and two bottle bonding system with or without laser preparation. Group I was prepared with high speed rotary instrument and $Prompt^{TM}$ L-$Pop^{TM}$, group II with Er:YAG laser and $Prompt^{TM}$ L-$Pop^{TM}$, group III with Er:YAG laser, 37% phosphoric acid and Single bond, group IV with Er:YAG laser and Single bond and group V with high speed, etching and Single bond. And also observation of the prepared and etched dentin surface were performed under scanning electro-microscope. The possibility of clinical application of laser preparation which might have an advantage to reduce pain for children with less unfavorable noise were evaluated. The results obtained are as follows; 1. Group V showed significantly higher bond strength than other groups. And group IV showed significantly lower bond strength than other groups. 2. There was no significant difference between group I and group III. 3. Group II showed significantly lower bond strength than group I, III, V, but showed significantly higher bond strength than group IV. 4. Under scanning electro-microscope, laser-preparated dentin surface showed high irregularity and no smear layer. The surface showed less irregularities and more exposed dentinal tubules with etching. Laser preparation has many advantages over conventional tooth preparation. But this method showed lower resin bonding strength. Laser preparated tooth surface differed from the conventionally preparated tooth surface. More researches are needed on suitable methods for laser preparated dentin surface.

• Proceedings of the Optical Society of Korea Conference
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• 2006.02a
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• pp.193-194
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• 2006