This is an outdated version published on 2021-03-31. Read the most recent version.

Retreatment of 6 Ceramic Restorations In A Single Session - The Application of Er:YAG Laser And CAD/CAM Technology: An 1 Year Follow Up Clinical Evaluation


  • Christian Giancarlo Bernal University of São Paulo
  • Ester Mi Ryoung Lee University of São Paulo
  • Carlos De Paula Eduardo University of São Paulo
  • Ana Maria Aparecida Souza University of São Paulo
  • Luciane Hiramatsu Azevedo University of São Paulo



Background: To present the benefits of high power lasers (Er: YAG and Nd: YAG) over the use of the high speed turbine for the extraction of ceramics restorations, without damaging the surfaces of the teeth; being a relatively easier and faster procedure without the use of anesthetic agents, and the preparation of the ceramic restorations and cementing in the single session; with a follow-up of 1 year. Objective: The benefits of lasers over high-speed turbine mechanical instrumentation for crown removal encompass efficient restoration recovery without damage to tooth surfaces; and a relatively easier and faster procedure without the use of anesthetic agents. Methods: The Er: YAG laser (no contact; 3.2-4.0 W, 20 Hz) was used to extract the porcelain prosthesis, followed by a gingivectomy with the Nd: YAG laser on tooth 12 to improve the gingival contour. The dental surfaces where the ceramic prosthesis will be cemented were scanned. Then, CAD / CAM technology was used to make the ceramic veneers that were cemented in the same session. Results: The efficacy the Er:YAG laser energy was observed by the decreased of the time to remove all-ceramic materials through ablation of bonding cements, reducing working time by 75% compared to a high-speed turbine. Conclusions: An Er: YAG laser can safely remove lithium disilicate crowns with the settings used in this study. Laser-assisted removal of all ceramic PDFs is a promising treatment protocol. The use of the Nd: YAG (2.0 W power, short 20Hz, 320 µm optical fiber, in contact) laser allowed gingivoplasty to be performed, automatically cauterizing avoiding post-operative bleeding, and facilitating the preparation of ceramic restorations the same day. The use of high-power lasers and the use of accompanying CAD / CAM technology allowed this clinical case to be completed in a single visit without the use of temporary restorations, achieving absolute patient satisfaction.



Er:YAG; Nd:YAG; Lithium disilicate ceramic; CAD/CAM.


Gurney ML, Sharples SD, Phillips WB, Lee DJ.Using an Er,Cr:YSGG laser to remove lithium disilicate restorations: A pilot study. J Prosthet Dent. 2016 Jan;115(1):90-4.

Rechmann P, Buu NC, Rechmann BM, Le CQ, Finzen FC, Featherstone JD. Laser all-ceramic crown removal-a laboratory proof-of-principle study-phase 1 material characteristics. Lasers Surg Med. 2014 Oct;46(8):628-35

Bayazıt EÖ, Karabıyık M.Chairside Restorations of Maxillary Anterior Teeth with CAD/CAM Porcelain Laminate Veneers Produced by Digital Workflow: A Case Report with a Step to Facilitate Restoration Design. Case Rep Dent. 2019 Apr 4;2019:6731905

Kursoglu P, Gursoy H. Removal of fractured laminate veneers with Er:YAG laser: report of two cases. Photomed Laser Surg. 2013;31(1):41-43.

Zhang Y, Rocca JP, Fornaini C, Zhen Y, Zhao Z, Merigo E. Erbium-Doped, Yttrium-Aluminum-Garnet Laser Debonding of Porcelain Laminate Veneers: An Ex vivo Study. Contemp Clin Dent. 2018;9(4):570-573.

de Siqueira F, Cardenas A, Gruber YL, et al. Using CAD/CAM-Modified Correlation Mode to Produce Laminate Veneers: A Six-Month Case Report. Oper Dent. 2017;42(5):E139-E147.

Restorations of Maxillary Anterior Teeth with CAD/CAM Porcelain Laminate Veneers Produced by Digital Workflow: A Case Report with a Step to Facilitate Restoration Design. Case Rep Dent. 2019;2019:6731905. Published 2019 Apr 4.

Seydler B, Schmitter M. Clinical performance of two different CAD/CAM-fabricated ceramic crowns: 2-Year results. J Prosthet Dent. 2015;114(2):212-216.

Sá TCM, de Carvalho MFF, de Sá JCM, Magalhães CS, Moreira AN, Yamauti M. Esthetic rehabilitation of anterior teeth with different thicknesses of porcelain laminate veneers: An 8-year follow-up clinical evaluation. Eur J Dent. 2018;12(4):590-593.

Blatz MB, Vonderheide M, Conejo J. The Effect of Resin Bonding on Long-Term Success of High-Strength Ceramics. J Dent Res. 2018;97(2):132-139.

Kellesarian SV, Ros Malignaggi V, Aldosary KM, Javed F.Laser-assisted removal of all ceramic fixed dental prostheses: A comprehensive review. J Esthet Restor Dent. 2018 May;30(3):216-222.

Inchingolo F1, Tatullo M, Abenavoli FM, Marrelli M, Inchingolo AD,

Inchingolo AM, Dipalma G. Comparison between traditional surgery, CO2 and Nd:YAG laser treatment for generalized gingival hyperplasia in Sturge-Weber syndrome: a retrospective study. J Investig Clin Dent. 2010 Nov;1(2):85-9.

Fornaini C, Rocca JP, Bertrand MF, Merigo E, Nammour S, Vescovi P. Nd:YAG and diode laser in the surgical management of soft tissues related to orthodontic treatment. Photomed Laser Surg. 2007;25(5):381-392.






Case Report / Clinical Technique Manuscript