Utilization of Er:YAG Laser in Retrieving and Reusing of Lithium Disilicate and Zirconia Monolithic Crowns in Natural Teeth: An In Vitro Study

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Abstract

The study examined the effect of noninvasive crown retrieval/reuse process using an erbium-doped yttrium aluminum garnet laser (Er:YAG). Twenty-six extracted human teeth were prepared for a crown. The crown was milled using lithium disilicate (LD) and zirconia (Z) materials, n = 13 per group, with three for scanning electron microscopy (SEM). The crown was luted using composite resin cement and subjected to a laser retrieval process. After the retrieval process, the crown was cleaned, re-cemented and laser-retrieved two more times, without and with additional tooth reduction mimicking clinical refreshment of dentin. Retrieval time and temperature were analyzed using analysis of variance (ANOVA). Surface changes were observed through SEM. The retrieval times were 267.1 ± 130.43, 220 ± 79.09, 277.1 ± 126.44, 368.4 ± 136.14, 355 ± 159.39, and 419.2 ± 121.36 s for first, second, third LD and Z groups, respectively (p = 0.009). The maximal temperatures were 23.95.1 ± 1.89 °C, 24.86 ± 2.01 °C, 24.17 ± 1.53 °C, 22.88 ± 1.51 °C, 24.03 ± 1.74 °C, and 21.99 ± 1.32 °C for first, second, third LD and Z groups, respectively (p = 0.006). Er:YAG laser crown removal is an effective retrieval tool for all-ceramic crowns. Minimal changes to teeth and crowns were observed following laser irradiation.

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Er:YAG Laser for Metal and Ceramic Bracket Debonding: An In Vitro Study on Intrapulpal Temperature, SEM, and EDS Analysis

Kinga Grzech-Leśniak, Jacek Matys, Dorota Żmuda-Stawowiak … (2018)

To evaluate the effects of bracket removal using an erbium laser on the pulp temperature and enamel surface.

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Using Er:YAG laser to remove lithium disilicate crowns from zirconia implant abutments: An in vitro study

Janina Deeb, Sompop Bencharit, Nishchal Dalal … (2019)

Background When implants are restored with cement-retained restorations, prosthetic retrievability can be difficult and often requires sectioning using rotary instruments. Sometimes repeated removals of a cement-retained implant crown are needed such as for treatment of peri-implantitis or immediate implant provisionalization. The purpose of this study was to evaluate the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser as a non-invasive treatment modality to remove lithium disilicate crowns from zirconia implant abutments following long-term cementation, repetitive debonding and re-cementation, and short-term retrieval. Material and methods Twenty identical lithium disilicate crowns were cemented onto zirconia prefabricated abutments using composite resin cement. Ten cemented crowns were removed at 48 hours after cementation as a short-term group (ST), while another 10 were removed 6 months after cementation as a long-term group (LT). To mimicking repetitive recementation and retrieval, the LT crowns were then recemented and removed after 48 hours as a long-term recemention (LTR) group. The LTR crowns were then again recemented and removed after 48 hours as a long-term repeated recemention (LTRR) group. Er:YAG laser was used to facilitate the retrieval of these crowns. recorded and analyzed using ANOVA and t-test. The surfaces of the crown and the abutment were further examined using light microscopy and scanning electron microscopy (SEM). Temperature changes of the abutment and crown upto 10 minutes were also measured and statistically analyzed (paired t-test). Results The average times of crown removal from zirconia abutments were 4 minutes (min) and 42 second (sec) in LT to 3 min 24 sec in LTR, and 3 min 12 sec in LTRR and ST groups. LTR took the longest time to remove, statistically (ANOVA and t-test, p < .001). No statistical differences were observed among the removal times of LTR, LTRR, and ST groups (t-test, p = .246, .246 and 1). SEM examination of the material surface showed no visual surface damaging from treatment with Er:YAG laser. The temperatures during irradiation ranged from 18.4°C to 20°C and 22.2°C to 24.5°C (Paired t-test, p < .0001) for the abutment and the crown during irradiation from 1 min to 10 mins. Conclusions Long-term cementation can increase time in lithium disilicate crown removal from zirconia abutment using Er:YAG. Er:YAG laser is a non-invasive tool to remove cement-retained implant prostheses and should be considered as a viable alternative to rotary instruments.

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A systematic review of all-ceramic crowns: clinical fracture rates in relation to restored tooth type.

Xiaodong Wang, Ke Zhao, Michael Swain … (2012)

The objective of this systematic review was to evaluate the clinical fracture incidence of tooth-supported all-ceramic crowns according to restored tooth type.