Sergio Varela Kellesarian1, Vanessa Ros Malignaggi2, Khaled M Aldosary3, Fawad Javed1. 1. Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York. 2. Department of General Dentistry, Dental School, Santa Maria University, Caracas, Venezuela. 3. King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia.
Abstract
OBJECTIVE: The aim of this comprehensive review was to assess the effectiveness of erbium lasers in the removal of all ceramic fixed dental prostheses (FDPs). OVERVIEW: Indexed databases were searched without language or time restriction up to and including December 2017 using different combinations of the following keywords: "lasers"; "phototherapy"; "crowns"; "prostheses and implants"; "inlays"; "ceramics"; "dental porcelain"; "zirconium"; "removal"; "debonding"; "fixed dental prostheses"; "veneers"; "laminates"; and "fixed bridge." All levels of available evidence including experimental studies, case reports and case series were included. Six clinical studies reporting a total of 13 cases and 6 experimental studies were included. Results from all studies showed that erbium lasers are effective reducing the shear bond strengths of all ceramic FDPs, in terms of easy removal of the restorations with none or minimal damage to teeth or ceramic surfaces. CONCLUSION: Laser-assisted removal of all ceramic FDPs is a promising treatment protocol. Further well-designed controlled clinical trials and longitudinal prospective studies are needed to determine the precise laser parameters and duration of irradiation that could be used for removal of ceramic restorations with varying thicknesses. CLINICAL SIGNIFICANCE: Benefits of lasers over mechanical instrumentation for crown removal encompass efficient restoration retrievability without restoration or teeth surfaces damages; and relatively easier and time effective procedure with no prerequisite for anesthetic agents. It is however imperative for clinicians to be well-trained and exhibit adequate knowledge regarding recommended power settings and laser-safety parameters with reference to interactions between light and different tissues and ceramics.
OBJECTIVE: The aim of this comprehensive review was to assess the effectiveness of erbium lasers in the removal of all ceramic fixed dental prostheses (FDPs). OVERVIEW: Indexed databases were searched without language or time restriction up to and including December 2017 using different combinations of the following keywords: "lasers"; "phototherapy"; "crowns"; "prostheses and implants"; "inlays"; "ceramics"; "dental porcelain"; "zirconium"; "removal"; "debonding"; "fixed dental prostheses"; "veneers"; "laminates"; and "fixed bridge." All levels of available evidence including experimental studies, case reports and case series were included. Six clinical studies reporting a total of 13 cases and 6 experimental studies were included. Results from all studies showed that erbium lasers are effective reducing the shear bond strengths of all ceramic FDPs, in terms of easy removal of the restorations with none or minimal damage to teeth or ceramic surfaces. CONCLUSION: Laser-assisted removal of all ceramic FDPs is a promising treatment protocol. Further well-designed controlled clinical trials and longitudinal prospective studies are needed to determine the precise laser parameters and duration of irradiation that could be used for removal of ceramic restorations with varying thicknesses. CLINICAL SIGNIFICANCE: Benefits of lasers over mechanical instrumentation for crown removal encompass efficient restoration retrievability without restoration or teeth surfaces damages; and relatively easier and time effective procedure with no prerequisite for anesthetic agents. It is however imperative for clinicians to be well-trained and exhibit adequate knowledge regarding recommended power settings and laser-safety parameters with reference to interactions between light and different tissues and ceramics.