Abstract
The aim of the study was to investigate the effects of neodymium: yttrium aluminium garnet (Nd:YAG) (1064 nm) and erbium: yttrium aluminium garnet (Er:YAG) (2940 nm) laser energy on titanium when delivered with conventional optics (focusing handpieces or plain ended optical fibres) or with a conical tip. Machined and micro-roughened implant discs were subjected to laser irradiation under a variety of energy settings either dry (without water) or wet (with water). Samples were scanned using a 3D non-contact laser profilometer and analysed for surface roughness, volume of peaks and the maximum diameter of the ablated area. Conical tip designs when used with both lasers showed no surface effect at any power setting on both machined and micro-roughened implant surfaces, regardless of the irrigation condition. When used with conventional delivery systems, laser effects on titanium were dose related, and were more profound with the Nd:YAG than with the Er:YAG laser. High laser pulse energies caused surface fusion which reduced the roughness of micro-roughened titanium surfaces. Likewise, repeated pulses and higher power densities also caused greater surface modifications. The presence of water reduced the influence of laser irradiation on titanium. It may be concluded that conical fibres can reduce unwanted surface modification, and this may be relevant to clinical protocols for debridement or disinfection of titanium dental implants.
Highlights
Titanium and its alloys are used commonly for dental implants
The neodymium: yttrium aluminium garnet (Nd:YAG) [11] the erbium: yttrium aluminium garnet (Er:YAG) [12,13], the erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) [14,15], the carbon dioxide (CO2) laser [11,16] and various diode lasers [17,18] have been used for periodontal applications
This observation change between dry and wet ablation changed with increase energy settings (Figure 1a)
Summary
Titanium and its alloys are used commonly for dental implants. After insertion of a titanium dental implant, the accumulation of a dental plaque biofilm and an adverse host inflammatory response to this biofilm can lead to peri-implantitis, a condition where the bone around the implant is resorbed, and where if untreated the implant may be lost. Conventional treatments for peri-implantitis have included [1] mechanical debridement of the titanium implant surface using hand, sonic and ultrasonic scalers with plastic, metal or carbon fibre tips, air–powder devices, or pulsed infrared lasers; [2] disinfection using antiseptics, photothermal laser disinfection or photodynamic therapy, [3] local or systemic antibiotics, and [4] combinations of the above methods [3,5,6]. Lasers have been increasingly utilised in dentistry for the treatment both of periodontitis and peri-implantitis [8,9,10]. The Er:YAG laser has shown the most promising results in non-surgical periodontal therapy, with outcomes for laser debridement of the roots of teeth similar to those seen with mechanical debridement [13,19]
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