Yrd Doç Dr Emine Şirin KARAARSLAN, Yrd Doç Dr Cihan YILDIRIM, Prof Dr Aslıhan ÜŞÜMEZ

Restoratif Tedavide Lazer Uygulamaları

Lazerler, diş hekimliğinde sert ve yumuşak doku tedavilerinde kullanılmaktadır. Diş çürüğünün kaldırılması ve kavite preparasyonu amacıyla yüksek hızla dönen frezlerin yerine klinik kullanıma ilk giren lazerler, CO2 ve Nd:YAG lazerlerdir. Bu derlemede, çürüğün önlenmesi, kaldırılması, kavitenin hazırlan ması, dezenfeksiyonu, dentin hassasiyeti tedavisi, kompozit rezin polimerizasyonu ve diş beyazlatmada lazer kullanımı konularına yer verildi. Restoratif tedavide lazerin uygulama alanlarıyla ilgili makalelerin sonuçları değerlendirildi. Erbium lazerler, kavite preparasyonu esnasında çoğu hastada anestezi ihtiyacı hissettirmemesi, geleneksel kavite preparasyonu yöntemlerine göre daha az titreşim ve gürültü oluşturması ve pulpa dokusunda minimal oranda yaralanmaya neden olması gibi avantajlara sahiptir. Mine yüzeyinde demineralizasyona direnç oluşturmak için, fluoridle birlikte lazer kullanımı önerilmektedir. Klasik tedavi yöntemlerinin yetersizliğinden dolayı, dentin hassasiyeti tedavisinde de lazer kullanımının etkili olduğu, Nd:YAG, Er:YAG ve CO2 lazer gibi yüksek güçteki lazerlerin, dentin kanallarını kapatarak, ağrının giderilmesini sağladığı bildirilmiştir. Photo Activated Disinfection (PAD) tekniği ile derin çürük lezyonları, kök kanalı, periodontal cepler ve implant çevresi dezenfeksiyonu sağlanabilmektedir. Diş beyazlatma ajanlarının aktivasyonunda, geleneksel Halojen ve LED (light-emitting diode) ışık kaynakları ve lazerler kullanılmaktadır. Klinisyenler, çalışmalarında lazeri kullanmaya karar verirken birçok faktörü göz önünde bulundurmalıdırlar. Vakaya göre uygun lazer sistemleri ve parametrelerinin belirlenmesi gerekmektedir. Bu derlemede, günümüzde restoratif tedavide lazer uygulamaları ve bu uygulamaların geleceği hakkında bilgi verilmesi amaçlanmaktadır

Anahtar Kelimeler:

Lazerler, diş çürükleri, diş hekimliği, diş beyazlatma

Laser Applications In Restorative Dentistry

Keywords:

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Stern RH, Sognnaes RF. Laser beam effect on dental hard tissues. J Dent Res 1964;43(5):873.
Lobene RR, Bhussry BR, Fine S. Interaction of carbon dioxide laser radiation with enamel and dentin. J Dent Res 1968;47(2):311-317.
Yamamoto H, Ooya K. Potential of yttrium- aluminium-garnet laser in caries prevention. J Oral Pathol 1974;3(1):7-15.
Wigdor H, Abt E, Ashrafi S, Walsh JT Jr. The effect of lasers on dental hard tissues. J Am Dent Assoc 1993;124(2):65-70.
Wigdor HA, Walsh JT, Featherstone JD, Visuri SR, Fried D, Waldvogel JL. Lasers in dentistry. Lasers Surg Med 1995;16(2):103-133.
Freitas PM, Navarro RS, Barros JA, Eduardo CDP. The use of Er:YAG laser for cavity preperation: an SEM evaluation. Micros Res Tech 2007;70(9):803- 808.
Moritz A, Schoopand U, Strabl M, Wintner E. Cavity Preparation in Moritz A. Oral Laser Application. 1. edition.Quintessenz Verlags-GmbH, Berlin, 2006. P.75-138.
Berggren U, Meynert G. Dental fear and avoidance: causes, symptoms, and consequences. J Am Dent Assoc 1984;109(2):247-251.
