Review Article

Lasers in Dentistry: Is It Really Safe?

Hamed Mortazavi, Maryam Baharvand, Maede Mokhber-Dezfuli, Niloofar Rostami-Fishomi, Maryam Doost-Hoseini, Orkideh Alavi-Chafi, Shalaleh Nourshad
Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract
Introduction: Lasers are used in various disciplines in dentistry such as restorative dentistry, endodontics, periodontics, pedodontics, and oral
and maxillofacial surgery. Despite many advantages of dental lasers, this method might have some adverse effects. The aim of this review
article is to debate about the impacts of lasers on orodental tissues. Methods: An electronic search was accomplished using specialized
databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as
“laser”, “dentistry”, “adverse effect”, and “side effect”. Results: Several adverse effects of laser were identified such as impacts on dental
pulp, effects on tooth surface, subcutaneous and submucosal effects, histopathological changes, and infection transmission due to laser smoke.
During dental procedures, necrosis of the pulp, periodontal ligament and odontoblasts, cemental lysis, bone resorption, hypo/
hyperpigmentation, burns, itching, and scarring might occur. In addition, laser can weaken the dentin by inducing surface cracks.
Restorative procedures by laser might increase microleakage and decrease shear bond strength, as well as microhardness of tooth walls.
Meanwhile, laser surgery might cause emphysema after abscess incision and drainage, frenectomy, flap elevation, and gingivoplasty.
Conclusion: Practitioners should be very cautious in treatment planning and case selection during laser-based therapeutic procedures.

Key words: Adverse effect, dental, lasers, oral

INTRODUCTION in different tissues such as soft tissue or hard tissue lasers,

[1]
Laser was introduced in dentistry in 1960s. Thereafter, a
continuous range of studies were conducted on various
usages of laser in dental practice. Two major types of lasers
were introduced in terms of clinical applications; hard lasers
such as carbon dioxide (CO2), neodymium–yttrium aluminum
garnet), and erbium–yttrium aluminum garnet (Er:YAG) with
both hard and soft tissue usages. Because of high cost and a
potential for thermal tissue damage, hard lasers have some
limitations.[2,3] On the other hand, soft or cold lasers have been
predominantly used for biostimulation or low level laser
therapy (LLLT).[4] Lasers are used in various disciplines in
dentistry such as restorative dentistry where they are used for
diagnosis of caries, improving the resistance of dental
enamel, and photopolymerization of composite resin;[5,6]
endodontics for bactericidal cleansing of root canal;[7]
periodontics for gingivectomy, gingivoplasty, frenectomy,
and vestibuloplasty;[8] pedodontics to prepare tooth surfaces
for sealant application;[9] and oral and maxillofacial surgery to
treat vascular malformation.[10,11]
Dental lasers are classified with regard to the lasting
medium used such as gas laser or solid laser, application
the range of wavelength, and the risk of laser usage
[Table 1].[12]
The literature about the inadvertent effects of laser irradiation
on orodental structures is limited and scanty to provoke
readers’ concerns regarding the potential hazards of laser
therapy. Insufficient knowledge about unwanted effects of
laser might give rise to overwhelming therapeutic pitfalls;
hence, an efficient treatment alternative would serve as a
potentially destructive modality.
The aim of the present review was to debate laser impacts on
orodental hard and soft tissues during dental procedures.
General precautions regarding prevention of laser damage
to the patient and the operator have been discussed several
times.[5,9,12] Side effects of dental laser are summarized in
five categories: (1) laser effects on dental pulp, (2) laser effect
on tooth surface, (3) subcutaneous and submucosal effects of
Address for correspondence: Dr. Maryam Baharvand, Department of Oral
Medicine, School of Dentistry, Shahid Beheshti University of Medical
Sciences, Daneshjoo Blvd, Tabnak St, Chamran Highway, Tehran, Iran.
E-mail: m-baharvand@sbmu.ac.ir

Access this article online This is an open access article distributed under the terms of the Creative Commons
Quick Response Code: Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix,
Website: tweak, and build upon the work noncommercially, as long as the author is
www.dentalhypotheses.com credited and the new creations are licensed under the identical terms.

