ERBIUM-YAG LASER APPLICATION IN CARIES THERAPY - EVALUATION OF PATIENT PERCEPTION AND ACCEPTANCE

Objectives: In previous studies it has been demonstrated that the Er:Y AG laser can be used to prepare cavities efficiently and without therm al damage to the adjacent dental hard and soft tissues. To investigate the patients' response to Er:YAG laser preparation of teeth, a prospe ctive clinical study was performed in five dental hospitals. Methods: To evaluate patients' perception and response to cavity preparation a direct comparison was made between conventional mechanical preparation and Er:YAG laser preparation of caries in dental hard tissues. Half o f the preparations were completed by the laser alone with standardized parameters, with the other half being mechanically prepared. The sequ ential order of treatment was randomized, and clinical parameters such as depth and location of the cavities were carefully balanced. A thre e-score evaluation scheme of patient responses was used: comfortable, uncomfortable. very uncomfortable. In addition the patients were asked to decide which was the more uncomfortable form of treatment and the preferred treatment for future caries therapy. Results: The study incl uded 103 patients with 206 preparations distributed amongst 194 teeth. All teeth gave vital responses (ice test) before and after both types of treatment. The laser treatment was found to be more comfortable th an the mechanical treatment. with high statistical significance. Durin g treatment, the need for local anaesthesia was 11% for mechanical pre paration compared to 6% during laser application. It was found that 80 % of the patients rated the conventional preparation as more uncomfort able than the laser treatment and 82% of the patients indicated that t hey would prefer the Er:YAG laser preparation for further caries treat ment. Conclusions: The application of the Er:YAG laser system is a mor e comfortable alternative or adjunctive method to conventional mechani cal cavity preparation. (C) 1998 Elsevier Science Ltd. All rights rese rved.