Morphological analysis of dental surfaces after apicoectomies with Er:YAG laser

Apicoectomies are usually performed using high speed burs and it results in dental surfaces covered of smear layer. The remotion of this structure and the obliteration of dentinal tubules are important and deseareble after the periapical surgery. Objective: The Er:YAG laser is able to eliminate this smear layer and depending of the parameters it also can obliterate the dentinal tubules. The aim of this study was to analyse the morphology of dental surfaces apicoectomized with Er:YAG laser (Kavo Key III) with variable parameters of energy (E) and pulses (P), followed or not by a superficial treatment (ST), performed with the same laser. Methods: The experimental groups were: Group 1) 350 mJ (E) and 4 Hz (P); Group 2) 350 mJ (E) and 6 Hz (P); Group 3) 250 mJ (E) and 6 Hz (P); Group 4) 200 mJ(E) and 10 Hz (P). In Groups 5) to 8), following the apicoectomies, we performed the (ST) with 60 mJ (E) and 10 Hz (P). Results: The morphological analysis with scanning electron microscopy showed that Er:YAG laser induced irregular surfaces that became more homogeneus using lower energies. We also observed that the following treatment with the Er:YAG laser resulted in less dentinal tubules exposed.

Conclusion: The Er:YAG laser showed to be efficient for the apicoectomies and also for the treatment superficial, cleaning and oblitering dentinal tubules of the apical area. Lower energies followed by the treatment with the same laser resulted in surfaces closer than the ideal.