Selective Removal of Necrotic Dentin in Primary Teeth Using Laser Irradiation: One-Year Clinical Evaluation of Composite Restorations

• Published in: Journal of lasers in medical sciences Vol. 10; no. 2; pp. 108 - 116
• Main Authors: Polizeli, Silvana Aparecida Fernandes, Curylofo-Zotti, Fabiana Almeida, Valério, Rodrigo Alexandre, Nemezio, Mariana Alencar, Souza-Gabriel, Aline Evangelista, Borsatto, Maria Cristina, Corona, Silmara Aparecida Milori
• Format: Journal Article
• Language: English
• Published: Iran Laser Application in Medical Sciences Research Center 2019
• Subjects: Original; Dental caries; Primary teeth; Dental restoration; Lasers; Stress
• ISSN: 2008-9783; 2228-6721
• DOI: 10.15171/jlms.2019.18

This study aimed to evaluate the child's salivary cortisol levels, clinical performance and marginal adaptation of restorations after selective removal of necrotic dentin in primary teeth using Er: YAG laser irradiation.
A double-blind clinical study was performed in children at 7-10 years. Children who had at least 2 teeth with carious lesions involving the occlusal and proximal surfaces of primary molars counterparts were selected. Removal of necrotic dentin was performed by 2 methods: Er: YAG laser irradiation and bur-preparation. Cortisol levels (n =24) was evaluated by ELISA. Clinical analysis (n =20) was performed after the restorations polish, 6 and 12 months after restorative procedure using United States Public Health Service (USPHS) method and photographs. Scanning electron microscopy (SEM) was used to analyz the marginal gap formation (n =20). The analysis of the data was performed by 95% confidence interval, Shapiro-Wilk test, Friedman and Wilcoxon post hoc tests (α =5%).
Cortisol levels were higher during selective removal of necrotic dentin, regardless of the method used (
>0.05). After 12 months, there was no evidence of the difference in the restorations performed on cavities prepared by both methods. SEM analysis revealed that the laser-irradiated teeth showed 10% of gaps in the full extent of restoration. For bur-prepared teeth, 20% of gaps were found at the cavosurface margin.
The salivary cortisol levels on children that received Er: YAG laser irradiation for removal the necrotic dentin was similar to the control group. Class II restorations evaluated after 1 year period did not suffer interference by the use of Er: YAG laser irradiation.