Original Research Articles
Vol. 32 No. 1 (2025)
Laser-enhanced tooth bleaching with Nd:YAG, Er:YAG, and diode lasers: an in vitro study
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 29 September 2024
Accepted: 19 February 2025
Accepted: 19 February 2025
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Tooth discoloration and staining are aesthetic issues that trouble many patients. The purpose of this study is to compare tooth color change after bleaching with Nd:YAG, Er:YAG, and diode lasers. Forty-eight upper and lower human anterior teeth and premolars were divided into four groups (12 teeth each). Bleaching gel with 38% hydrogen peroxide was placed on the teeth in all four groups. In the first, second, and third groups, Nd:YAG laser, Er:YAG laser, and diode laser were irradiated after applying the bleaching gel. In the fourth group, which is considered as control group, no laser rays were irradiated for activation after the bleaching gel was placed. Before and after bleaching, the shade of the teeth was measured using the CIELab system by a spectrophotometer (SpectroShade, MHT, Verona, Italy). The results were analyzed using one-way ANOVA and Tukey’s multiple comparison test. All bleaching methods resulted in significant changes in tooth shade (ΔE≥3.3). The average color changes between groups differed significantly (p<0.05). Diode laser caused the highest (ΔE=10.16), and Er:YAG laser caused the lowest amount of color change among all groups (ΔE=5.14). There was no difference between the Nd:YAG and Er:YAG lasers (p>0.05). The color change in the diode laser group was significantly higher than in the control group, whereas it was lower in the Er:YAG and Nd:YAG groups.
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Atali PY, Topbaşi FB. The effect of different bleaching methods on the surface roughness and hardness of resin composites. J Dent Oral Hyg 2011;3:10-7.
Gökay O, Müjdeci A, Algin E. In vitro peroxide penetration into the pulp chamber from newer bleaching products. Int Endod J 2005;38:516-20. DOI: https://doi.org/10.1111/j.1365-2591.2005.00979.x
Gomes MN, Francci C, Medeiros IS, et al. Effect of light irradiation on tooth whitening: enamel microhardness and colour change. J Esthet Restor Dent 2009;21:387-94. DOI: https://doi.org/10.1111/j.1708-8240.2009.00295.x
Gao Y, Zhao Z, Li L, et al. In vitro evaluation of the effectiveness of bleaching agents activated by KTP and Nd: YAG laser. Photodiagnosis Photodyn Ther 2020;31:101900. DOI: https://doi.org/10.1016/j.pdpdt.2020.101900
Luk K, Tam L, Hubert M. Effect of light energy on peroxide tooth bleaching. J Am Dent Assoc 2004;135:194-201. DOI: https://doi.org/10.14219/jada.archive.2004.0151
Yu H, Li Q, Cheng H, Wang Y. The effects of temperature and bleaching gels on the properties of tooth-coloured restorative materials. J Prosthet Dent 2011;105:100-7. DOI: https://doi.org/10.1016/S0022-3913(11)60007-3
Alqahtani MQ. Tooth-bleaching procedures and their controversial effects: A literature review. Saudi Dent J 2014;26:33-46. DOI: https://doi.org/10.1016/j.sdentj.2014.02.002
Eachempati P, Kumbargere Nagraj S, Kiran Kumar Krishanappa S, et al. Home-based chemically-induced whitening (bleaching) of teeth in adults. Cochrane Database Syst Rev 2018;12:Cd006202. DOI: https://doi.org/10.1002/14651858.CD006202.pub2
Silva EMD, Maia J, Mitraud CG, et al. Can whitening toothpastes maintain the optical stability of enamel over time? J Appl Oral Sci : revista FOB 2018;26:e20160460. DOI: https://doi.org/10.1590/1678-7757-2016-0460
Algarni AA, Ungar PS, Lippert F, et al. Trend-analysis of dental hard-tissue conditions as function of tooth age. J Dent 2018;74:107-12. DOI: https://doi.org/10.1016/j.jdent.2018.05.011
Epple M, Meyer F, Enax J. A Critical Review of Modern Concepts for Teeth Whitening. Dent J 2019;7. DOI: https://doi.org/10.3390/dj7030079
James P, Worthington HV, Parnell C, et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev 2017;3:Cd008676. DOI: https://doi.org/10.1002/14651858.CD008676.pub2
Kugel G, Gerlach RW, Aboushala A, et al. Long-term use of 6.5% hydrogen peroxide bleaching strips on tetracycline stain: a clinical study. Compend Contin Educ Dent (Jamesburg, NJ: 1995) 2011;32:50-6.
