Histologic and SEM evaluation of caries removal and restoration in enamel and dentin using a pulsed fiber optic delivered Nd:YAG laser

The pulsed Nd:YAG laser has been proposed as an alternative to the dental handpiece for caries removal in enamel and dentin. The purpose of this study was to systematically evaluate, in vitro, the process of caries removal and restoration in enamel and dentin. The effectiveness of this device was investigated utilizing scanning electron microscopy to determine the behavior of dentin after laser treatment of artificially created carious lesions in dentin. Histologic sections of extracted teeth after laser treatment and restoration demonstrated successful caries removal and restoration using the pulsed fiber optic delivered Nd:YAG laser as compared to both high and low speed rotary instrumentation. The adjacent enamel and dentin were unaffected by the laser irradiation although slight carbonization was seen on the dentin surface. Thermocouples placed in the pulp chamber during caries removal confirmed previous studies that showed laser parameters up to 1 W and 10 Hz being the same as conventional caries removal in the amount of heat generated which reaches the pulp. The addition of air/water coolant decreased pulpal temperature.