Comparison of Live Bacteria Aerosolization during Removal of Dental Enamel Using a 9.3μm CO2 Laser, a 2.78μm Erbium Laser and a High-Speed Dental Drill

Purpose: To measure the amount of viable pathogens in the aerosol/splatter generated during dental procedures using lasers and high-speed drill. Methods: Three systems were used in this in vitro study: 9.3μm CO2 laser, 2.78μm erbium laser and a high-speed drill. 45 uncleaned human molars were randomly selected to be used for the test groups for the three systems. Bacteria ejected while cutting the buccal or lingual surfaces were collected on tryptic soy agar (TSA) plates in identical conditions for each measurement. On the opposite surface of each tooth, a non-cutting mist spray was applied. Results: The CO2 laser resulted in colony-forming units (CFU) with a mean of 1570 ± 3850 CFU/m3/s, which is statistically different (p < 0.001) relative to both the erbium laser and the drill with a mean of 185,000 ± 182,000 CFU/m3/s and 440,000 ± 496,000 CFU/m3/s, respectively. CFU measured from the non-cutting mist spray on the teeth was higher for the drill than for the lasers. Conclusion: The 9.3μm CO2 laser resulted in the lowest CFU in the aerosol/splatter during enamel removal as compared to that of the 2.78μm erbium laser and the traditional high-speed drill. Furthermore, the CO2 laser was the only system that did not increase aerosolization of bacteria while cutting compared to the non-cutting mist spray.