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Evaluation of the Effects of Er,Cr:YSGG Laser, Ultrasonic Scaler and Curette on Root Surface Profile Using Surface Analyser and Scanning Electron Microscope: An In Vitro Study

Shipra Arora, Arundeep Kaur Lamba, Farrukh Faraz, Shruti Tandon, Abdul Ahad




Introduction: The periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects.

Methods: Thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A (n = 30) was taken as control and no instrumentation was performed. Part B (n = 30) was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser. Part C (n = 30) was treated by piezoelectric ultrasonic scaler. Part D (n = 30) was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average (Ra) value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope (SEM). The means across the groups were statistically compared with control using Dunnett test.

Results: Among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness (mean Ra value of 4.14 μm) as compared to ultrasonic scaler (1.727 μm) and curette group (1.22 μm). However, surface with smear layer were found to be maximum (50%) in curette treated samples and minimum (20%) in laser treated ones. Maximum cracks (83.34%) were produced by ultrasonic scaler, and minimum (43.33%) by curettes. Crater formation was maximum (50%) in laser treated samples and minimum (3.33%) in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes.

Conclusion: Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects.


Periodontal therapy; Er,Cr:YSGG; Laser; Smear layer; Scaling; Root planing


Yukna RA, Scott JB, Aichelman ME. Clinical evaluation of the speed and effectiveness of subgingival calculus removal on single rooted teeth with diamond-coated ultrasonic tips. J Periodontol. 1997;68:436-442. doi:10.1902/jop.1997.68.5.436.

Oda S, Nitta H, Setoguchi T, Izumi Y, Ishikawa I. Current concepts and advances in manual and power-driven instrumentation. Periodontology 2000. 2004;36:45-58. doi:10.1111/j.1600-0757.2004.03674.x.

Cobb CM. Lasers in periodontics:a review of the literature. J Periodontol. 2006;77:545-564. doi:10.1902/jop.2006.050417.

Koort HJ, Frentzen M. Laser Effects on Dental hard tissue. In: Miserendio LJ, Pick RM, eds. Lasers in Dentistry. Chicago: Quintessence; 1995:57-70.

Shafagh, I. Plaque accumulation on cast gold complete crowns polished by a conventional and an experimental method. J Prosth Dent. 1986;55:339-342. doi:10.1016/0022- 3913(86)90116-2.

Quirynen M, Bollen CML, Papaioannou W, Van Eldere J, Van Steenberghe D. The influence of titanium abutment surface roughness on plaque accumulation and gingivitis:short-term observations. Int J Oral Maxillofac Implants. 1996;11:169- 178. doi:10.1034/j.1600-0501.1996.070302.x.

de Mendonça AC, Máximo MB, Rodrigues JA, Arrais CA, de Freitas PM, Duarte PM. Er:YAG Laser, ultrasonic system, and curette produce different profiles on dentine root surfaces: an in vitro study. Photomed Laser Surg. 2008;26(2):91-97. doi:10.1089/pho.2007.2129.

Leitao J, Hegdahl T. On the measuring of roughness. Acta Odontol Scand. 1981;48:409-413.

Folwaczny M, George G, Thiele L, Mehl A, Hicke R. Root surface roughness following Er:YAG laser irradiation at different radiation energies and working tip angulations. J Clin Periodontol. 2002;29:598-603. doi:10.1034/j.1600- 051x.2002.290703.x.

Roulet JF, Mehrens TK. The surface roughness of restorative materials and dental tissues after polishing with prophylaxis and polishing pastes. J Periodontol. 1982;53:157-266.

Katia MS, Akira A, Shizuko I, Isao I. Morphological analysis of cementum and root dentin after Er:YAG laser irradiation. Lasers Surg Med. 2002;31:79-85. doi:10.1002/lsm.10074.

Crespi R, Romanos GE, Barone A, Sculean A, Covani U. Er:YAG laser In defocused mode for scaling of periodontally involved root surfaces:an in vitro pilot study. J Periodontol. 2005;76(5):686-90. doi:10.1902/jop.2005.76.5.686

Walmsley AD, Walsh TF, Laird WR, Williams AR. Effects of cavitational activity on the root surface of teeth during ultrasonic scaling. J Clin Periodontol. 1990;17(5):306-312. doi:10.1111/j.1600-051x.1990.tb01094.x.

Khambay BS, Walmsley AD. Acoustic microstreaming:detection and measurement around ultrasonic scalers. J Periodontol. 1999;70(6):626-631. doi:10.1902/jop.1999.70.6.626.

