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ePaper created 2015-12-29, 14:54:09 | version 1.38.0
36 3_2015 laser 36 laser_opis przypadku I research Figs. 3a–c_Lingual frenectomy of 7-year-old boy with Lite Touch, Er:YAG laser. speed caused by Er:YAG laser versus high-speed drill. Mean vibration speed during laser cavity preparation reaches 166 +/- 28 µm/second, at a characteristic fre- quencyof230Hz,whereasthehigh-speeddrillinduces a100timeshighervibrationspeedof65+/-48mm/sec- ond, at 5 kHz. In addition, this much higher frequency hasitsspectrumnearthepeaksensitivityofhearing,as apotentialfactorofdiscomfortandpainprovocation.12 A patient may suffer progression of oral disease if treatment is not provided on time because of age, be- haviour, inability to co-operate, disability, or medical status. Postponement of dental care can result in un- necessarypain,discomfort,increasedtreatmentneeds andcosts,unfavourabletreatmentexperiences,anddi- minished oral health outcomes. Using Er:YAG laser in patientswithfearorphobiaofdentaltreatmentisareal opportunitytotreatthemandshowanalternativewell- acceptedmethodtoovercomethebarrierofdentalcare. WiththehelpofEr:YAGlaser,patientsrealisethatthere isawaytopreservetheirteethwithoutpain,whichwill encourage them to take care of their oral health more frequentlyandattheendonlyforprevention. _Application of Er:YAG laser in hard tissues PrimaryCariesPrevention Laserisbecomingcommoninclinicaldentalcareand is one of the promising new modalities used for caries management.Inmanystudieswasinvestigatedthepos- sibility of sub-ablative energies to increase the acid re- sistanceandthemicro-hardnessofenamelsurfaceand to reduce enamel solubility by increasing caries resist- ance without severe alterations of the enamel.13 Laser–fluorideeffectonenamelfoundthatlow-energy Er:YAGlaserirradiationcoupledwithfluoridetreatment could inhibit enamel demineralisation through in- creased fluoride deposition on the surface and forma- tionoffluoridatedhydroxyapatite.14 Inonerecentstudy, silver diamine fluoride (SDF ) application followed by sub-ablative low-energy Er:YAG laser irradiation on dentinerenderedthedentinesurfacesmoreresistantto caries development, both chemically and mechani- cally.15 Lasershavealsobeenusedtopreventtheenamel demineralization caused by dental caries and have showngoodresults.16,17 TheEr:YAGlaserhasbeenshown to reduce or prevent the demineralization of tooth enamel.18 In some studies, when associated with fluo- ride,itleadstoareductioninmineralsurfaceloss.19,20 Sealants reduce the risk of caries in susceptible pits and fissures of primary and permanent teeth.13 The enamel surface prior to the placement of the sealant can be pre-treated in different ways. Non-invasive techniques include only etching with 37 per cent or- thophosphoricacidorairabrasionandacidetching.In- vasive techniques use burs for opening the deep and narrow fissures and then acid etching. Preparing the enamelsurfacewithEr:YAGlaserwithsubsequentacid etching is considered as non-invasive technique for pre-treatment of pits and fissures. This laser wave- length has special uses in the domain of primary and secondarypreventionwhichincludesealingofpitsand fissures and cavity preparation.14 This technology makes the enamel more resistant to caries attack, and alsotheneedtoacidetchingprocedureiseliminated,or reduced.14,15 Theuseoflasergivesthedentisttheability to clean and sterilise enamel fissures. The bactericidal effect of Er:YAG laser irradiation could boost the inter- 08 I laser2_2015 Fig. 3a Fig. 3b Fig. 3c