Acceptance and Efficiency of Er:YAG Laser for Cavity Preparation in Children

Objective: To evaluate the clinical efficiency and patient acceptance during cavity preparation in children, a direct comparison was made between Er:YAG laser preparation and conventional mechanical preparation of caries using a split-mouth design. Background Data: The Er:YAG laser system was developed for cutting dental hard tissue and has been approved as a useful alternative method for cavity preparation. Methods: Children with previously unrestored and matched carious cavities in non-pulpally involved anterior teeth were selected, and the sequential order of treatment was randomized. In total, 40 children from 4 to 12 years old took part in the study. Two teeth each in the 40 patients were prepared without anesthesia and restored with a light-cured compomer following application of a bonding agent. The time spent on cavity preparation and the behavior of the patients during cavity preparation were recorded; finally, a modified face scale was used for pain assessment. In addition, the children were asked to indicate whether they found the laser or the mechanical approach more uncomfortable, and their preferred treatment when undergoing future caries therapy. Results: The analysis of pain indicated that 82.5% of children felt no pain at all with the laser preparation, and they also showed much more body and head movement with the conventional mechanical preparation. Although the Er:YAG laser took about 2.35 times longer to prepare the same type of cavity, 92% of the children said that they would prefer laser preparation for further caries therapy. Conclusion: Cavity preparation with the Er:YAG laser would seem to be an option for fearful children, since it produces less pain and has acceptable efficiency compared to the conventional mechanical preparation.