Dental Laser Drilling: State of the Art with the Latest Generation of Variable Square Pulse Erbium Dental Laser Systems

Background and Objectives: The most recent technological breakthroughs incorporated in the latest generation of Variable Square Pulse (VSP) Er:YAG dental lasers involve two additional features: SSP (Super Short Pulse) mode for extremely fine and minimally invasive laser ablation; and MAX mode for maximum optical drilling speeds. The objective of this study was to make a comparison between the two new VSP Er:YAG laser modes and a mechanical handpiece, to test their efficacy in apicectomy procedures. In addition, the safety of the MAX mode was evaluated. Study design/Materials and Methods: Laser drilling speeds on extracted human teeth was measured under different VSP laser mode conditions and compared with the previously published drilling speeds of mechanical handpieces. Electron microscope pictures of the holes made in the hard dental tissue with the Er:YAG MAX mode were also made. Results: The SSP erbium laser mode exhibits the largest single pulse energy drilling efficiency while the treatment procedure with the MAX mode is 1.6 times faster than with a mechanical handpiece. The electron microscope pictures of the ablation holes made with the MAX mode reveal no cracks or thermal damage to the ablated hard dental tissue. Conclusions: The latest two Er:YAG laser modes: the SSP (Super Short Pulse) mode for extremely fine and minimally invasive laser ablation; and the MAX mode for maximum optical drilling speeds, offer superior alternatives to mechanical drills, are more precise and less invasive without sacrificing safety, ease;of use or operating speeds.