For reprints contact: reprints@medknow.com

DOI: How to cite this article: Mortazavi H, Baharvand M, Mokhber-Dezfuli

10.4103/2155-8213.195967 M, Rostami-Fishomi N, Doost-Hoseini M, Alavi-Chafi O, Nourshad S.
Lasers in dentistry: Is it really safe?. Dent Hypotheses 2016;7:123-7.

© 2016 Dental Hypotheses | Published by Wolters Kluwer - Medknow 123

 Mortazavi et al.: Safety of dental lasers

Table 1: Common dental lasers and their applications[12]

Type of laser Wavelength(s) Construction Delivery system(s) Major application
Argon 488, 515 nm Gas laser Optical fiber Bleaching
CO2 9600, 10600 nm Gas laser Waveguide, articulated arm Soft tissue removal
Diode 635, 670, 810, Semiconductor Optical fiber Photostimulation, soft tissue removal
830, 980 nm
Er,Cr:YSGG 2780 nm Solid state Optical fiber Treatment of dental hard tissues, soft tissue ablation
Er:YAG 2940 nm Solid state Optical fiber, waveguide, articulated arm Treatment of dental hard tissues, soft tissue ablation
Nd:YAG 1064 nm Solid state Optical fiber Cutting and coagulating oral soft tissues
Helium-neon 633 nm Gas laser Optical fiber Wound healing
KTP 532 nm Solid state Optical fiber Bleaching

laser, (4) histopathological changes of laser, and (5) infection
transmission due to laser smoke.
METHODS
An electronic search was accomplished using specialized
databases such as Google Scholar, PubMed, PubMed
Central, Science Direct, and Scopus to find relevant
studies by using keywords such as “laser”, “dentistry”,
“adverse effect”, and “side effect”.
Laser side effects
Laser effects on dental pulp
Laser energy is converted into heat when absorbed by tissue
components, such as DNA/RNA, chromophores, proteins,
enzymes, and water. Tissue damage due to the thermal effects
of laser is largely attributable to the degree of heating in a way that
increasing temperature leads to more severe changes;
hyperthermia begins at 42–45°C, which results in structural
alteration and shrinkage of collagen. Reduction of enzymatic
activity takes place at 50°C. Temperature of 60°C causes protein
denaturation, coagulation of collagens, and membrane
permeabilization. Tissue drying and formation of vacuoles
occur at 100°C. Beginning of vaporization and tissue
carbonization is the result of heat over 100°C. Temperature of
300–1000°C leads to thermoablation of tissues, photoablation,
and disruption.[13]
A study regarding the thermal effects of Nd:YAG, argon, and
CO2 laser beams on enamel, dentin, and dental pulp
demonstrated the potency of Nd:YAG laser beam to
penetrate deeply through the enamel and dentin to the pulp.
Although the effects of argon laser were closely associated with
the degree of enamel surface cleanliness, the superficial and
deep temperatures were reported to be low even after surface
cleaning. With respect to CO2 laser, very high temperatures
were yielded on the enamel and dentin surfaces; however, pulp
chamber reached low temperatures.[14]
An increase in temperature of 6°C can cause irreversible
pulpitis, whereas pulpal necrosis occurs when temperature
rises higher (11°C).[15] There is no consensus in the literature
about pulpal damage caused by laser thermal effects. Some
studies reported different grades of pulpal damage whereas
others showed no sign of pulpal changes in terms of laser type
and power setting.[16-18] In an article by von Fraunhofer et al.,
the effect of Nd:YAG laser at ≤240 J on third molars within 3
minutes after extraction was demonstrated that if the
remaining dentin thickness was greater than 1 mm,
irradiation causes no significant pulpal response.[16] In
contrast, thermal insult of CO2 laser at 5 × 103 J/cm2 was
reported to cause calcification in the pulp chamber and an
increase in pulpal volume by approximately one third.[18] In
another study, Bader and Krejci demonstrated that laser
cavity preparation caused overheating of teeth leading to
pulpitis. Moreover, different temperatures were recorded
according to the anatomic site of cavity preparation; Class
I preparations yielded the highest values, followed by Class V
cavities in enamel. On the other hand, caries removal or
preparation in cementum caused the lowest temperature
increase.[19]
Buchella and Attin showed that activation of bleaching agents
by heat, light, or laser might increase intrapulpal temperature
beyond the critical value of 5.5°C.[20]
Laser effects on tooth surface
Tooth surface maybe impacted by laser irradiation as well;
for example, significant decrease in shear bond strength of
brackets to the teeth following bleaching with carbamide
peroxide and diode laser has been reported.[21] Although
Er-YAG laser irradiation with water and 35 μs pulse
duration did not result in surface visible cracks, it
caused a 20% reduction in the bending strength of the
dentin.[22]
Er-YAG laser when used without water with 0.5 μs pulse
durations left severe surface cracks which served as initial
sites of destructive fractures, resulting in a 35% weakening of
dentin under bending pressures.[22] Meanwhile, ND:YAG
1064 nm and 980 nm diode lasers decreased the
microhardness of root dentin compared to the application
of ethylene diamine tetra acetic acid (EDTA) with man
ual agitation.[23] Ghanbarzadeh et al. proved that in-office
bleaching by means of laser significantly reduced the
microhardness of enamel.[24]
There is controversy regarding demineralization and
acid-resistance of enamel and dentin after Er:YAG laser

