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. 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). 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. 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.

Purpose: Removal of ceramic restorations and appliances can be time consuming, invasive, and inconvenient. Erbium lasers offer an alternative noninvasive method for debonding of ceramic appliances. This paper aims to provide a comprehensive review of current literature on the effectiveness of erbium lasers for removal of ceramic restorations and appliances from natural teeth and dental implants.Methods: A comprehensive search of 7 databases, including Medline (Ovid), Embase, Dentistry and Oral Sciences Source (DOSS), Web of Science, Cochrane Library, and ProQuest Dissertations and Theses was performed. The inclusion and exclusion criteria were agreed prior to the literature search. Two reviewers independently screened the title and A third reviewer then broke the tie, if any. The selected articles then underwent full text review and the data was extracted.Results: The search identified 4117 unique articles published through June 10, 2021. Studies were assessed and categorized based on the type of restoration/appliance, type of abutment, type of laser, laser settings, efficacy of debonding, and pulpal temperature rise. Thirty‐eight full‐text articles were reviewed for inclusion. Time for ceramic debonding varies depending on the type of restorations and materials. Removal of zirconia crowns from teeth and implant abutments requires a longer period of time compared to lithium disilicate crowns. Temperature increases were reported as 5.5 degrees or less. Laser setting and laser type affect the debonding time and the increase in temperature. Examinations of debonded ceramics demonstrated no known structural damages resulting from laser applications.Conclusions: Erbium lasers are effective noninvasive tools to remove all ceramic restorations/appliances from natural teeth and implant abutments without causing harm to abutments. Laser‐assisted debonding should be considered as a viable alternative to rotary instrumentation for ceramic crowns; however, clinical studies of erbium‐assisted ceramic retrieval are needed.

Ankyloglossia, commonly known as tongue-tie, is the most common disorder of tongue morphology characterized by aberrant attachment of the lingual frenum. This study aimed to provide a comprehensive literature review and evaluate the effectiveness of various laser wavelengths in the surgical treatment of patients with ankyloglossia. An electronic screening of PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted on 8 November 2021. The following search terms were used to review the available data on the subject of interest: (ankyloglossia OR tongue tie OR short lingual frenulum OR lingual frenectomy OR lingual frenulectomy OR lingual frenotomy OR lingual frenulotomy) AND laser. The use of lasers in ankyloglossia treatment resulted in shorter procedure time, reduced indications for general anesthesia, reduced administration of postoperative analgesics, fewer sutures or none needed, reduced postoperative bleeding, and improved healing. Despite many advantages, this method has its clinical limitations: it requires the use of expensive equipment; well-trained personnel familiar with lasers; and personal protective equipment for the patient, caregiver, operator, and assistant. The laser procedure does not eliminate the need for myofunctional exercises and work with a speech therapist.

The erbium-doped yttrium aluminum garnet (Er:YAG) laser is used to treat periodontal disease; however, its effectiveness at killing oral bacteria is not well known. Furthermore, the compounding effect of the combination of a laser treatment and irrigation methods with antimicrobials on bacterial viability is yet to be determined. The purpose of this in vitro study was to evaluate the effect of the Er:YAG laser with irrigation using chlorhexidine (CHX), hydrogen peroxide (H₂O₂), or sodium hypochlorite (NaOCl) on the viability of oral bacteria. Three bacterial species were used in our study: Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. Bacteria were grown in an anaerobic chamber in brain heart infusion broth and incubated at 37 °C. Bacterial samples with an OD of 0.5 were irradiated with the Er:YAG laser at 2940 nm using a 400-µm Varian tip. The experiment was repeated four times using these parameters: 40 mJ, 40 Hz, and 1.6 W for 20 seconds with the 300 µs short pulse duration in contact mode. Treatment groups consisted of the following: (1) no treatment, (2) 0.5% H₂O₂ alone, (3) 0.5% NaOCl alone, (4) 0.03% CHX alone, (5) Er:YAG irradiation alone, (6) Er:YAG irradiation with 0.5% H₂O₂, (7) Er:YAG irradiation with 0.5% NaOCl, and (8) Er:YAG irradiation with 0.03% CHX. Microbial viability was determined through plating and colony counts and calculated into CFU/ml. Statistical analysis was done using a two-tailed paired t-test. The use of the Er:YAG laser alone failed to show statistically significant antibacterial activity against any of bacteria. The most effective mono-treatment with irrigation solutions for all three bacteria were 0.5% H₂O₂ and 0.5% NaOCl (p < 0.001 for each solution). Irrigation with 0.03% CHX was most effective against F. nucleatum (p < 0.01) and less against P. gingivalis and S. gordonii and showed the least antibacterial action alone but improved significantly in combination therapy (p < 0.05). The combined treatment with the Er:YAG showed the greatest and most significant improvement in the reduction of bacterial viability compared to any other treatment group (p < 0.05 for each combined treatment). Irradiation with the Er:YAG laser with the addition of 0.5% H₂O₂, 0.5% NaOCl, or 0.03% CHX under a short working time (20 s) resulted in a significant reduction of bacterial viability for all three bacterial species compared with any single treatment option. The combination of irradiation with the Er:YAG laser with the addition of 0.5% H₂O₂, 0.5% NaOCl, or 0.03% CHX resulted in a larger reduction of bacterial survival when compared to monotherapies with antimicrobial solutions or laser. The combination of the Er:YAG laser with a low concentration irrigant solution of 0.5% H₂O₂, 0.5% NaOCl, or 0.03% CHX could be an effective treatment protocol for the reduction of periodontal pathogens and thus suitable treatment for non-surgical periodontal therapy.

Reduced tooth structure in the pediatric and adolescent population is frequently restored with prefabricated zirconia crowns. On permanent teeth, these restorations may need to be removed and replaced with permanent restorations. To explore and compare the use of 2 high-powered erbium lasers for removing prefabricated zirconia crowns from molar teeth as a non-invasive alternative to rotary instruments. Twenty-five permanent molars were prepared to dentin and prefabricated all-ceramic zirconia crowns were fitted and cemented with resin modified glass ionomer (RMGI) cement. The teeth were randomly assigned into one of the 2 retrieval treatment groups: the erbium-doped yttrium, aluminum and garnet (Er:YAG) laser group (G1; n = 12) or the erbium, chromium-doped yttrium, scandium, gallium and garnet laser (Er,Cr:YSGG) laser group (G2; n = 13). The laser operating parameters for the Er:YAG laser were 300 mJ, 15 Hz, 4.5 W, and 50-microsecond pulse duration (SSP mode); for the Er,Cr:YSGG laser, they were 4.5 W, 15 Hz, 20 water/20 air, and 5 W, 15 Hz, 50 water/50 air, and 60-microsecond pulse duration (H mode). The experiment was repeated twice. The surface area and the volume of teeth and crowns were measured and the cement space was calculated. The retrieval time and temperature changes were tested and recorded. The data were analyzed with the t-test. The surfaces of the dentin and the crown from each group were further examined using scanning electron microscopy (SEM). The average time for crown removal using the Er:YAG laser was 1 min 32.7 s; for the Er,Cr:YSGG laser it was 3 min 13.9 s (p < 0.0001). The mean temperature changes were 1.41 ±1.36°C for the Er:YAG laser and 2.2 ±0.99°C for the Er,Cr:YSGG laser (p = 0.0321). The SEM examination showed no damage or major structural changes caused by treatment with either erbium-family laser. Both lasers are effective, non-invasive tools to remove prefabricated zirconia crowns cemented with resin cement and should be considered as viable alternatives to rotary instrumentation.