Er:YAG laser or high-speed bur for cavity preparation in adolescents

Abstract

Objectives. The aim was to evaluate the effect on cavity preparation time, the pulse changes and the patient's subjective experience during removal of healthy tooth substance with high-speed bur and Er:YAG laser. Materials and methods. Thirty-five (13 male, 22 female) 14–18-year-olds participated. After local anaesthesia, Er:YAG laser and high-speed diamond bur were used for a 2 mm deep cavity preparation on the middle of the buccal surface on contra-lateral healthy maxillary first premolars. The cavity preparation time and the pulse were measured during the treatment. Subjective experience was evaluated using a VAS-scale and a questionnaire. Wilcoxon Signed Rank test and Chi-2-test were used for statistical analyses. Results. The mean (SD) cavity preparation time was 3.7-times longer (p < 0.001) for the laser [59 (41) s] than for the high-speed bur [16 (4) s]. The mean pulse change during preparation differed (p < 0.05) between the bur (+2.2%) and laser (−4.4%). The smell was worse when laser was used (p < 0.01); 65.7% expressed less discomfort and 57.1% experienced a lower sound level when laser was used. Laser was preferred for future treatment in 62.9% of the adolescents. Conclusion. Laser ablation caused unpleasant smell and longer cavity preparation time, but was preferred by a majority of the adolescents.