The Effect Of Er:YAG Laser On Socket Preservation Assisted Debridement After Extraction In Infected Areas

Aim: In recent years,Erbium laser has been widely used.The advantages is that it has high efficiency and little damage to soft and hard tissues.The purpose of this study was to evaluate the effect of Er: YAG laser assisted debridement and extraction of inflammatory granulation tissue in the extractive fossa during site preservation after tooth extraction.Materials and Methods: A total of 18 patients were included,including 12 males and 6females,aged from 21 to 59 years old,with an average age of 36.86±11.60 years old.For those who needed extraction and implant restoration due to failure of root canal treatment with infection,severe periapical infection or periodontitis,Er was used respectively during tooth extraction:YAG laser and curettors were used to remove inflammatory tissue in the alveolar fossa and then protein-free bovine bone mineral materials were used Bio-oss and collagen membrane Bio-Gide for site preservation.Changes in alveolar bone at the extraction site were assessed by cone beam computed tomography before and two to three months after extraction（mean 10.25 weeks,range 7 to 13 weeks）.The height and width of alveolar bone were measured to evaluate the changes of alveolar crest contour.Bone tissue samples were taken out by trephine with a diameter of 3mm at the implant implantation area and stored in Formalin for histological analysis to observe alveolar bone regeneration and replacement materials for residual bone.Result: In the process of site preservation,for the treatment in the alveolar fossa after the extraction of affected teeth with apical inflammation that could not be retained,the group treated with Er:YAG laser showed reduced postoperative pain and no inflammatory reactions such as bleeding or swelling in the operative area.At 8 weeks after surgery,the height and width of alveolar bone in the operation area showed that the height of alveolar bone increased after surgery by CBCT measurements.The height of proximal and distal alveolar ridge and width of alveolar bone were compared between the two groups immediately and 8 weeks after operation.The results showed that the height and width of alveolar bone in the two groups changed little immediately after surgery,and the difference was not statistically significant（P>0.05）.At 8 weeks postoperatively,the change of alveolar crest contour in the laser group was generally less than that in the conventional treatment group,and the width of alveolar crest was more than 1mm in the laser group.Histologically,new bone formation was observed in both groups at 8 weeks postoperatively.The expression of OCN and NFκB was up-regulated in the laser group,and the new bone formation was relatively mature.Conclusion: 1.Erbium-laser-assisted debridement is an effective method to promote the healing of soft tissue and maintain the contour and shape of socket after tooth extraction.2.Erbium laser irradiation may induce photobiological effect of the bone tissues in the extraction site and promote the expressions of OCN and NF κ B factors in the bone tissues.3.The relief effect of erbium laser treatment on postoperative pain remains unclear.