In 1997, the FDA cleared the Er:YAG laser for caries removal, cavity preparation, and laser etching of enamel. The clearance of the first Er:YAG (2.94 µm) laser focussed on the ability of this wavelength to create Class I, II, II, IV, and V dental preparations, and its role in restorative dentistry was established. An extensive number of studies were completed investigating adhesion and seal in association with Er:YAG, and evaluating whether laser cavity preparation and/or laser cavity conditioning could replace the acid-etch procedure or the classic pretreatment procedures prior to resin composite or glass-ionomer restoration. This review presents an overview of the literature regarding adhesion and sealing efficacy of different (pre)treatment protocols in association with Er:YAG laser preparation. It is concluded that at present, it is advisable to respect the conventional pretreatment procedures prescribed by the adhesive materials. Although the majority of present day reports show that microleakage and bond strength values are negatively influenced by laser (pre)treatment as compared to conventional preparation, contradictions remain on how adhesion is best achieved on Er:YAG-lased surfaces. An explanation for the disparate statements is the heterogeneity in the parameters used when preparing dental tissue with a laser. Based on these findings, it has to be emphasized that there is a need for "golden standards" regarding energy output in order to eliminate surface and subsurface alterations of dental substrate which negative influence adhesion and seal.
Keywords: Er:YAG laser, adhesion, resin composite, glass-ionomer cement, microleakage, tensile bond strength