124 Dental Hypotheses ¦ Oct-Dec 2016 ¦ Volume 7 ¦ Issue 4

 Mortazavi et al.: Safety of dental lasers
treatment in the literature. Subablative Er:YAG irradiation
resulting in 20% change in calcium solubility produces no
caries but fine cracks in the enamel surface.[19] On the other
hand, ablative dry laser treatment of 400 mJ resulted in the
lowest acid demineralization in enamel and dentin, which on
the micromorphological level induced thermal damage.[19]
Moreover, it has been shown that after bleaching with light
emitting diodes (LED)/laser microhardness of tooth
decreased.[25] One week after using Diod laser, shear bond
values were recorded to be diminished.[26] The mechanical
impact of Er:YAG laser on very breakable enamel is different
when high or low energies are applied similar to drilling with
different diamond bur sizes because Er:YAG laser causes
vaporization of the water content in tissues to induce microe
xplosions. Most of the studies regarding microleakage and
marginal adaptation used high energies (over 300 mJ) of Er:
YAG, which induced subsurface damages into enamel
leading to low marginal adaptation and a high degree of
microleakage.[16,19] Ozel et al. concluded that cavity
preparation with Er:YAG laser caused more microleakage
than preparation with bur in cervical regions.[27] In addition,
acid etching of enamel following Er:YAG, a kind of enamel
finishing method, showed much better results.[19]
Microleakage of occlusal walls in acid etched cavities was
significantly lower than that achieved by means of laser
treatment; hence, laser treatment of enamel is not a
superior alternative compared to acid etching prior to
adhesion of resin composite materials.[28] Conventional
rotary preparation and acid etching yielded stronger
adhesion to dentin and enamel in comparison to laser
preparation.[29]
Bahrololoomi et al. found that Er:YAG caused lower shear
bond strength in both enamel and dentin compared to
bur.[30] The same findings were also reported by von
Fraunhofer and Yildrim.[31,32] Moreover, Nd-YAG and
holmium:yttrium aluminium garnet (HO:YAG) lasers
were found to decrease the tensile bond strength of a
silicone-based liner to an acrylic denture.[33]
Subcutaneous and submucosal effects of laser
Inappropriate use of dental lasers with air cooling spray
might result in cervicofacial subcutaneous and mediastinal
emphysema (CSE) according to numerous reports. Despite
the fact that air pressure of an air turbine is higher than that of
a dental laser, the application time of the instrument tip might
be the causative factor for occurrence of CSE.[34-36] Use of
CO2 laser to treat gingival abscess, periapical lesion, and
surgery of pharynx and larynx carcinoma has been associated
with increased risk of CSE.[34] It has been demonstrated
that 69.2% of laser therapies lead to CSE, which is quite
higher than those treated with routine dental operations.[34]
Regarding CSE after dental laser treatment, out of 10 patients
in a case series (8 patients under CO2 laser and 2 under Er:
YAG laser therapy), 9 developed emphysema following soft
tissue incision. Emphysema occurred in 5 cases after abscess
incision and drainage, 2 pediatric patients after frenectomy, 2
Dental Hypotheses ¦ Oct-Dec 2016 ¦ Volume 7 ¦ Issue 4
cases following anti-inflammatory laser treatment for
periapical infection, and one case after each of subgingival
scaling, flap elevation, and gingivoplasty. Dentists and oral
surgeons should be familiar with the potential risk of
emphysema caused by air cooling spray of dental lasers to
