Ablation of composite resins using Er:YAG laser--comparison with enamel and dentin

The effect of different surface treatments and adhesive systems on shear bond strength in universal nanohybrid composite resin repair

BACKGROUND

The aim of this study is to evaluate the effect of different surface treatments and adhesives on shear bond strength (SBS) in the repair of composite resin restorations.

METHODS

In this study, 60 discs (2 mm x 10 mm) were prepared using a universal nanohybrid composite resin (GrandioSo, Voco, Germany). The discs were aged by exposure to 5000 thermal cycles between 5 and 55 °C for 30 s with an immersion procedure. Then samples were divided into 3 groups (n:20) according to the surface treatments (Group 1: no surface treatment, Group 2: roughening by bur, Group 3: roughening by Er, Cr: YSGG laser). Subsequently, the specimens were classified into two groups (n:10) according to the adhesive systems; a two-step self-etch adhesive (Clearfil SE bond (SE)), or a universal adhesive (Scotchbond Universal Plus (SB)). After surface treatments and adhesive applications, the same universal nanohybrid composite resin with a height of 2 mm and a diameter of 3 mm was placed in the center of the samples. The samples were then submitted to the SBS test using universal testing equipment (Autograph AGS-X; Shimadzu, Kyoto, Japan) with a crosshead speed of 1 mm/min. The failure modes were examined using a stereomicroscope. The surface topography of the roughened and fractured surfaces resin composite (n = 1) was assessed using scanning electron microscopy (SEM). Analyses were performed using IBM SPSS 25 programme (p < 0.05).

RESULTS

The highest bond strength was observed in the laser + SE group (22.69 ± 4.49), while the lowest was recorded in the control + SE group (14.12 ± 3.00). In the SE adhesive group, no significant difference was found between the laser + SE and bur + SE groups (p > 0.05). Similarly, in the SB adhesive group, there were no significant differences among the surface roughening procedures (p = 0.078). Additionally, no significant differences were observed between the adhesives according to various surface roughening procedures. The failure mode was predominantly cohesive in old composites.

CONCLUSION

The bond strength can be improved by surface treatments such as diamond burs, Er, Cr: YSGG laser application for better bonding strategies in the repair of nanohybrid resin composite restorations. There was no statistically significant difference in bond strength between the adhesives tested in this study.

The application of lasers in vital pulp therapy: a review of histological effects

Vital pulp therapy (VPT) is primarily intended to preserve the vitality of pulp tissues, which have been exposed for any reason. Various materials and techniques have been proposed to improve treatment outcomes, including the use of lasers. This study aimed to review the histological results of different dental lasers including low-level lasers, carbon dioxide (CO2), erbium-doped yttrium aluminum garnet laser (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, and diode lasers for VPT. This focused review included a comprehensive electronic search of Scopus, MEDLINE, Web of Science, and Google Scholar databases from 2000 to 2022 by two independent investigators. Different combinations of keywords were used, and reference mining of related papers was done. The review included studies related to histologic evaluation of laser-assisted vital pulp therapy that stated the laser parameters that were used. Articles with radiographic or clinical assessments or articles lacking necessary data were excluded. Non-English articles were excluded unless their abstract was in English and encompassed the necessary data. Most studies indicated the efficacy of lasers for reduction of inflammation, acceleration of healing, and increasing the thickness of dentinal bridge. According to the evidence, lasers used in combination with pulp capping agents are beneficial to enhance the success rate of VPT.

Microtensile Repair Bond Strength of a Composite After Accelerated Artificial Aging: Effect of the Air Abrasion, Bur, Er:YAG Laser, Two-Step Self-etch Bonding, and Universal Bonding Repair System

Introduction: Repair of old composite restorations is a conservative approach. This study sought to compare the effects of two adhesive systems on the bond strength of repaired composites prepared by three different surface treatments: erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation, air-abrasion, and bur preparation. Methods: Eight microhybrid (Polofil Supra, VOCO, Germany) composite resin blocks were fabricated. The blocks were aged and assigned to four groups as stated by the surface treatment: (I) air-abrasion (50 µ aluminum oxide particles), (II) diamond bur (fine grit), (III) Er:YAG laser (3 W output power, 300 mJ energy) and (IV) control. After surface treatment, the blocks were acid-etched and salinized. Each group was divided two subgroups, and the Clearfil SE Bond or All-Bond Universal was applied on their surface. Composite resin was bonded to the aged composites. The blocks were cut into eight samples, and the microtensile bond strength (MTBS) was measured. Results: The maximum MTBS was noted in the air-abrasion (25.1+6 MPa) group, followed by the Er:YAG laser (21.2+4.7 MPa). The mean MTBS in laser and air-abrasion groups was significantly higher than that in other groups (P<0.05). The mean MTBS was not significantly different between the laser and air-abrasion groups (P>0.05). Composite resin conditioning by All-Bond Universal in laser and air-abrasion groups yielded significantly higher MTBS than the Clearfil SE Bond (P<0.05). Conclusion: All surface treatments created acceptable bond strength. The surface treatment of the aged composite by the Er:YAG laser or air-abrasion along with the application of silane and All-Bond Universal provide high bond strength.

Repair potential of a bulk-fill resin composite: Effect of different surface-treatment protocols

This study evaluated the effect of different surface-treatment protocols on the repair bond strength of a bulk-fill resin composite. One-hundred and forty specimens (Filtek Bulk-fill) were created (5 mm diameter, 4 mm depth) and allocated to one of 14 groups according to surface treatment (no treatment, tribochemical silica coating, sandblasting with aluminum oxide), adhesive application (no adhesive, total-etch, self-etch), and type of repair resin (bulk-fill, universal resin) (n = 10 per group). Twenty specimens were selected for measuring the cohesive strengths of non-aged resin composites and used as reference. Other specimens were thermocycled. Shear bond-strength testing was performed. Data were analyzed using linear regression of bond strength as a function of the surface treatment, type of adhesive and whether or not adhesive was applied, and type of repair resin. The failure modes were analyzed using logistic regression of failure mode (cohesive failure vs. other types, or adhesive failure vs. other types) on the type of surface treatment, adhesive application, and repair resin used. Surface treatment, regardless of whether this was tribochemical silica coating (mean difference = 5.44 MPa; 95% CI = 4.77-6.11) or sandblasting with aluminum oxide (mean difference = 4.22 MPa; 95% CI = 3.55-4.88), resulted in higher shear bond strength than no treatment. Application of adhesive resulted in a substantial and statistically significant decrease of shear bond strength (by 8.77 MPa, for self-etch and by 7.26 MPa for total-etch) relative to no adhesive. Conversely, the type of repair resin did not influence the shear bond strength to any appreciable extent.