Flemmig TF, Petersilka GJ, Mehl A, Hickel R, Klaiber B. Working parameters of a magnetostrictive ultrasonic scaler influencing root substance removal in vitro. J Periodontol. 1998;69:547-553.

Schlageter T, Rateitschak-Plüss EM, Schwarz JP. Root surface smoothness or roughness following open debridement. An in vivo study. J Clin Periodontol. 1996;23(5):460-464. doi:10.1902/jop.1998.69.5.547.

Bollen CM, Papaioanno W, Van Eldere J, Schepers E, Quirynen M, van Steenberghe D. The influence of abutment surf ace roughness on plaque accumulation and per implant mucositis. Clin Oral Implants Res. 1996;7:201-211.

Pattison AM, Pattison GL. Scaling and Root planing. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds. 11th ed. Carranza’s Clinical Periodontology. Philadelphia: WB Saunders; 2012:461-473.

Aoki A, Ando Y, Watanabe H, Ishikawa I. In vitro studies on laser scaling of subgingival calculus with an erbium:YAG laser. J Periodontol. 1994;65(2):1097-1106. doi:10.1902/ jop.1994.65.12.1097.

Ting CC, Fukuda M, Watanabe T, Aoki T, Sanaoka A, Noguchi T. Effects of Er,Cr:YSGG laser irradiation on the root surface:morphologic analysis and efficiency of calculus removal. J Periodontol. 2007;78(11):2156-2164. doi:10.1902/ jop.2007.070160.

Polson AM, Caton J. Factors influencing periodontal repair and regeneration. J Periodontol. 1982;53(10):617-625. doi:10.1902/jop.1982.53.10.617.

Gómez C, Bisheimer M, Costela A, García-Moreno I, García A, García JA. Evaluation of the effects of Er:YAG and Nd:YAG lasers and ultrasonic instrumentation on root surfaces. Photomed Laser Surg. 2009;27:43-8.

Theodoro LH, Sampaio JE, Haypek P, Bachmann L, Zezell DM, Garcia VG. Effect of Er:YAG and Diode lasers on the adhesion of blood components and on the morphology of irradiated root surfaces. J Periodontal Res. 2006 ;41(5):381- 90. doi:10.1111/j.1600-0765.2005.00846.x.

Feist I, Micheli G, Carneiro S, Eduardo C, Miyagi S, Marques M. Adhesion and growth of cultured human gingival fibroblasts on periodontally involved root surfaces treated by Er:YAG laser. J Periodontol. 2003;73(9):1368-1375. doi:10.1902/jop.2003.74.9.1368.

Guilherme J, José E, Rosemary A. Effects of Er,Cr:YSGG laser irradiation on root surfaces for adhesion of blood components and morphology. Photomed Laser Surg. 2010;28(6):751-756. doi:10.1089/pho.2009.2681.

Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol. 1988;59(8):493-503. doi:10.1902/ jop.1988.59.8.493.

Renato CV, Ribeiro FR, Sallum AW, Sallum EA, Nociti- Jr FH, Casati MZ. Root surface defect produced by hand instruments and ultrasonic scaler with different power settings: an in vitro study. Braz Dent J. 2009;20(1):58-63. doi:10.1590/s0103-64402009000100010.

Fujii T, Baehni PC, Kawai O, Kawakami T, Matsuda K, Kowashi Y. Scanning electron microscopic study of the effects of Er:YAG laser on root cementum. J Periodontol. 1998;69(11):1283-1290. doi:10.1590/s0103- 64402009000100010.

Gholami GA, Fekrazad R, Esmaiel-Nejad A, Kalhori AM. An evaluation of the occluding effects of Er;Cr:YSGG, Nd:YAG, CO2 and diode lasers on dentinal tubules:a scanning electron microscope in vitro study. Photomed Laser Surg. 2011;29(2):115-121. doi:10.1089/pho.2009.2628.

Frentzen M, Braun A, Aniol D. Er:YAG laser scaling of diseased root surfaces. J Periodontol. 2002;73(5):524-530. doi:10.1902/jop.2002.73.5.524.

Aoki A, Sasaki KM, Watanabe H, Ishikawa I. Lasers in non-surgical periodontal therapy. Periodontology 2000. 2004;36:59-97. doi:10.1111/j.1600-0757.2004.03679.x.

DOI: https://doi.org/10.22037/jlms.v7i4.9586