ensure proper usage of lasers.[34]
Histopathological changes of laser
Dental laser therapy causes some histopathological changes
as well. Cell necrosis in the periodontal ligament (mostly
due to thermal effect) was noticed 1 day after laser treatment,
whereas teeth under conventional preparation developed
no evidence of cell necrosis. Fifteen days following
treatment, increased size and number of osteocytes and
osteoclasts were evident in the periradicular bone in both
laser and conventionally-treated teeth. Moreover, initial bone
resorption was detected in laser-treated teeth.
Conventionally-treated teeth began to return to normal
morphology within 30 days posttreatment. On the other
hand, the laser-treated teeth exhibited ankylosis, cemental
lysis, and significant bone remodeling.[37] Laser can cause
pulpal vasodilation, and high power lasers cause edema and
occasional inflammation.[38,39] In an animal study, rat teeth
irradiated with an acousto-optically Q-switched Nd-YAG
laser at 10 W for 0.2 seconds or 5 W for 0.3 seconds using
a beam diameter of 2 mm showed mild dilation of pulpal
vessels at the lowest levels with some calcified tissue 4 weeks
after laser irradiation.[38] Adrian et al. reported pulpal damage
due to ruby laser at 1880–2330 J/cm2, however, coagulation
necrosis of the odontoblasts, edema, and occasional
inflammation occurred between 2400 and 3000 J/cm2.[39]
In addition, delayed gingival healing following laser
surgery was revealed with the presence of epithelial
ulcerations and dense inflammatory infiltrate.[40] Thermal
interaction of laser radiant energy with tissue proteins
induces damage to the skin and other nontarget tissues
(oral tissue).[41] An increase in temperature 21°C above
37°C (normal body temperature) can cause cell destruction
by denaturation of cellular enzymes and structural proteins,
which interrupts basic metabolic processes.[41] The thermal
effect of absorbed radiant energy is manifested histologically
as thermal coagulation necrosis for wavelengths above
400 nm. Photochemical and photoacoustic mechanisms are
responsible for other nonthermal tissue injuries. They occur
with single or repetitive pulses of low duration. The potential
for mutagenic changes of laser irradiation has been
questioned; however, there have been no reports of laser-
induced carcinogenesis to date. Penetration of specific
wavelengths is potentially harmful to deeper tissues, e.g.,
prolonged exposures of low power density of continuous
wave Nd:YAG laser can cause inapparent excess thermal
necrosis.[41]
In addition, several side effects of laser have been mentioned
following surgical procedures such as burn, itching, tissue
hyperpigmentation (especially in dark-skinned people), tissue
hypopigmentation, scarring, and infection.[42]
125
 Mortazavi et al.: Safety of dental lasers
Infection transmission due to laser smoke
Copious amounts of noxious smoke or plume are released as a
by-product of laser vaporization mostly by CO2 laser. In general,
surgical smoke consists of 95% water and vapor and 5% other
materials. One million to one billion particles have been found in
laser smoke and aerosol, some of which have been identified as
intact cells, cell parts, blood cells, and viral DNA fragments.
Culture from tubing of the smoke evacuator yielded viable
bacteria. It has been determined that high heat does not
completely kill some bacterial spores regardless of the power
and length of exposure. Of note, Staphylococcus aureus is more
refractory to high temperatures than Escherichia coli.[43,44]
The viability or risk of exposure to viruses in laser smoke
