2010 Volume 53 Issue 6 Pages 562-569
Nowadays many endoscopic systems with fiberscope (FS) are widely used in the field of medicine for clinical diagnosis and treatment. However, this system is still not so popular in dentistry. Direct, real-time visualization of subgingival hard and soft tissues may improve the efficiency of subgingival treatment. Therefore, we have been developing an original endoscopic system with FS since 1996 to employ it in clinical dentistry, especially for periodontics and endodontics. Many studies have concluded that the Er:YAG laser has excellent ability to remove subgingival calculus and superficial layers of infected cementum. The purpose of this study was to evaluate the usefulness of combining the Er:YAG laser and the FS for subgingival periodontal treatment. An original jaw model in which the artificial teeth were uniformly coated with nail enamel was attached to a simulator head. The experimental teeth were painted on the root surfaces of #12 and #14, and in the furcation of #46. The laser apparatus used in this study was the Er:YAG laser with contact tip. The C400F tip (φ400μm) was used in the non-FS group as for the contact tip, and the E200FL tip (φ200μm) was used in the FS group. The FS system (6,000 pixels, φ1.1mm) with a laser channel, water channel and light guide were used. The operators were five dentists who were experienced with using FS and Er: YAG laser. Initially, the experimental teeth were treated with laser only (non-FS group). A new set of experimental teeth which replaced the treated teeth from the non-FS group, were treated with laser using the FS (FS group). The laser beam was applied to each of the experimental teeth at 80mJ, 10pps with water for 1 minute. Then each root surface was observed to analyze the residual nail enamel. The residual rates of nail enamel (non-FS group: FS group) were as follows: palatal surface of #12 (82.48±13.57%:23.0±84.15%), mesial surface of #14 (79.74±11.60%:19.05±8.08%), furcation of #46 (80.16±8.12%:22.39±3.31%). The residual rate in the FS group was significantly lower than that in the non-FS group (Mann-Whitney U test, p<0.05). On the observation of root surfaces after Er:YAG laser irradiation, the FS group had little irradiation to the part except the nail enamel in comparison with the non-FS group. The results suggest that the application of Er: YAG laser treatment with FS leads to better outcome in comparison with laser treatment without FS for subgingival periodontal treatment.
