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Laser all-ceramic crown removal and pulpal temperature--a laboratory proof-of-principle study
P Rechmann1, N C H Buu2, B M T Rechmann2
1Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA. rechmannp@dentistry.ucsf.edu.
Lasers in Medical Science
|March 19, 2015
Summary
Er:YAG laser efficiently debonds all-ceramic crowns, with minimal pulp chamber temperature rise. Inaccurate cooling during laser debonding can increase temperatures, suggesting the need for precise application and potentially cooled water for safety.
Area of Science:
- Dental Materials Science
- Laser Dentistry
- Biomaterials
Background:
- All-ceramic crowns are widely used in restorative dentistry.
- Debonding cemented crowns can be challenging, potentially requiring destructive methods.
- Lasers offer a potential non-destructive alternative for crown removal.
Purpose of the Study:
- To evaluate the temperature increase in the pulp chamber during Er:YAG laser debonding of all-ceramic crowns.
- To assess the efficacy and safety of Er:YAG laser for removing all-ceramic restorations in a worst-case scenario.
Main Methods:
- Twenty extracted molars with IPS E.max CAD all-ceramic crowns bonded with Multilink Automix were used.
- Er:YAG laser (560 mJ/pulse) at 5 mm distance with air-water spray was applied for debonding.
- Pulp chamber temperature rise was measured using micro-thermocouples during laser irradiation.
Main Results:
- All crowns were successfully debonded in an average of 135 ± 35 seconds without crown fracture or dentin damage.
- Average pulp chamber temperature rise was 5.4 ± 2.2 °C.
- Temperatures exceeding 5.5 °C occurred only with suboptimal, one-sided cooling, with a maximum recorded rise of 11.5 °C.
Conclusions:
- Er:YAG laser is an effective method for debonding all-ceramic crowns.
- Pulp chamber temperature increases are generally minimal and within safe limits.
- Precise application and adequate cooling are crucial to prevent excessive thermal effects.
