Experimental removal of subgingival calculus with the Er:YAG laser

The purpose of this study was to evaluate the effects of the Er:YAG laser removal of subgingival calculi in periodontal treatment and to describe laser-induced cementum surface alterations. Freshly extracted human teeth with adherent plaques and mineralized calculi were laser treated using modified quartz fiber tips in direct contact to the root surface. For the fiber tip tested, the ablation threshold was 6.5 mJ. An effective removal of calculi was possible with 50 mJ resp. 150 mJ for a triple fiber. For the latter, a mass loss with a mean of about 5.1. mg/min was achieved. Histologic examinations of the cementum surface showed smoothed appearance alternately with rough depressions of the fiber tips, which can be discussed as a good precondition for periodontal tissue regeneration. Maximum temperature increase of 1.4 K was reached in the pulp, if an additional water irrigation was applied to the root surface. From these results it can be concluded that with the Er:YAG laser an effective removal of subgingival calculi can be performed without thermal risk for the pulp.

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