Banerjee A, Kidd EA, Watson TF. In vitro evaluation of five alternative methods of carious dentine excavation. Caries Res 2000;34(2):144- 150.
Hibst R, Keller U. Experimental studies of the application of the Er:YAG laser on dental hard substances: I. Measurement of the ablation rate. Lasers Surg Med 1989;9(4):338-344.
Hibst R. Lasers for caries removal and cavity preparation: state of the art and future directions. J Oral Laser Appl 2002;2(4):203-212.
Kim ME, Jeoung DJ, Kim KS. Effects of water flow on dental hard tissue ablation using Er:YAG laser. J Clin Laser Med Surg 2003;21(3):139-144.
Bader C, Krejci I. Indications and limitations of Er:YAG laser applications in dentistry. Am J Dent
Dederich DN, Bushick RD. Lasers in dentistry: separating science from hype. J Am Dent Assoc 2004;135(2):204-212.
de Freitas PM, Soares-Geraldo D, Biella-Silva AC, Silva AV, da Silveira BL, Eduardo Cde P. Intrapulpal temperature variation during Er,Cr:YSGG enamel irradiation on caries prevention. J Appl Oral Sci 2008;16(2):95-99.
Sirin Karaarslan E, Secilmis A, Bulbul M, Yildirim C, Usumez A. Temperature increase beneath etched dentin discs during composite polymerization. Photomed Laser Surg 2011;29(1):47-52.
Apel C, Franzen R, Meister J, Sarrafzadegan H, Thelen S, Gutknecht N. Influence of the pulse duration of an Er:YAG laser system on the ablation threshold of dental enamel. Lasers Med Sci 2002;17(4):253-257.
Takeda FH, Harashima T, Kimura Y, Matsumoto K. Comparative study about the removal of smear layer by three types of laser devices. J Clin Laser Med Surg 1998;16(2):117-122.
Visuri SR, Walsh JT Jr, Wigdor HA. Erbium laser ablation of dental hard tissue: Effect of water cooling. Lasers Surg Med 1996;18(3):294-300.
Cavalcanti BN, Lage-Marques JL, Rode SM. Pulpa temperature increases with Er:YAG laser and high- speed 2003;90(5):447-451. J Prosthet Dent
Oelgiesser D, Blasbalg J, Ben-Amar A. Cavity preparation by Er-YAG laser on pulpal temperature rise. Am J Dent 2003;16(2):96-98.
Hibst R, Keller U. Removal of dental filling materials by Er:YAG laser radiation. Proc SPIE 1991;1424:120-126.
Cavalcanti BN, Otani C, Turns SM. High-speed cavity preparation techniques with different water flows. J Prosthet Dent 2002;87(2):158-161.
Hibst R, Keller U. Effect of water spray and repetition rate on temperature elevation of dentine. Proc SPIE 1996;2623(1):139-144.
Correa-Afonso AM, Palma-Dibb RG, Pécora JD Composite filling removal with erbium:yttrium- aluminum-garnet laser: morphological analyses. Lasers Med Sci 2010;25(1):1-7. Epub 2008 Jul 4
Pioch T, Matthias J. Mercury vapor release from dental amalgam after laser treatment. Eur J Oral Sci 1998;106(1):600-2.
Aranha AC, De Paula Eduardo C, Gutknecht N, Marques MM, Ramalho KM, Apel C. Analysis of the interfacial micromorphology of adhesive systems in cavities prepared with Er, Cr:YSGG, Er:YAG laser and bur. Microsc Res Tech 2007;70(8):745-751.
Hossain M, Nakamura Y, Yamada Y, Murakami Y, Matsumoto K. Microleakage of composite resin restoration in cavities prepared by Er,Cr:YSGG laser irradiation and etched bur cavities in primary teeth. J Clin Pediatr Dent 2002;26(3):263-268.
Shahabi S, Ebrahimpour L, Walsh LJ. Microleakage of composite resin restorations in cervical cavities prepared by Er,Cr: YSGG laser radiation. Aust Dent J 2008;53(2):172-175.
Eversole LR, Rizoiu I, Kimmel AI. Pulpal response to cavity preparation by an erbium, chromium: YSGG laser-powered hydrokinetic system. J Am Dent Assoc 1997;128(8):1099-1106.
