Improvement of Apical Papilla Cell Attachment after Erbium, Chromium-Doped Yttrium, Scandium, Gallium, and Garnet Laser Application: a Study in an Ex Vivo Immature Tooth Model

The purposes of this study were (1) to investigate the direct effect of an Er,Cr:YSGG laser on human apical papilla cell (APC) proliferation and mineralization and (2) to examine the effect of Er,Cr:YSGG laser, when applied to an ex vivo immature tooth model, on APC attachment. An Er,Cr:YSGG laser at various power outputs (0.1, 0.5, and 1 W) was used at different positions (2, 5, or 8 mm from the cells) to irradiate cultured APCs. APC proliferation and mineralization were assessed at various intervals. For the cell attachment evaluation, ex vivo tooth models containing dentin samples were irrigated with either EDTA or normal saline solution (NSS) and supplemented with laser activation. Fibronectin-positive-staining cells were counted and analyzed. The number of APCs was significantly greater when power outputs of 0.1 W and 0.5 W were used than when 1 W was used (P < 0.05). The close contact of laser application, at 2 and 5 mm, exerted a negative effect on cell proliferation at 24 and 48 h. The application at 8 mm did not show the deterioration effect. APC mineralization was reduced after laser irradiation, regardless of the power and the tip positioning, at 21 days. APC attachment in all laser-activated groups was significantly greater than in the groups without laser. The use of Er,Cr:YSGG laser significantly promoted APC attachment on the root canal dentin.