Er:YAG laser-induced damage to a dental composite in simulated clinical scenarios for inadvertent irradiation: an in vitro study

Inadvertent Er:YAG laser irradiation occurs in dentistry and may harm restorative materials in teeth. The aim of this in vitro study was to quantify Er:YAG laser-induced damage to a nanohybrid composite in simulated clinical scenarios for inadvertent direct and indirect (reflection) laser irradiation. The simulation was performed by varying the output energy (OE;direct˃indirect) reaching the specimen and the operating distance (OD;direct˂indirect). Composite specimens were irradiated by an Er:YAG laser. The ablation threshold was determined and clinically relevant parameters were applied (n = 6 for each OE/OD combination) for direct (OE: 570 mJ/OD: 10 mm, OE: 190 mJ/OD: 10 mm) and indirect irradiation (OE: 466 mJ/OD: 15 mm, OE: 57 mJ/OD: 15 mm, OE: 155 mJ/OD: 15 mm, OE: 19 mJ/OD: 15 mm). The extent of damage in the form of craters was evaluated using a laser scanning microscope (LSM) and a conventional light microscope (LM). The ablation threshold was determined to be 2.6 J/cm². The crater diameter showed the highest value (LM: 1075 ± 18 µm/LSM: 1082 ± 17 µm) for indirect irradiation (reflectant:dental mirror) (OE: 466 mJ/OD: 15 mm). The crater depth showed the highest and comparable value for direct (OE: 570 mJ/OD: 10 mm; LSM: 89 ± 2 µm) and indirect irradiation (OE: 466 mJ/OD: 15 mm; LSM: 90 ± 4 µm). For each OD, the crater diameter, depth, and volume increased with higher laser fluence. However, the OD—and thus the laser spot diameter—also had an enlarging effect. Thus, indirect irradiation (reflectant:dental mirror) with only 47% of the laser fluence of direct irradiation led to a larger diameter and a comparable depth. The three-dimensional extent of the crater was large enough to cause roughening, which may lead to plaque accumulation and encourage caries, gingivitis, and periodontitis under clinical conditions. Clinicians should be aware that reflected irradiation can still create such craters.

Repair bond strength and surface topography of resin-ceramic and ceramic restorative blocks treated by laser and conventional surface treatments

This study intended to compare the repair bond strength of computer-aided design/computer-aided manufacturing (CAD/CAM) blocks consisting of resin and feldspathic ceramics following different surface treatments using the microtensile bond strength (μTBS) test. Ten specimens were prepared with 4 mm height for Vita Enamic (VE), Lava Ultimate (LU), Vita Mark II (VM), and thermocycled (10,000 cycle, 5-55°C). Each material was categorized into one of five subgroups according to following surface treatments: (a) bur grinding (BG), (b) hydrofluoric acid etching (HF), (c) neodymium-doped yttrium aluminum garnet (Nd:YAG or NY), (d) erbium-doped yttrium aluminum garnet (Er:YAG or EY), and (e) erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG or ECY) laser conditioning. After surface treatment procedures, specimens were properly restored to 4 mm high with a micro-hybrid composite resin. Bar specimens (1 × 1 × 8 mm) were obtained using a low-speed cutting machine and then thermocycled (10,000 cycle, 5-55°C). The μTBS was tested at 1 mm/min crosshead speed, and failure modes were evaluated. Data were analyzed with two-way ANOVA and post hoc Tukey tests. LU-BG showed significantly higher μTBS (32.94 ± 5.80 MPa) compared to LU-laser groups (p < .05). VE-BG showed significantly higher μTBS (22.06 ± 4.26 MPa) compared to other VE groups (p < .05). Among the laser groups, the NY laser produced the lowest (p < .05) μTBS for LU (13.42 ± 3.44 MPa) and VE (2.27 ± 0.85 MPa), while EY showed the highest (p < .05). Laser-treated VM groups were all prefailured. VM-HF produced a higher μTBS (18.73 ± 3.75 MPa) than VM-BG (5.05 ± 1.76 MPa) (p < .05).

Removal of Composite Restoration from the Root Surface in the Cervical Region Using Er: YAG Laser and Drill-In Vitro Study

Background: Recently, the defects of the tooth surface in the cervical region are often restored using composite filling materials. It should meet the needs of the patients regarding esthetics and material stability. The aim of the study was to analyze the tooth root surface at the cervical region after the removal of the composite filling material by means of the Erbium-doped Yttrium Aluminium Garnet (Er: YAG) laser or drill using the scanning electron microscopy (SEM) and fluorescence microscopy. Materials and Methods: For the purposes of this study, 14 premolar teeth (n = 14) were removed due to orthodontic reasons. The rectangular shape cavities with 3 mm in width and 1.5 mm in height were prepared with a 0.8 mm bur on high-speed contra-angle in the tooth surface just below cemento-enamel junction (CEJ) and filled with the composite material. The composite material was removed with the Er: YAG laser at a power of 3.4 W, energy 170 mJ, frequency 20 Hz, pulse duration 300 μs, tip diameter 0.8 mm, air/fluid cooling 3 mL/s, and time of irradiation: 6 sec, at a distance from teeth of 2 mm (G1 group, n = 7) or a high-speed contra-angle bur (G2 group, n = 7). After the removal of composite material, the surfaces of teeth were examined using the scanning electron microscopy (SEM) and fluorescence microscopy. Results: The Er: YAG irradiation allowed to remove completely the composite material from the tooth cavity. The study confirmed, that the ends of collagen fibers were only partially denatured after the Er: YAG laser application. Conclusion: It has been proved that using the Er: YAG laser is an effective and safe method of composite removal for the dentin surface.