remains a matter of debate. Viral DNA has been captured in
laser smoke. Transmission of Human papilloma virus (HPV)
during a laser procedure from patient-to-caregiver has been
reported. Moreover, particles of Human immunodeficiency
virus (HIV) have been detected in the inner lumen of a
smoke evacuator tubing after in vitro laser vaporization of
HIV particles. Although human-to-human transmission of
viruses and bacteria from laser smoke has not been
established, there is enough preliminary evidence to warrant
a cautious and self-protective approach to laser plume by all
operating room personnel.
Biologic hazards of laser smoke are viruses (e.g., HIV, HPV,
hepatitis B and C); bacteria (e.g., S. aureus, Mycobacterium
tuberculosis, E. coli, spores); and cells (e.g., carbonized
tissue, aerosolized blood).[45,46]
By-products of laser smoke are considered to be potentially
toxic chemicals. More than 600 organic compounds have been
identified in plume generated by vaporized tissue. Many of
these compounds have been documented to have harmful health
effects including irritation to the eyes, nose, and respiratory
tract; liver and kidney damage; carcinogenic cell changes;
headaches; dizziness; drowsiness; stomach pains; vomiting
and nausea; and rapid breathing. Some chemical compounds
that may be found in laser smoke are as follows: acetylene,
benzene, creosols, methane, ethylene, formaldehyde, hydrogen
cyanide, propylene, styrene, toluene, and free radicals.[47]
DISCUSSION
Although general precautions are widely implemented to
reduce physical hazards of therapeutic lasers, there have been
several reports regarding the occurrence of laser side effects.
During dental procedures, pulpitis, necrosis of the pulp,
periodontal ligament, and odontoblasts, cemental lysis, bone
resorption, hypo/hyperpigmentation, burns, itching, and scarring
might occur.[19,37,39,42] In addition, laser beam can weaken
the dentin through inducing surface cracks as well as reducing
bending strength.[22] Restorative and prosthodontics procedures
with laser might increase microleakage and decrease shear bond
strength and microhardness of dental walls.[19,23-25,29-31] One of
the most important side effects of laser surgery is soft tissue
emphysema, which is frequently seen after abscess incision and
126
drainage, frenectomy, flap elevation, and gingivoplasty.[34]
Transmission of some infectious agents such as HIV, HPV,
hepatitis B and C, S. aureus, M. tuberculosis, and E. coli has also
been reported during laser treatments.[45,46] Meanwhile,
chemical ingredients of laser smoke are potentially toxic to
some organ systems of the body.[47]
CONCLUSION
Despite many advantages of dental lasers, this method can be
potentially hazardous due to impacts on dental pulp, tooth
surface, subcutaneous and submucosal tissues, and risk of
infection transmission. Therefore, dental practitioners should
be aware of laser adverse effects during therapeutic
procedures to minimize the potential risks for patients.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
1. Shajahan PA, Kumar PR, Hariprasad A, Mathew J, Shaji AP,
Ahammed MF. Lasers: The Magic Wand in Esthetic Dentistry!! J
Int Oral Health 2015;7:119-21.
2. Walsh LJ. Dental lasers: Some basic principles. Postgrad Dent
1994;4:26-9.
3. Walsh LJ. The current status of laser applications in dentistry. Aust
Dent J 2003;48:146-55.
4. Martens LC. Laser physics and a review of laser applications in
dentistry for children. Eur Arch Paediatr Dent 2011;12:61-7.
5. Slavoljub Z, Larisa B, Mila K. Lasers in dentistry. Serbian Dent J