Mendes L, Laxe L, Passos L. Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach. Case Rep Dent 2017;2017:2106245. DOI: https://doi.org/10.1155/2017/2106245
Toupenay S, Fournier BP, Manière MC, et al. Amelogenesis imperfecta: therapeutic strategy from primary to permanent dentition across case reports. BMC Oral Health 2018;18:108. DOI: https://doi.org/10.1186/s12903-018-0554-y
Joiner A. The bleaching of teeth: a review of the literature. J Dent 2006;34:412-9. DOI: https://doi.org/10.1016/j.jdent.2006.02.002
Kashima-Tanaka M, Tsujimoto Y, Kawamoto K, et al. Generation of free radicals and/or active oxygen by light or laser irradiation of hydrogen peroxide or sodium hypochlorite. J Endod 2003;29:141-3. DOI: https://doi.org/10.1097/00004770-200302000-00013
Coutinho DS, Silveira L Jr, Nicolau RA, et al. Comparison of temperature increase in in vitro human tooth pulp by different light sources in the dental whitening process. Lasers Med Sci 2009;24:179-85. DOI: https://doi.org/10.1007/s10103-008-0546-2
Ergin E, Ruya Yazici A, Kalender B, et al. In vitro comparison of an Er:YAG laser-activated bleaching system with different light-activated bleaching systems for colour change, surface roughness and enamel bond strength. Lasers Med Sci 2018;33:1913-8. DOI: https://doi.org/10.1007/s10103-018-2555-0
Kiomarsi N, Salim S, Sarraf P, et al. Evaluation of the Diode laser (810nm,980nm) on dentin tubule diameter following internal bleaching. J Clin Exp Dent 2016;8:e241-5. DOI: https://doi.org/10.4317/jced.52666
Sağlam BC, Koçak MM, Koçak S, et al. Comparison of Nd:YAG and Diode laser irradiation during intracoronal bleaching with sodium perborate: colour and Raman spectroscopy analysis. Photomed Laser Surg 2015;33:77-81. DOI: https://doi.org/10.1089/pho.2014.3845
Strobl A, Gutknecht N, Franzen R, et al. Laser-assisted in-office bleaching using a neodymium:yttrium-aluminum-garnet laser: an in vivo study. Lasers Med Sci 2010;25:503-9. DOI: https://doi.org/10.1007/s10103-009-0675-2
Mirzaie M, Yassini E, Ganji S, et al. A Comparative Study of Enamel Surface Roughness After Bleaching With Diode Laser and Nd: YAG Laser. J Lasers Med Sci 2016;7:197-200. DOI: https://doi.org/10.15171/jlms.2016.34
Sharma A, Grover N, Khan S, et al. Effect of Diode Laser Office Bleaching on Mineral Content and Surface Topography of Enamel Surface: An SEM Study. Int J Clin Pediatr Dent 2021;13:481-5. DOI: https://doi.org/10.5005/jp-journals-10005-1823
Abdelfattah MM. Different Types of Laser use in Teeth Bleaching. J Med Sci 2014;5:230-7.
Nguyen C, Augros C, Rocca JP, et al. KTP and Er:YAG laser dental bleaching comparison: a spectrophotometric, thermal and morphologic analysis. Lasers Med Sci 2015;30:2157-64. DOI: https://doi.org/10.1007/s10103-015-1778-6
Coluzzi DJ. Fundamentals of dental lasers: science and instruments. Dent Clin N Am 2004;48:751-70, v. DOI: https://doi.org/10.1016/j.cden.2004.05.003
Dostalova T, Jelínková H, Housova D, et al. Diode laser-activated bleaching. Braz Dent J 2004;15:SI3-8.