Hossain M, Nakamura Y, Tamaki Y, Yamada Y, Murakami Y, Matsumoto K. Atomic analysis and Knoop hardness measurement of the cavity floor prepared by Er,Cr:YSGG laser irradiation in vitro. J Oral Rehabil 2003;30(5):515-521.
Douglas N, Dederich and Ronald D. Bushick. Lasers in dentistry:Separating from hype. J Am Dent Assoc 2004;135(2):204-212.
Mc Donald A, Claffey N, Pearson G, Blau W, Setchell D. The effect of Nd:YAG radiation at nanosecond pulse duration on dentine crater depth. Biomaterials 2002;23(1):51-58.
Yamada Y, Hossain M, Kawanaka T, Kinoshita J, Matsumoto K. Removal effects of the Nd:YAG laser and Carisolv on carious dentin. J Clin Laser Med Surg 2000;18(5):241-245.
Mehl A, Kremers L, Salzmann K, Hickel R. 3D volume-ablation rate and thermal side effects with the Er:YAG and Nd:YAG laser. Dent Mater. 1997;13(4):246-251.
Brucoli HCP, Arita ES, Eduardo CP. In vitro radiographic analysis of Nd:YAGlaser-irradiated dentin. Lasers Med Sci 2005;20(2):89-94.
Cheong WF, Prahl SA, Welch AJ. A review of the optical properties of biological tissues. IEEE J Quantum Eletron 1990; 26(12):2166-2185.
Stern RH, Sognnaes RF. Laser inhibition of dental caries suggested by first tests in vivo. J Am Dent Assoc 1972;85(5):1087-1090.
Kimura Y, Wilder-Smith P, Arrastia-Jitosho AMA, Liaw LHL, Matsumoto K, Berns MW. Effects of nanosecond pulsed Nd:YAG laser irradiation on dentin resistance to artificial caries-like lesions. Lasers Surg Med 1997;20(1):15-21.
Nelson DG, Jongebloed WL, Featherstone JD. Laser irradiation of human dental enamel and dentine. NZ Dent J 1986;82(369):74-77.
Hicks J, Winn D 2nd, Flaitz C, Powell L. In vivo caries formation in enamel following argon laser irradiation and combined fluoride and argon laser treatment: A clinical pilot study. Quintessence Int 2004;35(1):15-20.
Apel C, Birker L, Mesiter J, Gutknecht N. The caries preventive potential of subalative Er:YAG and Er:YSGG laser radiation in a intraoral model: a pilot study. Lasers Surg Med 2004;22(4):312-317.
Apel C, Meister J, Schmitt N, Graber HG, Gutknecht N. Calcium solubility of dental enamel following sub-ablative Er:YAG and Er:YSGG laser irradiation in vitro. Lasers Surg Med 2002;30(5):337-341.
Ana PA, Bachmann L, Zezell DM. Lasers effects on enamel for caries prevention. Laser Phys 2006;16(5):865-875.
Walsh LJ, Perham SJ. Enamel fusion using a carbon dioxide laser: A technique for sealing pits and fissures. Clin Prev Dent 1991;13(3):16-20.
Hossain M, Kimura Y, YamadaY, NakamuraY, Yamada Y, Kinoshita JI, Matsumoto K. A study on acquired acid resistance of enamel and dentin irradiated by Er,Cr:YSGG laser. J Clin Laser Med Surg 2001;19(3):159-163.
Apel C, Meister J, Gotz H, Duschner H, Gutknecht N. Structural changes in human dental enamel after subablative erbium laser irradiation and its potential use for caries prevention. Caries Res 2005;39(1):65-70.
Ceballos L, Toledano M, Osorio R, Tay FR, Marshall GW. Bonding to Er:YAG laser treated dentin. J Dent Res 2002;81(2):119-122.
Hossain M, Nakamura Y, Kimura Y, Yamada Y, Ito M, Matsumoto K. Caries-preventive effect of Er:YAG laser irradiation with or without water mist. J Clin Laser Med Surg 2000;18(2):61-65.
