Treatment of deciduous teeth in children using the Er:YAG laser compared to the traditional method: A randomized clinical trial.

Background: Erbium family lasers have been used as an alternative method for the treatment of dental caries in deciduous teeth, in comparison to traditional methods.

Objectives: The study aimed to determine the most optimal erbium-doped yttrium-aluminum-garnet (Er:YAG) laser settings for carious lesions in deciduous teeth on different surfaces with the evaluation of treatment time and pain level on a visual analog scale (VAS).

Material and methods: The randomized clinical trial involved 66 teeth with deep caries in 33 children aged 3-8 years, divided into 2 study groups: Er:YAG laser (test group); and conventional treatment with a dental turbine (control group). The time required for caries removal and cavity preparation using both methods was recorded. The inclusion criteria encompassed generally healthy pediatric patients, pain-free subjects, first-time dental appointment, and unicuspid primary teeth with caries. Dental caries treatment was performed without the administration of local anesthesia.

Results: The cavity preparation time was on average 2.5 times longer when the Er:YAG laser was used compared to the conventional method. The study demonstrated the effectiveness of the Er:YAG laser in hard tissue preparation of deciduous teeth with a pulse energy of 230 mJ for enamel preparation, mainly on occlusal and proximal surfaces, and with a pulse energy of 120 mJ and 150 mJ for dentin preparation. Optimum operating frequencies were 10 Hz and 20 Hz with corresponding water consumption. The level of discomfort among the laser-treated patients indicated 0 based on VAS, meaning no pain. Among patients treated with the traditional method, the pain level averaged 5.27.

Conclusions: The use of the Er:YAG laser offers substantial advancements in comparison to traditional treatment with dental turbines by enhancing the overall comfort during caries therapy in children. It fosters better patient cooperation and reduces the need for intraoperative anesthetics due to its minimally invasive nature and the fact that it is a relatively quiet operation. This approach minimizes anxiety and discomfort often associated with dental procedures, making them more amenable to children.