Temperature rise during Er:YAG cavity preparation of primary enamel

This study aimed to assess in vitro thermal alterations taking place during the Er:YAG laser cavity preparation of primary tooth enamel at different energies and pulse repetition rates. Forty healthy human primary molars were bisected in a mesio-distal direction, thus providing 80 fragments. Two small orifices were made on the dentin surface to which type K thermocouples were attached. The fragments were individually fixed with wax in a cylindrical Plexiglass® abutment and randomly assigned to eight groups, according to the laser parameters (n = 10): G1 – 250 mJ/ 3 Hz, G2 – 250 mJ/ 4 Hz, G3 – 250 mJ/ 6 Hz, G4 – 250 mJ/10 Hz, G5 – 250 mJ/ 15 Hz, G6 – 300 mJ/ 3 Hz, G7 – 300 mJ/ 4 Hz and G8 – 300 mJ/ 6 Hz. An area of 4 mm² was delimited. Cavities were done (2 mm long × 2 mm wide × 1 mm thick) using non-contact (12 mm) and focused mode. Temperature values were registered from the start of laser irradiation until the end of cavity preparation. Data were analyzed by one-way ANOVA and Tukey test (p ≤ 0.05). Groups G1, G2, G6, and G7 were statistically similar and furnished the lowest mean values of temperature rise. The set 250 mJ/10 and 15 Hz yielded the highest temperature values. The sets 250 and 300 mJ and 6 Hz provided temperatures with mean values below the acceptable critical value, suggesting that these parameters ablate the primary tooth enamel. Moreover, the temperature elevation was directly related to the increase in the employed pulse repetition rates. In addition, there was no direct correlation between temperature rise and energy density. Therefore, it is important to use a lower pulse frequency, such as 300 mJ and 6 Hz, during cavity preparation in pediatric patients.