Goharkhay K, Moritz A. Caries Prevention in Moritz A. Oral Laser Application. 1.edition, Quintessenz Verlags-GmbH, Berlin. 2006, 193-239.
Hennon DK, Stookey GK, Muhler JC. Prevelance and distribution of dental caries in preschool children. J Am Dent Assoc 1969;79(6):1405-1414.
Barr JH, Diodati RR, Stephens RG. Incidence of caries at different locations on the teeth. J Dent Res 1957;36(4):536-545.
Zezell DM, Boari HGD, Ana PA, Eduardo and Powell GL. Nd:YAG Laser in Caries Prevention: A Clinical Trial. Lasers Surg Med 2009;41(1):31-35.
Huang GF, Lan WH, Guo MK, Chiang CP. Synergistic effect of Nd:YAG laser combined with fluoride varnish on inhibition of caries formation in dental pits and fissures in vitro. J Formos Med Assoc 2001;100(3):181-185.
Westerman GH, Hicks MJ, Flaitz CM, Blankenau RJ, Powell GL, Berg JH. Argon laser irradiation in root surface caries: in vitro study examines laser’s effects. J Am Dent Assoc 1994;125(4):401-407.
Powell GL, Morton TH, Whisenant BK. Argon laser oral safety parameters for teeth. Laser Surg Med 1993;13(5):548-552.
Haider SM, White GE, Rich A. Combined effects of argon laser irradiation and fluoride treatments in prevention of caries like lesion formation in enamel. J Clin Pediatr Dent 1999;23(3):247-257.
Fried D, Ragadio J, Akrivou M, Featherstone JDB. Dental hard tissue modification and removal using sealed transverse excited atmospheric-pressure lasers operating at λ=9.6 and 10.6µm. J Biomed Optics 2001;6(2):231-238.
Steiner-Oliveira C, Rodrigues LK, Soares LE, Martin AA, Zezell DM, Nobre-dos-Santos M. Chemical, morphological and thermal effects of 10.6-microm CO2 laser on the inhibition of enamel demineralization. Dent Mater J 2006;25(3):455- 462.
Romano AC, Aranha AC, da Silveira BL, Baldochi SL, Eduardo Cde P. Evaluation of carbon dioxide laser irradiation associated with calcium hydroxide in the treatment of dentinal hypersensitivity. A preliminary study. Lasers Med Sci 2011 26(1):35- 42.
Hsu J Fox JL, Wang Z, Powelll GL, Otsuka M, Higuchi WI. Combined effects of irradiation/solution fluoride ion on enamel demineralization. J Clin Laser Med Surg
Schuurs AHB, Wesselink PR, Eijkman MAJ, Duivenvoorden HJ. Dentists’ views on cervical hypersensitivity and their knowledge of its treatment. Endod Dent Traumatol 1995;11(5):240- 244.
Orchardson R, Gillam DG. Managing dentin hypersensitivity. J Am Dent Assoc
Matsumoto K, Funai H, Shirasuka T, Wakabayashi H. Effects of Nd:YAG-laser in treatment of cervical hypersensitive 1985;28:760-765. J Conserv Dent
Kimura Y, Wilder-Smith P, Matsumoto K. Treatment of dentine hypersensitivity by lasers: a review. J Clin Periodontol 2000;27(10):715-721.
Birang R, Jamshid Poursamimi J, Gutknecht N, Lampert F, Mir M. Comparative evaluation of the effects of Nd:YAG and Er:YAG laser in dentin hypersensitivity treatment. Lasers Med Sci 2007;22(1):21-24.
Birang R, Kaviani N, Mohammadpour M, Abed AM, Gutknecht N, Mir M. Evaluation of Nd:YAG laser on partial oxygen saturation of pulpal blood in anterior hypersensitive teeth. Lasers Med Sci 2008;23(3):291-294.
Wakabayashi H, Hamba M, Matsumoto K, Tachibana H. Effect of irradiation by semiconductor laser on responses evoked in trigeminal caudal neurons by tooth pulp stimulation. Lasers Surg Med 1993;13(6):605-610.
