A comparative SEM study of the effects of hand scaling, diode laser and erbium, chromium: Yittrium-Scandium-Gallium-Garnet (Er,Cr:YSGG) laser on root surface

Background: Various curettes and lasers are used in periodontal therapy. Although curettes and diode laser have their own shortcomings compared to Er,Cr:YSGG laser, adequate evidence comparing their effects on root surface morphology and change in root surface composition is lacking. Materials and Method: 7 periodontally compromised teeth were extracted, cut into 27 specimens and divided into 3 groups. All the groups were instrumented by Gracey curettes and the other groups were irradiated by diode and Er,Cr:YSGG laser respectively. SEM was employed to check the presence or absence of smear layer, roughness of tooth surface and loss of tooth substance. EDAX software was used to check the compositional changes. Results: SEM results show that the groups where Er,Cr:YSGG was used as an adjunct, showed the least presence of smear layer, the roughest surface and most loss of tooth substance. EDAX results show that the most inorganic content in the Er,Cr:YSGG group. Conclusion: Er,Cr:YSGG causes greatest amount of surface alteration. Its ability to ablate the smear layer without causing any changes in the composition at the structural level makes Er,Cr:YSGG a safe and effective adjunct in non-surgical periodontal therapy. Clinical relevance: Er, Cr:YSGG is an excellent treatment modality to gain new attachment.