Er:YAG laser biofilm removal from zero-gap periodontal/peri-implant model system mimicking clinical attachment loss

Significance: Here, we present a photoacoustic method to remove biofilms from periodontal and peri-implant-constrained geometries. Aim: We aim to remove biofilms from narrow periodontal and peri-implant model systems with the application of Er:YAG ultrashort laser pulses. Approach: Construction of zero-gap model system from PDMS and titanium, growth of biofilms on titanium surfaces, and removal of biofilms with Er:YAG USP, 20 mJ, 15 Hz, and 10 s were performed. Results The results suggest that geometry, the vertical position of the laser fiber tip, and the evolution of the primary cavitation bubble significantly affect cleaning effectiveness. Cleaning was higher in the wedge part of the model system. In the zero-gap part of the model system, biofilm cleaning effectiveness was highest at the position of the laser fiber tip and decreased above and below the fiber tip. The dimension of the space in which the cavitation bubble develops determines the size and dynamics of the expanded cavitation bubble and consequently the biofilm cleaning effectiveness. Conclusions: The obtained results suggest a very good biofilm removal effectiveness in difficult-to-reach narrow geometries mimicking clinical attachment loss in the periodontal/peri-implant pocket.