Utilization of Er:YAG Laser in Retrieving and Reusing of Lithium Disilicate and Zirconia Monolithic Crowns in Natural Teeth: An In Vitro Study

The study examined the effect of noninvasive crown retrieval/reuse process using an erbium-doped yttrium aluminum garnet laser (Er:YAG). Twenty-six extracted human teeth were prepared for a crown. The crown was milled using lithium disilicate (LD) and zirconia (Z) materials, n = 13 per group, with three for scanning electron microscopy (SEM). The crown was luted using composite resin cement and subjected to a laser retrieval process. After the retrieval process, the crown was cleaned, re-cemented and laser-retrieved two more times, without and with additional tooth reduction mimicking clinical refreshment of dentin. Retrieval time and temperature were analyzed using analysis of variance (ANOVA). Surface changes were observed through SEM. The retrieval times were 267.1 ± 130.43, 220 ± 79.09, 277.1 ± 126.44, 368.4 ± 136.14, 355 ± 159.39, and 419.2 ± 121.36 s for first, second, third LD and Z groups, respectively (p = 0.009). The maximal temperatures were 23.95.1 ± 1.89 °C, 24.86 ± 2.01 °C, 24.17 ± 1.53 °C, 22.88 ± 1.51 °C, 24.03 ± 1.74 °C, and 21.99 ± 1.32 °C for first, second, third LD and Z groups, respectively (p = 0.006). Er:YAG laser crown removal is an effective retrieval tool for all-ceramic crowns. Minimal changes to teeth and crowns were observed following laser irradiation.

In vivo spectral guided removal of composite from tooth surfaces with a CO2 laser

Dental composites are used as restorative materials to replace tooth structure after the removal of caries, shaping, covering teeth for esthetic purposes and as adhesives. Dentists spend more time replacing existing restorations that fail than they do placing new restorations. Tooth colored restorations are difficult to differentiate from the surrounding tooth structure making them challenging to remove completely without incidental removal of healthy tooth structure. Previous studies have demonstrated that CO₂ lasers in conjunction with spectral feedback can be used to selectively remove composite from tooth surfaces. In addition, we assembled a system feasible for clinical use that incorporates a spectral feedback system, scanning system, articulating arm and a clinical handpiece and subsequently evaluated the performance of that system on extracted teeth. The purpose of this study was to test this system in vivo to demonstrate its efficacy relative to dental clinicians. Eight test subjects with premolar teeth scheduled for extraction for orthodontic reasons had bilateral premolars prepared with small occlusal cavity preparations and filled with dental composite. The laser scanning system was used to remove the composite from one of the preparations and a dental handpiece was used to remove the composite from the other. Cross polarization optical coherence tomography was used to measure the volume of the preparation before and after composite placement and removal. There was no significant difference in the loss of enamel and residual composite between the laser and the handpiece. This study demonstrated that a computer controlled spectral guided CO₂ laser scanning system can be used in vivo to selectively remove composite from tooth surfaces.

Composite removal by means of erbium, chromium:yttrium-scandium-gallium-garnet laser compared with rotary instruments

BACKGROUND

Complete removal of existing composite restorations without unnecessary removal of tooth structure is challenging. The authors compared the amount of tooth structure removed and composite remaining in Class III preparations when using an erbium laser or a rotary instrument.

METHODS

Mesiolingual and distolingual preparations were prepared in 14 extracted anterior teeth, restored with shade-matched composite, finished, and polished. One restoration was removed with an erbium, chromium:yttrium-scandium-gallium-garnet laser and the other with a rotary instrument (handpiece and carbide burs). Gypsum models made from vinyl polysiloxane impressions of the preparation and removal stages were scanned. The 2 scans were precisely aligned to calculate the amount of tooth structure removed and residual composite, which were statistically compared (t test) between the bur and laser groups.

RESULTS

Rotary instruments removed significantly more tooth structure than the laser in terms of mean depth (P = .0017) but not maximum depth (P = .0762). Although mean depth of tooth loss was smaller in the laser group, the area of tooth loss was significantly larger (P = .0004) because the rotary instrumentation left significantly more composite than the laser in terms of volume (P = .0104), mean depth (P = .0375), maximum depth (P = .0318), and area (P = .0056).

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The erbium, chromium:yttrium-scandium-gallium-garnet laser was more selective in removing existing composite restorations than a rotary instrument because it removed less tooth structure and left behind less composite. Unintentional loss of tooth structure and unnoticeable residual composite are inevitable when removing existing composites. Erbium lasers are alternative means of composite removal that may be more selective than a rotary instrument.

Effect of Different Surface Treatments and Roughness on the Repair Bond Strength of Aged Nanohybrid Composite

Objective and background: Different surface treatments have been tested in composite repair studies. However, there is still no consensus on the most effective repair protocol. The aim of this study is to measure the roughness values of eight different surface treatments for the repair procedure, to examine the effect of each surface treatment and three different composites on the repair bond strength with and without silane, and to evaluate whether there is a correlation between bond strength and roughness. Methods: The blocks were prepared with Filtek Z550 (3M ESPE) for the roughness measurements and divided into eight groups according to surface treatments. The roughness values of the surface treatments were measured by a 3D scanning contact profilometer (Nanomap LS). For the shear test, further samples were prepared, aged, and divided into three subgroups for the repair procedure with Filtek Z550 (3M ESPE), Vertise Flow (Kerr, USA), and G-aenial Flo (GC, Japan) after the surface treatments. Then, the shear test was performed. The Kruskal-Wallis and Spearman's Correlation tests were used for statistical evaluation of the data. Results: Significant differences were found between surface treatments and composite resins in terms of bond strength (p < 0.05). There is no correlation between the roughness and bond strength values. Conclusions: In bond strength, surface topography is more important than the numerical value of roughness. In the repair of composite restorations, methods that are already in clinical practice and more practical can be used instead of methods that require additional costs and devices.

Use of a DPSS Er:YAG laser for the selective removal of composite from tooth surfaces

New diode-pumped solid state (DPSS) Er:YAG lasers have become available operating at high pulse repetition rates. These lasers are ideally suited for integration with laser scanning systems for the selective removal of dental decay and composite restorative materials from tooth surfaces. The purpose of this study was to determine if a DPSS Er:YAG laser system is suitable for the selective removal of composite from tooth surfaces. Relative ablation rates of composite and enamel were determined and composite was removed from tooth surfaces using a DPSS Er:YAG laser. Composite was removed very rapidly with ablation rates approaching 50-µm per pulse. A fluence of ~50 J/cm² appeared optimal for the removal of composite and damage to the enamel was limited to less than 100-µm after the removal of composite as thick as 700-800-µm; however, dentin is removed at similar rates to composite. The DPSS Er:YAG laser appears to be better suited for the removal of composite than conventional flash-lamp pumped Er:YAG lasers since composite is ablated at higher rates than dental enamel and the high pulse repetition rates enable greater selectivity while maintaining high removal rates.

