Comparing the effects of root surface scaling with ultrasound instruments and Er,Cr:YSGG laser


There are several studies done to show the comparability of laser scaling and root planing with routine methods. The most suitable wavelengths for such an application are reported as 2,940 and 2,780 nm. The superficial interactions of the current wavelength with root surface is investigated in this study to compare the crater and crack formation during the procedures between ultrasound and Er,Cr:yttrium–scandium–gallium garnet (YSGG; 2,780 nm) laser-treated teeth. Thirty human teeth with calculus on their root surface, which were extracted because of the severe periodontitis, were selected for this interventional in vitro study. Calculus area were divided into two equal parts: One of them was prepared for Er,Cr:YSGG (Biolase, Waterlase, USA) laser irradiation and the other one for ultrasound treatment (Dentsply cavitron, DENTSPLY International, USA). The Er,Cr:YSGG laser was specified as follows: pulse energy = 50 mJ, power = 1 W, wavelength = 2,780 nm, pulse repetition rate = 20 pulse per seconds, tip length = 6 mm, and tip diameter = 600 μm. Nineteen of the laser samples (95%) and eight of ultrasound ones (40%) out of 20 samples in each group had craters showing a statistical significant difference (p < 0.001). The number and depth of these craters are also evaluated. Thirteen samples of the laser cases (65%) and all samples of the ultrasound group showed cracks with significant differences (p = 0.008). In addition, the number and width of cracks in both groups are reported. As a general conclusion, the laser-treated samples show more craters but less cracks.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. 1.

    Gutknecht N et al (2007) Proceedings of the 1st International Workshop of Evidence Based Dentistry on Lasers in Dentistry. Quintessence, Germany

  2. 2.

    Tucker D, Cobb CM, Rapley JW, Killoy WJ (1996) Morphologic changes following in vitro CO2 laser treatment of calculus-ladened root surfaces. Lasers Surg Med 18(2):150–156

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Israel M, Cobb CM, Rossmann JA, Spencer P (1997) The effects of CO2, Nd: YAG and Er: YAG lasers with and without surface coolant on tooth root surfaces. J Clin Periodontol 24:595–602

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Aoki A, Ando Y, Watanabe H, Ishikawa (1994) In vitro studies on laser scaling of I: subgingival calculus with an erbium:YAG laser. J Periodontol 65(12):1097–1106

    PubMed  CAS  Google Scholar 

  5. 5.

    Frentzen M, Braun A, Aniol D (2002) Er:YAG laser scaling of diseased root surfaces. J Periodontol 73(5):524–530

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Eberhard J, Ehlers H, Falk W, Acil Y, Albers HK, Jepsen S (2003) Efficacy of subgingival calculus removal with Er:YAG laser compared to mechanical debridement: an in situ study. J Clin Periodontol 30(6):511–518

    PubMed  Article  Google Scholar 

  7. 7.

    Folwaczny M, Mehl A, Haffner C, Benz C, Hickel R (2000) Root substance removal with Er:YAG laser radiation at different working parameters using anew delivery system. J Periodontol 71:147–155

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Lasho DJ, O’Leary TJ, Kafrawy AH (1983) A scanning electron microscopic study of the effects of various agents on instrumented periodontally involved root surfaces. J Periodontol 54:210–220

    PubMed  CAS  Google Scholar 

  9. 9.

    Albair WB, Cobb CM, Killoy WJ (1982) Connective tissue attachment to periodontally diseased roots after citric acid demineralization. J Periodontol 53:515–526

    PubMed  CAS  Google Scholar 

  10. 10.

    Morlock B, Pippin DJ, Cobb CM, Killoy WJ, Rapley JW (1992) The effect of Nd:YAG laser exposure on root surfaces when used as an adjunct to root planing: an in vitro study. J Periodontol 63:637–641

    PubMed  CAS  Google Scholar 

  11. 11.

    Crespi R, Romanos GE, Barone A, Sculean A, Covani U (2005) Er: YAG laser in defocused mode for scaling of periodontally involved root surfaces. An in vitro pilot study. J Periodontol 76(5):686–690

    PubMed  Article  Google Scholar 

  12. 12.

    Gopin BW, Cobb CM, Replay JW, Killoy WJ (1997) Histologic evaluation of soft tissue attachment to CO2 laser-treated root surfaces: an in vivo study. Int J Periodontics Restorative Dent 17:316–325

    PubMed  CAS  Google Scholar 

  13. 13.

    Schwarz F, Sculean A, George T (2001) Periodontal treatment with an Er:YAG laser compared to scaling and root planing. J Periodontol 72:361–367

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Schwarz F, Putz N, George T (2001) Effect of an Er:YAG laser on periodontally involved root surfaces: an in vivo and in vitro SEM comparison. Lasers Surg Med 29:328–335

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Schwarz F, Aoki A, Sculean A, Georg T, Scherbaum W, Becker J (2003) In vivo effects of an Er:YAG laser, an ultrasonic system and scaling and root planing on the biocompatibility of periodontally diseased root surfaces in cultures of human PDL fibroblasts. Lasers Surg Med 33(2):140–147

    PubMed  Article  Google Scholar 

  16. 16.

    Moghare Abed A, Tawakkoli M, Dehchenari MA, Gutknecht N, Mir M (2007) A comparative SEM study between hand instrument and Er:YAG laser scaling and root planing. Lasers Med Sci 22(1):25–9

    PubMed  Article  CAS  Google Scholar 

Download references


This study was done with the support of the Center of dental research in Shaheed Beheshti University of Medical Sciences. Therefore, the authors would like to thanks the directors and staff of this center for their help.

Author information



Corresponding author

Correspondence to Maziar Mir.

Additional information

An erratum to this article can be found at

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Noori, Z.T., Fekrazad, R., Eslami, B. et al. Comparing the effects of root surface scaling with ultrasound instruments and Er,Cr:YSGG laser. Lasers Med Sci 23, 283–287 (2008).

Download citation


  • Er
  • Cr:YSGG laser
  • Ultrasound scaler
  • Root planing
  • Crater
  • Crack
  • SEM