2004;51:146-52.
6. Green J, Weiss A, Stern A. Lasers and radiofrequency devices in
dentistry. Dent Clin North Am 2011;55:585-97.
7. Gutknecht N, Kaiser F, Hassan A, Lampert F. Long-term clinical
evaluation of endodontically treated teeth by Nd:YAG lasers. J Clin
Laser Med Surg 1996;14:7-11.
8. Research, Science and Therapy Committee of the American Academy of
Periodontology. Lasers in periodontics. J Periodontol 2002;73:1231-9.
9. Stabholz A, Zeltser R, Sela M, Peretz B, Moshonov J, Ziskind D, et al.
The use of lasers in dentistry: Principles of operation and clinical
applications. Compend Contin Educ Dent 2003;24:935-48.
10. Strauss RA. Lasers in oral and maxillofacial surgery. Dent Clin North
Am 2000;44:851-73.
11. Bornstein ES. Why wavelength and delivery systems are the most
important factors in using a dental hard-tissue laser: A literature review.
Compend Contin Educ Dent 2003;24:837-47.
12. Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Laser in
dentistry: An innovative tool in modern dental practice. Natl J
Maxillofac Surg 2012;3:124-32.
13. Steiner R. Laser tissue – Interaction. In: Raulin C, Karsai S, Editors.
Laser and IPL Technology in Dermatology and Aesthetic Medicine.
Berlin Heidelberg, 2011, p. 23-36.
14. Launay Y, Mordon S, Cornil A, Brunetaud JM, Moschetto Y. Thermal
effects of lasers on dental tissues. Lasers Surg Med 1987;7:473-7.
15. Zach L, Cohen G. Pulp response to externally applied heat. Oral Surg
Oral Med Oral Pathol 1965;19:515-30.
16. von Fraunhofer JA, Allen DJ. Thermal effects associated with the Nd/
YAG dental laser. Angle Orthod 1993;63:299-303.
Dental Hypotheses ¦ Oct-Dec 2016 ¦ Volume 7 ¦ Issue 4
 Mortazavi et al.: Safety of dental lasers
17. Powell GL, Whisenant BK, Morton TH. Carbon dioxide laser oral
safety parameters for teeth. Lasers Surg Med 1990;10:389-92.
18. Melcer J. Lasers in Dentistry. Amsterdam: Elsevier Science Publishers
BV; 1989.
19. Bader C, Krejci I. Indications and limitations of Er:YAG laser
applications in dentistry. Am J Dent 2006;19:178-86.
20. Buchalla W, Attin T. External bleaching therapy with activation
by heat, light or laser-A systematic review. Dent Mater
2007;23:586-96.
21. Vahid Dastjerdi E, Khaloo N, Mojahedi SM, Azarsina M. Shear Bond
Strength of Orthodontic Brackets to Tooth Enamel After Treatment
With Different Tooth Bleaching Methods. Iran Red Crescent Med J
2015;17:e20618.
22. Staninec M, Meshkin N, Manesh SK, Ritchie RO, Fried D. Weakening
of dentin from cracks resulting from laser irradiation. Dent Mater
2009;25:520-5.
23. de Macedo HS, Colucci V, Messias DC, Rached-Júnior FJ, Fernandes
FS, Silva-Sousa YT, et al. Effect of Nd:YAG (1064-nm) and Diode
Laser (980-nm) EDTA Agitation on Root Dentin Ultrastructure
Properties. Photomed Laser Surg 2015;33:349-56.
24. Ghanbarzadeh M, Ahrari F, Akbari M, Hamzei H. Microhardness of
demineralized enamel following home bleaching and laser-assisted in
office bleaching. J Clin Exp Dent 2015;7:e405-9.
25. Parreiras SO, Vianna P, Kossatz S, Loguercio AD, Reis A. Effects of
light activated in-office bleaching on permeability, microhardness, and
mineral content of enamel. Oper Dent 2014;39:E225-30.
26. Can-Karabulut DC, Karabulut B. Shear bond strength to enamel after
power bleaching activated by different sources. Eur J Esthet Dent
2010;5:382-96.
27. Ozel E, Tuna EB, Firatli S, Firatli E. Effect of different parameters of Er:
YAG laser irradiations on class V composite restorations: A scanning
electron microscopy study. Scanning. 2016; [Epub ahead of print].