Comparison of Different Energy Levels of Er:YAG Laser Regarding Intrapulpal Temperature Change During Safe Ceramic Bracket Removal

OBJECTIVE

This study was done to compare the intrapulpal temperature change generated by different energy levels of Er:YAG laser used during debonding of ceramic brackets and find the most suitable level for clinical use.

MATERIAL AND METHODS

Eighty polycrystalline alumina brackets were bonded on bovine incisor teeth, which were randomly divided into 4 groups of 20. One group was assigned as control. In the study groups, after laser exposure with 2, 4, or 6 Watt energy levels, brackets were debonded using an Instron Universal Testing machine. Adhesive remnant index (ARI) scores were recorded to evaluate the site of debonding. To assess intrapulpal thermal increase, 60 human premolar teeth that were prepared in the same way, at the same energy levels, by a thermocouple were used.

RESULTS

When the debonding forces, intrapulpal temperature increases, and ARI of the groups were examined, statistically significant difference was observed between the groups. Mean temperature increases of 0.67°C ± 0.12°C, 1.25°C ± 0.16°C, and 2.36°C ± 0.23°C were recorded for the 2, 4, and 6 Watt laser groups. The mean shear bond strength was 21.35 ± 3.43 megapascals (MPa) for the control group, whereas they were 8.79 ± 2.47, 3.28 ± 0.73, and 2.46 ± 0.54 MPa for the 2, 4, and 6 Watt laser groups, respectively.

CONCLUSIONS

Four watts is the most efficient and safe energy level to be used, utilizing Er:YAG laser with water cooling spray for 6 sec by scanning method during debonding of polycrystalline alumina brackets without any carbonization effects and detrimental temperature changes at debond sites.

Effect of Various Laser Surface Treatments on Repair Shear Bond Strength of Aged Silorane-Based Composite

Introduction: Successful repair of composite restorations depends on a strong bond between the old composite and the repair composite. This study sought to assess the repair shear bond strength of aged silorane-based composite following surface treatment with Nd:YAG, Er,Cr:YSGG and CO2 lasers. Methods: Seventy-six Filtek silorane composite cylinders were fabricated and aged by 2 months of water storage at 37°C. The samples were randomly divided into 4 groups (n=19) of no surface treatment (group 1) and surface treatment with Er,Cr:YSGG (group 2), Nd:YAG (group 3) and CO2 (group 4) lasers. The repair composite was applied and the shear bond strength was measured. The data were analyzed using one-way analysis of variance (ANOVA) and Tukey posthoc test. Prior to the application of the repair composite, 2 samples were randomly selected from each group and topographic changes on their surfaces following laser irradiation were studied using a scanning electron microscope (SEM). Seventeen other samples were also fabricated for assessment of cohesive strength of composite. Results: The highest and the lowest mean bond strength values were 8.99 MPa and 6.69 MPa for Er,Cr:YSGG and control groups, respectively. The difference in the repair bond strength was statistically significant between the Er,Cr:YSGG and other groups. Bond strength of the control, Nd:YAG and CO2 groups was not significantly different. The SEM micrographs revealed variable degrees of ablation and surface roughness in laser-treated groups. Conclusion: Surface treatment with Er,Cr:YSGG laser significantly increase the repair bond strength of aged silorane-based composite resin.

Effect of thermocycling and surface treatment on repair bond strength of composite

Background

Repair of composite restorations is a conservative method that can increase the longevity and durability of restorations while preserving the tooth structure. Achieving a suitable bond between the old and new composite is difficult. To overcome this problem, some methods have been recommended to increase the repair bond strength of composite.This study aimed to assess the effect of aging by thermocycling (5,000 and 10,000 cycles) and mechanical surface treatments (Er,Cr:YSGG laser and bur) on repair shear bond strength of composite resin.

Material and Methods

Totally, 120 composite blocks measuring 6x4x4 mm were fabricated of Filtek Z250 composite and were randomly divided into three groups (n=40) based on initial aging protocol: (a) no aging: storage in distilled water at 37°C for 24 hours, (b) 5,000 thermal cycles, (c) 10,000 thermal cycles. Each group was then randomly divided into two subgroups (n=20) based on mechanical surface treatment (laser and bur). The laser and bur-prepared surfaces were silanized and Adper Single Bond 2 was then applied. The repair composite was bonded to surfaces. Half of the samples in each subgroup (n=10) were subjected to 5,000 thermal cycles to assess durability of bond. The remaining half were stored in distilled water at 37°C for 24 hours and all samples were then subjected to shear bond strength testing in a universal testing machine with a crosshead speed of 1mm/min. Data (in megapascals) were subjected to one-way ANOVA and Tukey’s test (P=0.05). Mode of failure was determined under a stereomicroscope.

Results

Bur preparation significantly improved the bond strength compared to laser (P<0.001). Aging by 10,000 thermal cycles significantly decreased the repair bond strength of composite (P<0.001). No significant difference was noted in this regard between distilled water and 5,000 thermal cycles groups (P=0.699). Primary bond strength and bond strength after 5,000 thermal cycles in the same subgroups were not significantly different either (P=0.342).

Conclusions

Aging by 10,000 thermal cycles significantly decreases the repair bond strength of composite and surface preparation by bur provides a higher bond strength compared to laser.

Key words:Thermocycling, Composite, Repair, Laser.

In vitro evaluation of repair bond strength of composite: Effect of surface treatments with bur and laser and application of universal adhesive

Objectives

This study aimed to assess the effect of surface treatment by bur and laser and application of universal adhesive on repair bond strength of composite resin.

Materials and Methods

A total of 120 composite blocks measuring 6×4×4 mm were fabricated of Filtek Z250 composite. All samples were subjected to 5,000 thermal cycles and divided into two groups for surface preparation by bur and by Er,Cr:YSGG laser (n = 60). The surfaces were then etched with orthophosphoric acid, rinsed with water and divided into three groups (silane, silane plus Single Bond and silane plus Single Bond Universal). Repair composite was then bonded to aged composite. Half of the samples in each group were stored in distilled water at 37°C for 24 hours and the other half underwent 5000 thermal cycles. All samples were then subjected to shear bond strength testing using a universal testing machine at a crosshead speed of 1 mm/minute. The data were analyzed using one-way ANOVA and Tukey's HSD test. Mode of failure was determined using a stereomicroscope.

Results

Bur preparation plus universal adhesive yielded the highest bond strength (30.16 µ 2.26 MPa). Laser plus silane yielded the lowest bond strength (5.63 µ 2.43 MPa). Bur preparation yielded significantly higher bond strength than laser (P < 0.001). Also, application of universal adhesive significantly improved bond strength compared to conventional adhesive and silane (P < 0.001). Bond strength after aging (5000 thermal cycles) had no significant difference with primary bond strength at 24 hours within each group (P = 0.182).

