Clinical evaluation of tooth sensitivity during cavity preparation with Er: YAG laser

The efficacy of a high-pulse Er:YAG laser in treating caries was evaluated clinically. Caries removal and cavity preparation were performed using an Er:YAG laser (Er-D1, Hoya Continuum, Japan) at 30-350 mJ/pulse, 20 or 30 pps without local anesthesia. The cavities were restored with adhesive resin composite according to the manufacturer's instructions. After treatment, the patients were asked to express the level of pain and discomfort felt during cavity preparation with the Er:YAG laser by means of a Visual Analogue Scale (VAS). The mean VAS value for discomfort was 6.03 and female patients recorded a lower value than male patients (P<0.05). The mean VAS value of pain was 22.53 and a statistically significant tendency for elderly patients to record a lower value than younger patients was found (P<0.05). The mean value and the tendency were comparable to those obtained in a previous study in which caries removal and cavity preparation were performed using rotary cutting instruments and caries detection dye. Patients with sensitivity caused by a jet of air before the treatment gave a higher value for pain during the treatment than patients without any sensitivity before treatment (P<0.05). It was concluded that caries removal and cavity preparation for adhesive restorations could be performed using an Er:YAG laser with little or no pain or discomfort.