A Preliminary Study in Er:YAG Laser Debonding of Lithium Disilicate Crowns: Laser Power Setting vs Crown Thickness

Background: Er:YAG laser is widely used in debonding of all-ceramic veneers nowadays. However, the data about laser parameters in all-ceramic crown removal is limited. The aim of this preliminary study was to determine the most appropriate laser parameters at safe heat transmission values ​​for lithium disilicate crowns in different thicknesses. Methods: Twenty-seven intact premolars were prepared to fabricate lithium disilicate CAD/CAM full-coverage crowns in three different thicknesses: 1, 1.5 mm, and mixed thickness (n=9). Each thickness group was divided into 3 subgroups and subjected to Er:YAG laser at different wattages (5, 5.6 and 5.9 W) to determine the appropriate wattage for each thickness. The removal time and temperature rise values were recorded. The Kruskal-Wallis test was performed to evaluate any significant differences in removal time, Mann-Whitney U test with Bonferroni correction for multiple comparisons, and the Pearson chi-square test for temperature rise over the critical value (p<0.05). Results: Laser irradiation at 5 W was safe and efficient for 1 mm thickness, while not efficient for others. Laser application at 5.9 W was efficient for all thicknesses, but, not safe for 1 mm thickness. The statistically significant difference in removal time was only between 5 W and 5.9 W groups (p=0.035). Pearson's chi-square test revealed that the temperature rise after 5.9 W laser application was significantly different from 5 W in 1 mm thickness group (p=0.043). Conclusion: Er:YAG laser lithium disilicate crown removal is an effective and safe method using laser settings appropriate for crown thickness.