Conclusion

Surface preparation of aged composite by bur and application of universal adhesive can improve the repair bond strength of composite. Application of silane (without adhesive) in the process of repair cannot provide adequately high repair bond strength.

Surface treatment comparison by application of diamond bur and Er,Cr:YSGG at different powers: morphological and mechanical evaluation

Purpose: This study evaluated the micro-tensile bond strength of new and previous composite resin restorations after surface treatment with diamond bur and Er,Cr:YSGG laser at different power settings (2,3 and 4 W). Materials and methods: Micro-hybride composite resin was inserted in metallic mold 5 ×5 ×15 mm and cured for 40 sec according to manufacturer's instruction.12 blocks were made. The bonded surfaces of the 12 blocks so obtained were subsequently ground using Silicon Carbide papers 1200 grit, for 15 seconds under running water. Then the samples randomly were divided into 4 groups: (G1) Bur-treated, (G2) Er,Cr:YSGG laser with power of 2 W and energy of 100 mJ, (G3) Er,Cr:YSGG laser with power of 3 W and energy of 150 mJ, (G4) Er,Cr:YSGG laser with power of 4 W and energy of 200 mJ. One sample of each group was analyzed by SEM while, after cutting the blocks to 1 mm² of area samples, the others samples were mechanically tested by Universal testing machine with the speed of 0.5 mm per minute till fracture point. Data were analysed using One-Way ANOVA and Tukey Test. Results: T-test showed no significantly differences between G2 and G4(P=0.064) while G3 demonstrated significant differences than G2 (P=0.001) and G4(P=0.000) and also between samples treated with bur (G1) and G2 (P=0.242) ,G3 (P=0.000) ,G4 (P=0.829); G1 didn't significantly differ to G2 and G4(P>0.05), while G1 and G3(P<0.05). Conclusion: On surface treatment of repaired composite, samples treated by laser at 3W power showed better condition of micro-tensile bond strength.

Ablative Potential of Er:YAG Laser in Dentin: Quantum Versus Variable Square Pulse

OBJECTIVE

The primary objective of this study was to compare the dentin ablation volume and ablation rate of quantum square pulse (QSP), using two different pulse energy settings plus a new digitally controlled dental laser handpiece (X-Runner), with those of variable square pulse (VSP), using three different pulse durations. The secondary objective was to examine, by scanning electron microscopy (SEM), the surface effects of ablation with the different Er:YAG laser modes on the dentin surfaces.

BACKGROUND DATA

The available literature has limited data on the efficiency of different operating modes, pulse durations, and the new digitally controlled handpiece of the Er:YAG laser on human dentin.

MATERIALS AND METHODS

Freshly extracted human molars (n = 72) were divided into two experimental groups (n = 36 each): (1) QSP group, and (2) VSP group. Each group was randomly divided into three subgroups (n = 12 each). In the QSP group, preparations in dentin were performed using 250 and 500 mJ of pulse energy with the conventional handpiece, and with the X-Runner handpiece set at 250 mJ pulse energy. In the VSP group, cavity preparations were performed using three pulse variables: super short pulse (SSP), micro short pulse (MSP), and short pulse (SP). Cavity preparations were made in dentin at time intervals of 1, 2, and 5 sec. A laser triangulation profilometer was used to determine cavity volumes. Surface analysis of the ablated dentin specimens was performed by SEM.

RESULTS

For time intervals of 1 and 2 sec, ablated volume and ablation rate for QSP-500 mJ were significantly higher than for all other groups (p < 0.0001). For the 5-sec time interval, X-Runner and QSP-500 mJ were the most efficient in dentin ablation (p < 0.0001). Dentin surfaces were free of smear layer in all groups.

CONCLUSIONS

The most efficient modes of dentin ablation in the study were the QSP-500 mJ and X-Runner groups. Dentin surfaces were free of smear layer in all groups.

Evaluation of the bond strength between aged composite cores and luting agent

PURPOSE

The aim of this study was to evaluate effect of different surface treatment methods on the bond strength between aged composite-resin core and luting agent.

MATERIALS AND METHODS

Seventy-five resin composites and also seventy-five zirconia ceramic discs were prepared. 60 composite samples were exposed to thermal aging (10,000 cycles, 5 to 55℃) and different surface treatment. All specimens were separated into 5 groups (n=15): 1) Intact specimens 2) Thermal aging-air polishing 3) Thermal aging- Er:YAG laser irradiation 4) Thermal aging- acid etching 5) Thermal-aging. All specimens were bonded to the zirconia discs with resin cement and fixed to universal testing machine and bond strength testing loaded to failure with a crosshead speed of 0.5 mm/min. The fractured surface was classified as adhesive failure, cohesive failure and adhesive-cohesive failure. The bond strength data was statistically compared by the Kruskal-Wallis method complemented by the Bonferroni correction Mann-Whitney U test. The probability level for statistical significance was set at α=.05.

RESULTS

Thermal aging and different surface treatment methods have significant effect on the bond strength between composite-resin cores and luting-agent (P<.05). The mean baseline bond strength values ranged between 7.07 ± 2.11 and 26.05 ± 6.53 N. The highest bond strength of 26.05 ± 6.53 N was obtained with Group 3. Group 5 showed the lowest value of bond strength.

CONCLUSION

Appropriate surface treatment method should be applied to aged composite resin cores or aged-composites restorations should be replaced for the optimal bond strength and the clinical success.

Effect of Mechanical Surface Treatment on the Repair Bond Strength of the Silorane-based Composite Resin

Background and aims. A proper bond must be created between the existing composite resin and the new one for successful repair. The aim of this study was to compare the effect of three mechanical surface treatments, using diamond bur, air abrasion, and Er,Cr:YSGG laser, on the repair bond strength of the silorane-based composite resin. Materials and methods. Sixty cylindrical composite resin specimens (Filtek Silorane) were fabricated and randomly divided into four groups according to surface treatment: group 1 (control group) without any mechanical surface treatment, groups 24 were treated with air abrasion, Er,Cr:YSGG laser, and diamond bur, respectively. In addition, a positive control group was assigned in order to measure the cohesive strength. Silorane bonding agent was used in groups 14 before adding the new composite resin. Then, the specimens were subjected to a shear bond strength test and data was analyzed using one-way ANOVA and post hoc Tukey tests at a significance level of P &0.05. The topographical effects of surface treatments were characterized under a scanning electron microscope. Results. There were statistically significant differences in the repair bond strength values between groups 1 and 2 and groups 3 and 4 (P &0.001). There were no significant differences between groups 1 and 2 (P = 0.98) and groups 3 and 4 (P= 0.97). Conclusion. Surface treatment using Er,Cr:YSGG laser and diamond bur were effective in silorane-based composite resin repair.

