Improving the efficiency of an Er:YAG laser on enamel and dentin

Objective: To evaluate the influence of air pressure, water flow rate, and pulse frequency on the removal speed of enamel and dentin as well as on their surface morphology. Method and Materials: Twenty-four bovine incisors were horizontally cut in slices. Each sample was mounted on an experimental assembly, allowing precise orientation. Eighteen cavities were prepared, nine in enamel and nine in dentin. Specific parameters for frequency, water flow rate, and air pressure were applied for each experimental group. Three groups were randomly formed according to the air pressure settings. Cavity depth was measured using a digital micrometer gauge, and surface morphology was checked by means of scanning electron microscopy. Data was analyzed with ANOVA and Duncan post hoc test. Results: Irradiation at 25 Hz for enamel and 30 Hz for dentin provided the best ablation rates within this study, but efficiency decreased if the frequency was raised further. Greater tissue ablation was found with water flow rate set to low and dropped with higher values. Air pressure was found to have an interaction with the other settings, since ablation rates varied with different air pressure values. Conclusion: Fine-tuning of all parameters to get a good ablation rate with minimum surface damage seems to be key in achieving optimal efficiency for cavity preparation with an Er:YAG laser. (Quintessence lot 2012;42:153-160)