Akın M, Ozyılmaz OY, Yavuz T, et al. Effect of Nd:YAG laser bleaching and antioxidizing agents on the shear bond strength of brackets. Photomed Laser Surg 2013;31:365-70. DOI: https://doi.org/10.1089/pho.2012.3467
Gutknecht N, Franzen R, Meister J, et al. A novel Er:YAG laser-assisted tooth whitening method. LA&HA - Journal of the Laser and Health Academy 2011;2011:1-10.
Tekce AU, Yazici AR. Clinical comparison of diode laser- and LED-activated tooth bleaching: 9-month follow-up. Lasers Med Sci 2022;37:3237-2. DOI: https://doi.org/10.1007/s10103-022-03612-1
Dederich DN, Bushick RD. Lasers in dentistry: separating science from hype. J Am Dent Assoc (1939) 2004;135:204-12; quiz 29. DOI: https://doi.org/10.14219/jada.archive.2004.0153
Saffarpour M, Gerami S, Parviz N, Chiniforush N. Evaluating the effectiveness of two wavelengths of 810 and 980 nm Diode laser with two different beam profiles on tooth discoloration in bleaching: an experimental study. Laser Ther J 2024;31. DOI: https://doi.org/10.4081/ltj.2024.387
Sikri VK. Colour: Implications in dentistry. J Conserv Dent 2010;13:249-55. DOI: https://doi.org/10.4103/0972-0707.73381
Tabatabaian F, Beyabanaki E, Alirezaei P, Epakchi S. Visual and digital tooth shade selection methods, related effective factors and conditions, and their accuracy and precision: A literature review. J Esthet Restor Dent 2021;33:1084-104. DOI: https://doi.org/10.1111/jerd.12816
Hou X, Yuan K, Huang Z, Ma R. Effects of Bleaching Associated with Er:YAG and Nd:YAG Laser on Enamel Structure and Bacterial Biofilm Formation. Scanning 2021;2021:6400605. DOI: https://doi.org/10.1155/2021/6400605
Joiner A. Tooth colour: a review of the literature. J Dent 2004;32:3-12. DOI: https://doi.org/10.1016/j.jdent.2003.10.013
Rohaninasab M, Alinejad N, Kiomarsi N, Hashemikamangar SS. Efficacy and durability of bleaching with Diode lasers: an in vitro study. Gen Dent 2022;70:35-9.
Kwon SR, Kurti SR Jr, Oyoyo U, Li Y. Effect of Light-Activated Tooth Whitening on Colour Change Relative to Colour of Artificially Stained Teeth. J Esthet Restor Dent 2015;27:S10-7. DOI: https://doi.org/10.1111/jerd.12142
Möbius D, Braun A, Franzen R. Evaluation of tooth colour change after a bleaching process with different lasers. Odontology 2024;112:872-83. DOI: https://doi.org/10.1007/s10266-023-00886-x
Saluja I, Shetty N, Shenoy R, Pangal SN. Evaluation of the efficacy of Diode laser in bleaching of the tooth at different time intervals using spectrophotometer: An in vitro study. J Conserv Dent 2022;25:166-72. DOI: https://doi.org/10.4103/jcd.jcd_621_21
Ethics Approval
This study was approved by the Ethics Committee of Alborz University of Medical Sciences (IR.ABZUMS.REC. 1402.251). All patients agreed to participate.CRediT authorship contribution
Mahshid Saffarpour, Nasim Chiniforush: conceptualization; Nasim Chiniforush: methodology; Noushin Imeni, Luca Solimei: formal analysis; Nasim Chiniforush, Noushin Imeni: investigation, writing – review & editing; Noushin Imeni: writing – original draft; Stefano Benedicenti: sources; Mahshid Saffarpour, Noushin Imeni, Nasim Chiniforush: supervision. All the authors have read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work.
Data Availability Statement
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
How to Cite
Laser-enhanced tooth bleaching with Nd:YAG, Er:YAG, and diode lasers: an in vitro study. (2025). Laser Therapy, 32(1). https://doi.org/10.4081/ltj.2025.409
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