Effect of Surface Treatment with Er;Cr:YSSG, Nd:YAG, and CO2 Lasers on Repair Shear Bond Strength of a Silorane-based Composite Resin

Background and aims. The aim of the present study was to compare the effect ofsurface treatment with Er; Cr:YSSG, Nd:YAG, and CO₂ lasers on repair shear bond strength of a silorane-based composite resin.

Materials and methods. Sixty eight cylindrical samples of a silorane-based composite resin (Filtek Silorane) were pre-pared and randomly divided into 4 groups as follows: group 1: without surface treatment; groups 2, 3 and 4 with surface treatments using Er; Cr:YSSG, Nd:YAG, and CO₂ lasers, respectively. A positive control group (group 5) was assigned in order to measure cohesive strength. Repair shear bond strength values were measured and data was analyzed using one-way ANOVA and a post hoc Tukey test at a significance level of α=0.05.

Results. There were statistically significant differences in repair shear bond strength values between group 2 and other groups (P < 0.05); and between group 1and groups 3and 4 (P < 0.001); however, there were no significant differences be-tween groups 3 and 4 (P = 0.91).

Conclusion. The repair shear bond strength of silorane-based composite resin was acceptable by surface treatment with lasers

Effect of Er,Cr:YSGG Laser, Air Abrasion, and Silane Application on Repaired Shear Bond Strength of Composites

Aged resin composites have a limited number of carbon-carbon double bonds to adhere to a new layer of resin. Study objectives were to 1) evaluate various surface treatments on repaired shear bond strength between aged and new resin composites and 2) to assess the influence of a silane coupling agent after surface treatments.

Methods

Eighty disk-shape resin composite specimens were fabricated and thermocycled 5000 times prior to surface treatment. Specimens were randomly assigned to one of the three surface treatment groups (n=20): 1) air abrasion with 50-μm aluminum oxide, 2) tribochemical silica coating (CoJet), or 3) Er,Cr:YSGG (erbium, chromium: yttrium-scandium-gallium-garnet) laser or to a no-treatment control group (n=20). Specimens were etched with 35% phosphoric acid, rinsed, and dried. Each group was divided into two subgroups (n=10): A) no silanization and B) with silanization. The adhesive agent was applied and new resin composite was bonded to each conditioned surface. Shear bond strength was evaluated and data analyzed using two-way analysis of variance (ANOVA).

Results

Air abrasion with 50-μm aluminum oxide showed significantly higher repair bond strength than the Er,Cr:YSGG laser and control groups. Air abrasion with 50-μm aluminum oxide was not significantly different from tribochemical silica coating. Tribochemical silica coating had significantly higher repair bond strength than Er,Cr:YSGG laser and the control. Er,Cr:YSGG laser and the control did not have significantly different repair bond strengths. Silanization had no influence on repair bond strength for any of the surface treatment methods.

Conclusion

Air abrasion with 50-μm aluminum oxide and tribochemical silica followed by the application of bonding agent provided the highest repair shear bond strength values, suggesting that they might be adequate methods to improve the quality of repairs of resin composites.

Thermal effects and morphological aspects of human dentin surface irradiated with different frequencies of Er:YAG laser

This study reports the effects on micromorphology and temperature rise in human dentin using different frequencies of Er:YAG laser. Sixty human dentin fragments were randomly assigned into two groups (n = 30): carious or sound dentin. Both groups were divided into three subgroups (n = 10), according to the Er:YAG laser frequency used: 4, 6, or 10 Hz (energy: 200 mJ; irradiation distance: 12 mm; and irradiation time: 20 s). A thermocouple adapted to the tooth fragment recorded the initial temperature value (°C); then, the temperature was measured after the end of the irradiation (20 s). Morphological analysis was performed using images obtained with scanning electron microscope. There was no difference between the temperatures obtained with 4 and 6 Hz; the highest temperatures were achieved with 10 Hz. No difference was observed between carious and sound dentin. Morphological analyses revealed that all frequencies promoted irregular surface in sound dentin, being observed more selectively ablation especially in intertubular dentin with tubule protrusion. The caries dentin presented flat surface for all frequencies used. Both substrates revealed absence of any signs of thermal damage. It may be concluded that the parameters used in this study are capable to remove caries lesion, having acceptable limits of temperature rise and no significant morphological alterations on dentin surface.

Ablative potential of four different pulses of Er:YAG lasers and low-speed hand piece

OBJECTIVE

The aim of the study was to evaluate the ablation rate of caries in dentin with fluorescence-feedback controlled Er:YAG, Variable Square Pulse technology (VSPt) based Er:YAG working in different pulse durations, and steel bur.

MATERIALS AND METHODS

Sixty human molar teeth with caries in dentin, extracted for periodontal reasons, were selected for this study. All selected teeth were randomly divided into five groups, each containing twelve specimens: (1) group FFC, fluorescence feedback-controlled Er:YAG laser; (2) group SSP (super short pulse: 50 μs); (3) group MSP (medium short pulse; 100 μs); (4) group SP (short pulse; 300 μs); and (5) group SB, steel bur in a slow-speed hand piece. A profilometer was used to determine the volume of the ablated caries in dentin. The clinical and real ablation rates of caries in dentin were calculated. Two specimens from each experimental group were selected randomly and subjected to SEM examination.

RESULTS

The volumes of the ablated caries in dentin in the SSP and SB groups were statistically significantly different in comparison with other experimental groups (p<0.05). The clinical and real ablation rate of caries in dentin was the highest for the SSP group (0.15±0.05 and 0.17±0.05 mm(3)/sec, respectively) and statistically significantly different in comparison with the MSP and SB groups (p<0.05). The SB and FFC groups revealed a dentin surface with a smear layer and closed dentinal tubules on SEM micrographs. In the SSP, MSP, and SP groups, an irregular surface without a smear layer was found.

CONCLUSIONS

Taking into consideration the experimental conditions of the present study, SSP was the most efficient in ablation of caries in dentin, providing a smear layer-free surface with open dentinal tubules.

