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25 4 2016 laser industry | but also on the tissue's chemical composition. The enamel contains 95 per cent of hydroxyapatite (Ca10 (PO4 )6 (OH)2 ),4percentofwaterand1 per cent ofcollagenfibres.Dentineconsistsof70percentof hydroxyapatite, 20 per cent of collagen fibres and 10 per cent of water.17 Decayed tissue contains more water than healthy tissue. The above information suggest that the speed of Er:YAG laser preparation of dentine is higher than of enamel, and diseased tissue is more easily re- moved than healthy tissue. This should be kept in mind during the cavity preparation, in order to safelyandconsciouslycontrolthescopeofthecav- ity according to the concept of minimally invasive therapy.Thelightoflasershowsantibacterialprop- erties, and it acts through overheating and disrup- tion of bacteria cell.18 Er:YAG laser is a promising toolforthecavitypreparationinprimaryteethdue to the reduction of pain perception and antibacte- rial effect.19 The contraindications to the use of Er:YAG laser are cutting crowns and the removal of amalgam fillings. There are no restrictions on the removalofcementandcompositefillings;however, in these cases, because of the modest speed, take advantage of the combined approach and use the turbine additionally. The big advantage of Er:YAG laser is its low invasiveness, which allows to work according to the concept of minimally invasive therapy.20–21 Simultaneously, it is characterized by the efficiency and safety at work,22 and is well per- ceived by patients. Clinical case A 23-year-old, non-smoker, generally healthy patient visited the clinic. The following was re- ported in a clinical study: numerous carious fo- cuses in the buccal grooves of 46 and 47, the pri- mary decay on the occlusal surface of 47 and recurrent decay on the occlusal surface of 46. The patient reported no pain of these teeth. During the preparation according to the concept of minimally invasivetherapy,varioustechniquesofEr:YAGlaser application with the same parameters were used (H14conicaltip,QSP,0.90 W/90 mJ/10 Hz,4 W/4 A). Theaveragecariesinthebuccalgrooveofthetooth 46 was prepared using a non-contact technique (head H02 ). No pain during the preparation (NRS = 0). Deep carries in the buccal groove of 47 waspreparedusingacontacttechnique(headH14, cylindrical tip). Moderate sensation of pain during the preparation (NRS = 4). Deep carries on the oc- clusal surface of the tooth 47 was prepared using a combined method—a turbine (diamond drill) and Er:YAG laser (H14 head, cylindrical tip). During the preparation,severepainwasexperienced(NRS=8), infiltration anaesthesia was administered (Ubiste- sin forte 1/2 of ampoule) and the preparation was completed.Directreconstructionofhardtissuesof tooth was performed with the use of composite material (Gradia A3/NT)._ Kurz & bündig In ihrem Artikel beschreiben die Autoren die fünf Prinzipien der Kavitätenpräparation und Kariesbehandlung: 1) So schnell wie möglich, 2) Beachtung von physiologischen, gesundheitlichen, funktionalen und ästhetischen Faktoren, 3) Minimalinvasive Behandlung, 4) Evidenzbasierte Behandlungsansätze, 5) Regelmäßige Check-ups und Recall- Intervalle. Im Anschluss gehen sie näher auf die Kariestherapie mithilfe des Er:YAG-Lasers ein, der zur Preparation des betroffenen Hardgewebes für den Austausch dentaler Füllungen genutzt werden kann. Gleichzeitig zeigen sie die Vorteile der dentalen Lasertherapie auf: Schmerzreduktion aufgrund geringer Vibrationen und Wärmeentwicklung, kurzer Pulsdauer und der Vermeidung einer Stimulation der Nervenenden sowie eine Minimierung der für manche Pa tienten angstauslösenden Geräusche. Dies habe zur Folge, dass die Patienten stärker für die weitere Zusammenarbeit motiviert werden können. Neben umfassenden Erkenntnissen aus der Literatur führen die Autoren auch einen kurzen Fallbericht an, um die Vorteile der Er:YAG-Kariestherapie zu belegen. contact Dr n. med. Kinga Grzech-Les ´niak – specjalista periodontolog, Polskie Towarzystwo Stomatologii Laserowej PTSL www.periocare.pl www.laser.org.pl Literature Author details 42016