28. Ceballos L, Osorio R, Toledano M, Marshall GW. Microleakage of
composite restorations after acid or Er-YAG laser cavity treatments.
Dent Mater 2001;17:340-6.
29. Dunn WJ, Davis JT, Bush AC. Shear bond strength and SEM
evaluation of composite bonded to Er:YAG laser-prepared dentin
and enamel. Dent Mater 2005;21:616-24.
30. Bahrololoomi Z, Kabudan M, Gholami L. Effect of Er:YAG Laser on
Shear Bond Strength of Composite to Enamel and Dentin of Primary
Teeth. J Dent 2015;12:163-70.
31. von Fraunhofer JA, Allen DJ, Orbell GM. Laser etching of enamel for
direct bonding. Angle Orthod 1993;63:73-6.
32. Yildirim T, Ayar MK, Yesilyurt C. Influence of different Er,Cr:YSGG
laser parameters on long-term dentin bond strength of self-etch
adhesive. Lasers Med Sci 2015;30:2363-8.
Dental Hypotheses ¦ Oct-Dec 2016 ¦ Volume 7 ¦ Issue 4
33. Gorler O, Dogan DO, Ulgey M, Goze A, Hubbezoğlu I, Zan R, et al.
The Effects of Er:YAG, Nd:YAG, and Ho:YAG Laser Surface
Treatments to Acrylic Resin Denture Bases on the Tensile Bond
Strength of Silicone-Based Resilient Liners. Photomed Laser Surg
2015;33:409-14.
34. Mitsunaga S, Iwai T, Kitajima H, Yajima Y, Ohya T, Hirota M, et al.
Cervicofacial subcutaneous emphysema associated with dental laser
treatment. Aust Dent J 2013;58:424-7.
35. Mitsunaga S, Iwai T, Aoki N, Yamashita Y, Omura S, Matsui Y, et al.
Cervicofacial subcutaneous and mediastinal emphysema caused by air
cooling spray of dental laser. Oral Surg Oral Med Oral Pathol Oral
Radiol 2013;115:e13-6.
36. Imai T, Michizawa M, Arimoto E, Kimoto M, Yura Y.
Cervicofacial subcutaneous emphysema and pneumomediastinum
after intraoral laser irradiation. J Oral Maxillofac Surg 2009;67:
428-30.
37. Bahcall J, Howard P, Miserendino L, Walia H. Preliminary
investigation of the histological effects of laser endodontic
treatment on the periradicular tissues in dogs. J Endod 1992;18:
47-51.
38. Shoji S, Horiuchi H. Histopathological changes of dental pulp after
irradiation by Argon, Carbon-Dioxide or Nd:YAG laser in rats. In:
Shoji S, Horiuchi H, editors. Lasers in Dentistry. Elsevier Science
Publishers BV, Amsterdam; 1989. p. 253-8.
39. Adrian JC, Bernier JL, Sprague WG. Laser and the dental pulp. J Am
Dent Assoc 1971;83:113-7.
40. Goultschin J, Gazit D, Bichacho N, Bab I. Changes in teeth and gingiva
of dogs following laser surgery: A black surface light microscope
study. Lasers Surg Med 1988;8:402-8.
41. Singh S, Gambhir RS, Kaur A, Singh G, Sharma S, Kakar H.
Dental lasers: A review of safety essentials. J Lasers Med Sci
2012;3:91-6.
42. Kripal K, Sirajuddin S, Rafiuddin S, Mp R, Chungkham S. Iatrogenic
damage to the periodontium caused by laser: An overview. Open Dent J
2015;26;9: 210-3.
43. Ferenczy A, Bergeron C, Richart RM. Human papillomavirus DNA in
CO2 laser-generated plume of smoke and its consequences to the
surgeon. Obstet Gynecol 1990;75:114–8.
44. Smalley PJ. Laser safety: Risks, hazards, and control measures. Laser
Ther 2011;20:95-106.
45. Castelluccio D. Implementing AORN recommended practices for laser
safety. AORN J 2012;95:612-24.
46. Hughes AB. Implementing AORN recommended practices for a safe
environment of care. AORN J 2013;98:153-66.
47. Andersen K. Safe use of lasers in the operating room-what
perioperative nurses should know. AORN J 2004;79:171-88.
127
Copyright of Dental Hypotheses is the property of Dental Hypotheses and its content may not
be copied or emailed to multiple sites or posted to a listserv without the copyright holder's
express written permission. However, users may print, download, or email articles for
individual use.