Clinical application of the erbium: YAG laser for apicoectomy

doi:10.1016/S0099-2399(97)80348-2

Journal of Endodontics

Volume 23, Issue 12, December 1997, Pages 748-750

https://doi.org/10.1016/S0099-2399(97)80348-2 Get rights and content

Recently, an Er:YAG laser has attracted attention because of the possibility of cutting hard tissues with extremely small thermal effects.

In this article, we report 8 cases (13 teeth) of apicoectomy using Er:YAG laser. All procedures were performed without using an air turbine or an electric drill. Although the cutting speed of this laser was slightly slower than ordinary methods, its clinical application for apicoectomy has many advantages including absence of discomfort and vibration, less chance for contamination of the surgical site, and reduced risk of trauma to adjacent tissue.

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Citation Excerpt :
Lasers can also cause morphologic alterations in dentin and interfere with cell attachment, retarding tissue repair (51). Moreover, the “no-touch” characteristic of laser methods results in a loss of tactile feedback to the operator, rendering it difficult to maintain conservative preparations (52). Few published studies evaluate the use of both ultrasound and piezosurgery instruments for apicoectomy (Fig. 4A–I).
Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery.
We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles.
A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples.
Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation.
Use of laser therapy in the treatment of jaw bone diseases
2011, Dental Cadmos
Obiettivi. La possibilità di realizzare terapie laser-assistite nel trattamento di patologie delle ossa mascellari risulta correlata a indubbi vantaggi per l’operatore e il paziente, in quanto si rendono possibili, per esempio, interventi chirurgici mininvasivi e un buon controllo dell’emostasi e del dolore postoperatorio. Obiettivo del presente lavoro è descrivere l’utilizzo dei dispositivi laser in odontostomatologia e, in particolare, nel trattamento delle patologie delle ossa mascellari. Materiali e metodi. La riduzione dei rischi intraoperatori e degli effetti indesiderati nell’impiego dei laser a livello delle ossa mascellari è fortemente influenzata dalla conoscenza delle caratteristiche intrinseche alla lunghezza d’onda utilizzata e al tessuto bersaglio, così come alle interazioni laser-tessuto. A partire da queste caratteristiche è possibile pianificare correttamente “il trattamento” dall’approccio non chirurgico della Low Level Laser Therapy (LLLT) all’approccio chirurgico nei differenti gradi di invasività. Conclusioni. Il laser comporta notevoli vantaggi nel trattamento delle patologie ossee mascellari di varia natura dal punto di vista biologico, della tecnica operatoria e della compliance del paziente, grazie, per esempio, alle azioni antibatterica e biostimolante. L’impiego di questa tecnologia richiede ovviamente una curva di apprendimento, assolutamente necessaria per ottimizzare i risultati clinici riducendo sensibilmente i potenziali effetti negativi, legati non tanto all’azione intrinseca dell’apparecchio quanto a un suo imperfetto utilizzo.
Objectives. Laser-based treatment of jaw bone diseases offers advantages for both clinicians and patients, including mini-invasiveness, facilitated control of hemostasis, and reduced postoperative pain. The aim of the present article is to review the use of laser tools in dentistry, with particular reference to their use in the treatment of diseases involving the jaw bones. Materials and methods. Reducing the intraoperative risks and side effects of laser therapy for the treatment of jaw bone diseases requires complete knowledge of the characteristics of the wavelength used, those of the target tissue, and laser-tissue interactions. Considering these aspects, one can elaborate an appropriate “treatment plan” that includes low level laser therapy and surgical approaches with different degrees of invasiveness. Conclusions. Laser therapy can considerably improve the treatment of jaw bone diseases from a biological point of view and in terms of surgical technique and patient compliance. These advantages are related to its antibacterial and biomodulative properties. The use of lasers requires a period of training to optimize clinical results and to minimize adverse effects, which are mainly caused by the incorrect use of these tools.
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2011, Principles and Practice of Laser Dentistry
Lasers in Endodontics
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¹: Dr. Komori is an assistant professor, Department of Oral Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan.

²: Dr. Yokoyama is an assistant professor, Department of Endodontics, School of Dentistry, Showa University, Tokyo, Japan.

³: Dr. Takato is an associate professor, Department of Oral Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan.

⁴: Dr. Matsumoto is chief professor, Department of Endodontics, School of Dentistry, Showa University, Tokyo, Japan.

View full text

Clinical application of the erbium: YAG laser for apicoectomy

J Prosth Dent

J Endodon

Experimental studies of the application of the Er:YAG laser on dental hard substances: II. light microscopic and SEM investigations

Lasers Surg Med