Pulpal temperature increases with Er:YAG laser and high-speed handpieces☆

Abstract 

Statement of problem

During tooth preparation, both high-speed handpieces and lasers generate heat, which, if not controlled, can cause pulpal necrosis.

Purpose

The aim of this study was to compare temperature increases produced by a high-speed dental handpiece with those produced by a relatively new instrument, the Er:YAG (erbium: yttrium-aluminum-garnet) laser.

Material and methods

Thirty bovine mandibular incisors were reduced to an enamel/dentin thickness of 2.5 mm. Class V preparations were completed to a depth of 2.0 mm, measured with a caliper or by a mark on the burs. A thermocouple was placed inside the pulp chamber to determine temperature increases (°C). Analysis was performed on the following groups (n=10): Group I, high-speed handpiece without water cooling, Group II, high-speed handpiece with water cooling (30 mL/min), and Group III, the noncontact Er:YAG laser (2.94 μm at 350 mJ/10 Hz) with water cooling (4.5 mL/min). The temperature increases were recorded by a computer linked to the thermocouples. The data were analyzed using the Kruskal-Wallis test. The Dunn multiple comparison test was used as post hoc test (α=.05).

Results

The average temperature rises were: 11.64°C (± 4.35) for Group I, 0.96°C (± 0.71) for Group II, and 2.69°C (± 1.12) for Group III. There were no statistical differences between Groups II and III; both II and III differed from Group I significantly (P=.000 and P=.002, respectively).

Conclusion

The preparations made with the high-speed and the laser instrument generated similar heat increases under water cooling. Water cooling was essential to avoid destructive temperature increases when using both the high-speed handpiece and laser.