Er:YAG laser settings for debonding zirconia restorations: An in vitro study

Abstract

This in vitro study aimed to determine the optimal frequency and energy settings for debonding zirconia restorations using an erbium-doped yttrium aluminum garnet (Er:YAG) laser. A total of 200 zirconia specimens (5 mm × 5 mm × 1.5 mm) were fabricated from two types of materials: (1) 3 mol% yttria oxide stabilized tetragonal zirconia polycrystalline (3Y-TZP) and (2) 5 mol% yttria oxide stabilized tetragonal zirconia polycrystalline (5Y-TZP). The zirconia specimens were bonded to dentin using resin cement (RelyX Ultimate, 3 M) and divided into 20 groups based on their laser treatments (n = 5). Er:YAG laser treatment was applied at various frequencies (10 Hz and 20 Hz) and energies (80 mJ, 100 mJ, 120 mJ, 140 mJ, 160 mJ, 180 mJ, 200 mJ, 220 mJ, 240 mJ, and 260 mJ). The time required to debond the specimens and the temperature changes that dentin underwent during the laser treatment were recorded. The surface morphologies of the debonded dentin and zirconia specimens were observed using scanning electron microscopy (SEM). Additional zirconia specimens were fabricated for 4-point flexural strength testing and surface roughness measurements. Statistical analyses were conducted using three-way analysis of variance (ANOVA) and Student–Newman–Keuls (SNK)-q tests (α = 0.05). The debonding time of each specimen varied between 4.8 and 160.4 s, with an average value of 59.2 s. The dentin temperature change for each specimen ranged from 2.3 to 3.6 °C, with an average value of 2.7 °C. The debonding time was significantly influenced by the zirconia material type and laser energy, but it was not affected by the laser frequency. Among the specimens, those made of 3Y-TZP needed significantly more time for debonding than 5Y-TZP. The optimal energies were 220 mJ for 3Y-TZP and 200 mJ for 5Y-TZP. The laser frequency, laser energy, and type of zirconia material had no effect on the dentin temperature change. Additionally, no surface alternations were observed on the dentin or zirconia materials after laser treatment. The surface roughness and flexural strength of the zirconia materials remained unchanged after laser treatment. In summary, Er:YAG laser treatment effectively and safely removes zirconia restorations without impacting their mechanical properties, with a safe temperature change of less than 5.6 °C. The optimum frequency and energy settings for debonding 3Y-TZP and 5Y-TZP restorations were found to be 10/20 Hz and 220 mJ and 10/20 Hz and 200 mJ, respectively.