Rapid and selective removal of composite from tooth surfaces with a 9.3 µm CO2 laser using spectral feedback

OBJECTIVE

Dental composite restorative materials are color matched to the tooth and are difficult to remove by mechanical means without excessive removal or damage to peripheral enamel and dentin. Lasers are ideally suited for selective ablation to minimize healthy tissue loss when replacing existing restorations, sealants, or removing composite adhesives such as residual composite left after debonding orthodontic brackets.

METHODS

In this study, a carbon dioxide laser operating at 9.3-µm with a pulse duration of 10-20-microsecond and a pulse repetition rate of ∼200 Hz was integrated with a galvanometer based scanner and used to selectively remove composite from tooth surfaces. Spectra of the plume emission were acquired after each laser pulse and used to differentiate between the ablation of dental enamel or composite. Microthermocouples were used to monitor the temperature rise in the pulp chamber during composite removal. The composite was placed on tooth buccal and occlusal surfaces and the carbon dioxide laser beam was scanned across the surface to selectively remove the composite without excessive damage to the underlying sound enamel. The residual composite and the damage to the underlying enamel was evaluated using optical microscopy.

RESULTS

The laser was able to rapidly remove composite from tooth buccal and occlusal surfaces with minimal damage to the underlying sound enamel and without excessive heat accumulation in the tooth.

CONCLUSION

This study demonstrated that composite can be selectively removed from tooth surfaces at clinically relevant rates using a CO(2) laser operating at 9.3-µm with high pulse repetition rates with minimal heat deposition and damage to the underlying enamel.

Effect of thermocycling on the bond strength of composite resin to bur and laser treated composite resin

The objective of this study was to investigate the effect of two different surface treatments (Er:YAG laser and bur) and three different numbers of thermal cycling (no aging, 1,000, 5,000, and 10,000 cycles) on the micro-shear bond strength of repaired composite resin. Ninety-six composite blocks (4 mm × 4 mm × 1 mm) obtained with a micromatrix hybrid composite were prepared. The composite blocks were then randomly divided into four groups (n = 24), according to the thermal cycling procedure: (1) stored in distilled water at 37°C for 24 h (control group), (2) 1,000 cycles, (3) 5,000 cycles, and (4) 10,000 cycles. After aging, the blocks were further subdivided into two subgroups (n = 12), according to surface treatment. Bur and laser-treated composite surfaces were treated with an etch&rinse adhesive system. In addition, a microhybrid composite resin was bonded to the surfaces via polyethylene tubing. Specimens were subjected to micro-shear bond strength test by a universal testing machine with a crosshead speed of 0 and 5 mm/min. The data were analyzed using one-way analysis of variance and Tukey tests (α = 0.05) for micro-shear bond strengths. After conducting a bond strength test, it was found that the laser and bur-treated specimens had similar results. Aging with 10,000 thermocycles significantly affected the repair bond strength of composite resins.

Shear strength of the bond to primary dentin: influence of Er:YAG laser irradiation distance

The aim of this study was to assess in vitro the influence of Er:YAG laser irradiation distance on the shear strength of the bond between an adhesive restorative system and primary dentin. A total of 60 crowns of primary molars were embedded in acrylic resin and mechanically ground to expose a flat dentin surface and were randomly assigned to six groups (n = 10). The control group was etched with 37% phosphoric acid. The remaining five groups were irradiated (80 mJ, 2 Hz) at different irradiation distances (11, 12, 16, 17 and 20 mm), followed by acid etching. An adhesive agent (Single Bond) was applied to the bonding sites, and resin cylinders (Filtek Z250) were prepared. The shear bond strength tests were performed in a universal testing machine (0.5 mm/min). Data were submitted to statistical analysis using one-way ANOVA and the Kruskal-Wallis test (p<0.05). The mean shear bond strengths were: 7.32 ± 3.83, 5.07 ± 2.62, 6.49 ± 1.64, 7.71 ± 0.66, 7.33 ± 0.02, and 9.65 ± 2.41 MPa in the control group and the groups irradiated at 11, 12, 16, 17, and 20 mm, respectively. The differences between the bond strengths in groups II and IV and between the bond strengths in groups II and VI were statistically significant (p<0.05). Increasing the laser irradiation distance resulted in increasing shear strength of the bond to primary dentin.

Ablative potential of the erbium-doped yttrium aluminium garnet laser and conventional handpieces: a comparative study

OBJECTIVES

To compare the ability of the Variable Square Pulse technology (VSP-technology)-based erbium-doped yttrium aluminium garnet (Er:YAG) laser working in maximum speed (MAX) mode (1000 mJ, 300 micros, 20 Hz) and the high-speed handpiece to ablate enamel, to compare the ability of for the VSP-technology-based Er:YAG laser working in MAX mode and the low-speed handpiece to ablate dentin, and to analyze in vitro effects of Er:YAG ablation of enamel and dentine surfaces using scanning electron microscopy (SEM).

BACKGROUND DATA

A VSP-technology-based Er:YAG laser operating in MAX mode should be appropriate for achieving the maximum ablating speed in hard dental tissues.

MATERIALS AND METHODS

The experiment was conducted on extracted, cleaned, sterilized human molar teeth. Cavity preparations were made in hard dental tissues using the VSP-technology Er:YAG laser in MAX mode, in enamel using the high-speed handpiece, and in dentin using the low-speed handpiece at different time intervals. A laser triangulation profilometer was used to determine cavity volumes. The cavity surfaces of five specimens were examined using SEM.

RESULTS

The Er:YAG laser removed a volume of enamel that was 3.3 times as large as that removed by the high-speed handpiece in the same period of time. In dentin, the Er:YAG laser removed 8 to 18 times as much volume as the steel bur in the same period of time. The Er:YAG ablation rate in dentin was faster than in enamel. SEM of laser prepared cavities showed a well-defined surface, free of the smear layer.

CONCLUSIONS

The VSP-technology-based Er:YAG laser, working in MAX mode, is more efficient than mechanical drills for enamel and dentin ablation.

Effect of erbium-doped yttrium aluminium garnet laser parameters on ablation capacity and morphology of primary dentin

OBJECTIVE

To evaluate the ablation capacity of different energies and pulse repetition rates of an erbium-doped yttrium aluminium garnet (Er:YAG) laser on primary dentin by assessing mass loss and to analyze the surface morphology using scanning electron microscopy (SEM).

BACKGROUND DATA

Previous studies have demonstrated the ability of the Er:YAG laser to ablate dentin substrate.

