The use of an Er:YAG laser to remove demineralized dentin and its influence on dentin permeability

Abstract

The purpose of this study was to analyze, correlate, and compare the demineralization and permeability of dentin remaining after caries removal with either an Er:YAG laser, a bur, or a curette. Thirty human dentin fragments were immersed in a demineralizing solution for 20 days and were randomly divided into three groups (n = 10) for the removal of the demineralized lesion. The groups were G1-Er:YAG laser (200 mJ/6 Hz; noncontact at 12 mm; spot: 0.63 mm), G2-Bur, and G3-Curette. The specimens were then immersed in a 10% copper sulfate solution, then in a 1% dithiooxamide alcoholic solution for 30 min and kept in ammonia vapor for 7 days. Next, the specimens were examined with optical microscopy. The amount of demineralized dentin and the level of copper ion infiltration in the dentin were quantified in μm using Axion Vision software. Data were analyzed with the Kruskal-Wallis test (p < 0.05) and Pearson's Correlation test. The analysis revealed no significant differences between the three caries removal methods in terms of their capacity to remove demineralized tissue (G1: 10.6 μm; G2: 8.4 μm; G3: 11 μm), although the laser removal generated more tissue permeability than the others methods (G1: 17.6 μm; G2: 6.6 μm; G3: 5.5 μm). The correlation between the remaining demineralized dentin and the dentin permeability was moderate for the conventional methods and higher for the Er:YAG laser. It can therefore be concluded that the laser produced an increase in permeability that was directly proportional to the amount of demineralized tissue removal.