A Randomized Controlled Trial Comparing Er:YAG Laser and Rotary Bur in the Excavation of Caries - Patients' Experiences and the Quality of Composite Restoration

Roxana Sarmadi1, 3, *, Elin Viktoria Andersson1, Peter Lingström3, Pia Gabre2, 3
1 Department of Paediatric Dentistry, Public Dental Health, Uppsala County Council, Uppsala, Sweden
2 Department of Preventive Dentistry, Public Dental Health, Uppsala County Council, Uppsala, Sweden
3 Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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© 2018 Sarmadi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to the author at the Department of Paediatric dentistry, Public Dental Health, Uppsala County Council, Vretgränd 9A,75322 Uppsala, Sweden; Tel: +46-73-5018848; Fax: +46-18-150215; E-mail: roxana.sarmadi@lul.se



The aim of this study was to evaluate patients´ experiences of two excavation methods, Er:YAG laser and rotary bur and time required by the methods as well as objective assessments of quality and durability of restorations over a two-year period.


A prospective, single-blind, randomized and controlled investigation was performed. Patients aged 15 to 40 years with at least two primary caries lesions, which had been radiographically assessed as of the same size, were recruited. In each patient, one cavity was excavated using rotary bur and one using Er:YAG laser technique. The time required for excavations and, where applicable, local anaesthesia, was measured during the treatments. Patient experiences were measured using questionnaires. The quality and durability of restorations were assessed over a two-year period in accordance with modified Ryges criteria and radiographs. Twenty-five patients (mean age 22.6 years) participated in the study. In total, 56 cavities were included of which 28 were treated with Er:YAG laser and 28 were treated with a rotary bur.


The patients associated the laser method with less discomfort. The mean time for excavation by laser was three times longer than by rotary bur (13.2 min vs. 4.3 min, P<0.0001). Over a two-year period, no statistically significant differences with regard to quality or durability could be seen between the restorations associated with the methods.


The Er:YAG laser technique was more time-consuming than the rotary bur. Despite this, the laser technique caused less discomfort and was preferred as an excavation method by patients.

Keywords: Clinical trial, Composite restorations, Er:YAG laser, Patients’ experiences, Rotary bur, Dental caries.