The effect of enhanced Nd:YAG laser fiber tip for periodontal treatment

An activated Nd:YAG fiber tip using fiber-tip enhanced device (FTED) makes an activated and scattered irradiation beam. The enhanced (activated) fiber tip could be irradiated parallel to the target surface. The purpose of this study was to determine the effect of the activated laser fiber tip for calculus removal compared with other techniques. Specimens of extracted teeth with or without calculus were prepared. Nd:YAG laser power pulse 1 (SLT Japan, Tokyo, Japan) was used. The diameter of the optimal fiber was 400 μm. The enhanced condition was firstly examined using irradiation power from 100 to 900 mJ, 1 to 10 pps, in order to verify which is the best condition for calculus removal with scattering irradiation beam. Four types of calculus removal methods were compared: (1) hand curette; (2) ultrasonic scaler; (3) laser irradiation through a normal optimal fiber tip at 900 mJ, 10 pps, using a perpendicular irradiation mode with water coolant; (4) laser irradiation through the active fiber tip at 900 mJ, 10 pps, using a parallel irradiation mode with water coolant. After the roughness of the surfaces was clinically measured, the specimens were then prepared for scanning electron microscopy (SEM) observation. These results indicated that the best enhanced condition of the FTED for calculus removal with scattering irradiation beam was 800 mJ, 10 pps. The FTED was more useful for calculus removal than the normal fiber tip. However, it was less effective than hand and ultrasonic scaling considering the treatment time.