METHODS

Forty-eight sound primary molars were bisected in the mesiodistal direction. The dentin surfaces were flattened, and initial mass (mg) was obtained. A 4-mm2 area was delimited. Specimens were randomly assigned to 12 groups according to the combination of energy (160, 200, 250, and 300 mJ) and pulse repetition rate (2, 3, and 4 Hz). Er:YAG laser irradiation was performed for 20 s. After irradiation, the final mass was obtained, and specimens were prepared for SEM. The data obtained by subtracting the final mass from the initial mass were statistically analyzed using analysis of variance and Tukey test (alpha=0.05).

RESULTS

The pulse repetition rate of 4 Hz provided greater mass loss, and it was different from 2 Hz and 3 HZ. The energy of 300 mJ resulted in greater mass loss, similar to 200 and 160 mJ. SEM micrographs showed dentinal tubule obliteration, structural alterations, and the presence of cracked areas in all specimens.

CONCLUSION

The settings of 160, 200, and 250 mJ at 2 and 3 Hz promoted a good ablation rate with fewer surface alterations in primary dentin.

Vibrations produced during erbium:yttrium-aluminum-garnet laser irradiation

The purpose of this study was to evaluate vibrations induced by an erbium:yttrium-aluminum-garnet (Er:YAG) laser in the non-contact mode and compare the vibrations with different pulse durations and energy parameters. The experiment was conducted on an extracted tooth built up in silicone impression material. The vibrations were measured by piezoelectric accelerometer for a super-short pulse (SSP), a very short pulse (VSP), and a short pulse (SP) at a frequency of 5 Hz for 1 s. For VSP and SP, the energy parameters tested were 200 mJ, 300 mJ, and 400 mJ. Measurements were performed 15 times for each individual irradiation energy level. The highest values of vibrations were measured for SP (0.160 +/- 0.04 m/s(2)), and the lowest were measured for VSP mode at the energy parameter 200 mJ (0.05 +/- 0.02 m/s(2)). There was a statistically significant (P < 0.01) difference between the various laser pulse modes (SSP, VSP, SP) at different energy parameters. At energy levels of 300 mJ and 400 mJ, the least amount of vibration during cavity preparations with the non-contact Er:YAG laser was produced by SSP mode.

Bond strength of self-etching primer to bur cut, Er,Cr:YSGG, and Er:YAG lased dental surfaces

OBJECTIVE

The purpose of this study was to evaluate the tensile bond strength of a self-etching primer system to enamel and dentin surfaces treated with Er:YAG and Er,Cr:YSGG lasers.

BACKGROUND DATA

The recently introduced self-etching primer systems have been shown to adhere better to dental surfaces with thin or no smear layers. Moreover, there have been no previous reports on the bond strength of these adhesives to Er,Cr:YSGG laser-irradiated enamel and dentin, which have been shown to be free of a smear layer.

METHODS

Thirty samples of enamel and thirty of dentin were divided into three groups. The first group of each substrate served as a control with a standardized bur cut, and the other two groups were conditioned with Er:YAG (350 mJ, 10 Hz, 20 J/cm(2) for enamel; 300 mJ, 6 Hz, 17 J/cm(2) for dentin) and Er,Cr:YSGG laser (125 mJ, 20 Hz, 16 J/cm(2) for both substrates). After the bonding procedure, samples were restored with composite resin, and the tensile bond strength test was performed.

RESULTS

The ANOVA two-way analysis and the Tukey test at 5% significance level showed that for enamel and dentin, the bond strength values were statistically higher in Er:YAG-laser treated than in Er,Cr:YSGG-laser treated surfaces (p = 0.0001). However, bond strength means for both laser-irradiated groups were statistically lower than for the bur cut group (Er:YAG: p = 0.0281 and Er,Cr:YSGG: p < 0.0001). SEM observation of laser-irradiated surfaces revealed a roughened aspect and absence of smear layer.

CONCLUSIONS

The self-etching system adhesion was influenced by the type of erbium laser used, and the bond strength was higher in the Er:YAG-laser irradiated than in the Er,Cr:YSGG-laser irradiated surfaces.

Influence of energy and pulse repetition rate of Er:YAG laser on enamel ablation ability and morphological analysis of the laser-irradiated surface

OBJECTIVE

To assess the influence of energy and pulse repetition rate of Er:YAG laser on the enamel ablation ability and substrate morphology.

METHODS

Fifteen crowns of molars were sectioned in four fragments, providing 60 samples, which were ground to flatten the enamel surface. The initial mass was obtained by weighing the fragments. The specimens were hydrated for 1 h, fixed, and a 3-mm-diameter area was delimited. Twelve groups were randomly formed according to the combination of laser energies (200, 250, 300, or 350 mJ) and pulse repetition rates (2, 3, or 4 Hz). The final mass was obtained and mass loss was calculated by the difference between the initial and final mass. The specimens were prepared for SEM. Data were submitted to ANOVA and Scheffé test.

RESULTS

The 4 Hz frequency resulted in higher mass loss and was statistically different from 2 and 3 Hz (p < 0.05). The increase of frequency produced more melted areas, cracks, and unselective and deeper ablation. The 350 mJ energy promoted greater mass loss, similar to 300 mJ.

CONCLUSIONS

The pulse repetition rate influenced more intensively the mass loss and morphological alteration. Among the tested parameters, 350 mJ/3 Hz improved the ability of enamel ablation with less surface morphological alterations.

Assessment of Thermal Alteration during Class V Cavity Preparation Using the Er:YAG Laser

OBJECTIVE

The aim of this study was to evaluate in vitro the pulp thermal alterations during class V cavity preparations using the Er:YAG laser and high-speed water flow.

MATERIALS AND METHODS

Forty human teeth were selected and prepared for the thermocouple adaptation in the pulp chamber. The specimens were assigned to four groups: (1) laser 300 mJ/3 Hz, (2) laser 300 mJ/4 Hz, (3) high-speed 9 mL/min water flow, and (4) high-speed 100 mL/min water flow. The temperature was measured before the beginning and at the end of the preparation, as well as during the procedures. The groups were analyzed by scanning electron microscopy.

RESULT

Data analysis disclosed temperature reduction at high-speed drilling with the high-speed total water flow group, and these values were statistically different from the other groups. The results of the 9-mL/min water flow group were similar to those of the 300-mJ/3-Hz group and different from the 300-mJ/4-Hz laser group.

CONCLUSION

The laser promoted a greater increase in temperature only when compared with high-speed handpiece and water flow rate of 100 mL/min.