A Narrative Review and Clinical Study on Er:YAG Laser Debonding of Ceramic and Composite Veneers.

Abstract

Background: Composite resin veneers have gained popularity due to their affordability and minimally invasive application as biomimetic restorations. However, long-term clinical challenges, such as discoloration, wear, and reduced fracture resistance, necessitate their replacement over time. Ceramic veneers, particularly feldspathic and lithium disilicate, offer superior esthetics and durability, as demonstrated by studies showing their high survival rates and enamel-preserving preparation designs. However, while ceramic veneers survive longer than composite resin veneers, ceramic veneers may need to be removed and replaced. Reports vary for using Er:YAG (erbium-doped yttrium aluminum garnet) lasers for the removal of existing veneers.

Methods: A review was conducted to evaluate the effectiveness of removing restorative materials with an Er:YAG laser. A clinical study was included, highlighting the conservative removal of aged composite resin veneers using the Er:YAG laser. This method minimizes enamel damage and facilitates efficient debonding. Following laser application, minimally invasive tooth preparation was performed, and feldspathic porcelain veneers were bonded.

Results: The review showed positive outcomes whenever the Er:YAG laser was used. In the case study, after a 3-year follow-up, the restorations exhibited optimal function and esthetics.

Conclusions: Laser-assisted debonding provides a safe and predictable method for replacing failing composite veneers with ceramic alternatives, aligning with contemporary biomimetic principles.