Schwarz F, Arweiler N, Georg T, Reich E. Desensitizing effects of an Er:YAG laser on hypersensitive dentine. J Clin Periodontol 2002;29(3):211-215.
Kumar NG, Mehta DS. Short-term assessment of the Nd-YAG laser with and without sodium fluoride varnish in the treatment of dentin hypersensitivity- a clinical and scanning electron microscopy study. J Periodontol 2005;76(7):1140-1147.
Hsu PJ, Chen JH, Chuang FH, Roan RT. The combined occluding effects of fluoride-containing dentin desensitizer and Nd-Yag laser irradiation on human dentinal tubules: an in vitro study. Kaohsiung J Med Sci 2006;22(1):24-29.
Cavalcante LM, Peris AR, Ambrosano GM, Ritter AV, Pimenta LA. Effect of photoactivation systems and resin composite on the microleakage of esthetic restorations. J Contemp Dent Pract 2007; 8(2):70-79.
Asmussen E, Peutzfeldt A. Temperature rise induced by some light emitting diode and quartz- tungsten-halogen curing units. Eur J Oral Sci 2005; 113(1):96-98.
Jung YH, Cho BH, Nah KS, Kim HI, Kwon YH. Effect of diode-pumped solid state laser on polymerization shrinkage and color change in composite resins. Lasers Med Sci 2010;25(3):339- 343.
Jang CM, Seol HJ, Kim H, Kwon YH. Effect of different blue light-curing systems on the polymerization of nanocomposite resins. Photomed Laser Surg 2009;27(6):871-876.
Knezevic A, Ristic M, Demoli N, Tarle Z, Music S, Negovetic photopolymerization with diode laser. Oper Dent 2007; 32(3):279-284. V. Composite
Hashimoto K, Inai N, and Tagami J. Evaluation of the light intensity of higher intensity light units. Am J Dent 2006;19(April, June, August):143-146.
Wilson M, Dobson J, Harvey W. Sensitization of oral bacteria to killing by low-power laser radiation. Curr Microbiol 1992;25(2):77-81.
Wilson M. Bacterial effect of laser light and its potential use in the treatment of plaque-related diseases. Int Dent J 1994;44(2):181-189.
O’Neill JF, Hope CK, Wilson M. Oral bacteria in multi-species biofilms can be killed by red light in the presence of toluidine blue. Lasers Surg Med 2002;31(2):86-90.
Burns T, Wilson M, Pearson GJ. Effect of dentine and collagen on the lethal photosensitization of Streptococcus mutans. Caries Res 1995;29(3):192- 7.
Dortbudak O, Haas R, Bernhart T, Mailath-Pokorny G. Lethal photosensitization for decontamination of implant surfaces in the treatment of peri- implantitis. Clin Oral Implants Res 2001;12(2):104- 108.
Pirnat S, Lukac M, Ihan A. Study of the direct bactericidal effect of Nd:YAG and diode laser parameters used in endodontics on pigmented and nonpigmented bacteria. Lasers Med Sci 2011; 26(6): 755-761.
Palmer TM, Hansen LD. In-office vital tooth bleaching - what do lights add? Compend Contin Educ Dent 2003;24(4A):340-352.
ADA Council on Scientific Affairs. Laser-assisted bleaching: an update. J Am Dent Assoc 1998; 129(10): 1484-1487.
Carrasco TG, Carrasco-Guerisoli LD, Fröner IC. In vitro study of the pulp chamber temperature rise during light-activated bleaching. J Appl Oral Sci
Sulieman M, Rees JS, Addy M. Surface and pulp chamber temperature rises during tooth bleaching using a diode laser: a study in vitro. Br Dent J 2006; 200(11):631-634.
Dostalova T, Jelinkova H, Housova D, Sulc J, Nemec M, Miyagi M, Brugnera JA, Zanin F. Diode laser-activated bleaching. Braz Dent J 2004; 15: SI3-18.
Marcondes M, Paranhos MP, Spohr AM, Mota EG, da Silva IN, Souto AA, Burnett LH Jr. The influence of the Nd:YAG laser bleaching on physical and mechanical properties of the dental enamel. J Biomed Mater Res B Appl Biomater 2009; 90(1): 388-395.