Effect of Er: YAG laser irradiation on the bonding strength of permanent teeth

The concept of“minimally invasive dentistry”aims to provide conservative treatment of cavities in which sound dentin is removed. Because the Er: YAG laser can selectively remove caries, the smear layer is removed, dentin tubules are exposed after the preparation of substrate conditioning, and its advantages of precision, safety and painlessness are deeply valued. At the same time, the bonding strength between the prepared dentin surface and the filling material is different due to the different parameters of the Er: YAG laser. In this paper, the principle of dentin bonding, the mechanism of Er: YAG laser action, after treatment of dentin with different parameters (power, energy density, pulse duration, and irradiation distance), whether there is thermal damage to pulp tissue, the ultramicro morphology of dentin surface, the bonding properties of different bonding systems and the filling materials between irradiated hard tissues were reviewed. An appropriate parameter range (power ≤ 10 Hz, energy density ≤ 60 mJ, and pulse duration ≤ 50 μs) combined with water spray cooling will not cause thermal damage to the pulp tissue, while the higher power, energy density and pulse duration of laser treatment for dentin will lead to melting, carbonization, cracks, narrowing of the gap between collagen fibers, etc., which will limit the penetration of adhesives and have a negative impact on bonding. However, whether the adhesive systems based on the smear layer are suitable for dentin after laser treatment needs to be further explored.