Influence of etching with erbium, chromium:yttrium–scandium–gallium–garnet laser on microleakage of class V restoration

An in vitro assessment of the residual dentin after using three minimally invasive caries removal techniques

To evaluate the efficiency and effectiveness of three minimally invasive (MI) techniques in removing deep dentin carious lesions. Forty extracted carious molars were treated by conventional rotary excavation (control), chemomechanical caries removal agent (Brix 3000), ultrasonic abrasion (WOODPECKER, GUILIN, China); and Er, Cr: YSGG laser ablation (BIOLASE San Clemente, CA, USA). The assessments include; the excavation time, DIAGNOdent pen, Raman spectroscopy, Vickers microhardness, and scanning electron microscope combined with energy dispersive X-ray spectroscopy (SEM-EDX). The rotary method recorded the shortest excavation time (p < 0.001), Brix 3000 gel was the slowest. DIAGNOdent pen values ranged between 14 and 18 in the remaining dentin and laser-ablated surfaces recorded the lowest reading (p < 0.001). The Ca:P ratios of the remaining dentin were close to sound dentin after all excavation methods; however, it was higher in the ultrasonic technique (p < 0.05). The bur-excavated dentin showed higher phosphate and lower matrix contents with higher tissue hardness that was comparable to sound dentin indicating the non-selectiveness of this technique in removing the potentially repairable dentin tissue. In contrast, the MI techniques exhibited lower phosphate and higher organic contents associated with lower microhardness in the deeper dentin layers. This was associated with smooth residual dentin without smearing and patent dentinal tubules. This study supports the efficiency of using MI methods in caries removal as conservative alternatives to rotary excavation, providing a promising strategy for the clinical dental practice.

Evaluation of the microleakage of class V composite restoration after cavity treatment with Erbium, CO2 lasers, Papain, and Bromelain enzymes

OBJECTVES

Different surface preparation and treatment methods may have dissimilar effects on the microleakage of composite resin. This study was conducted to determine the deproteinizing effect of 10% bromelain enzyme, 10% papain enzyme, CO2 , and erbium-YAG laser in regard to decrease in the microleakage of composite restorations.

MATERIALS AND METHODS

Thirty teeth were selected and 60 class V cavities were prepared on the lingual and buccal sides. They were divided into six groups (n = 10): Group 1, phosphoric acid gel; Group 2, bromelain enzyme 10%; Group 3, papain enzyme 10%; Group 4, mixed papain and bromelain enzymes 10%; Group 5, CO2 laser; and Group 6, erbium-YAG laser. They were stored in basic fuchsine and dye penetration was evaluated. Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis, p < 0.05 RESULTS: In both occlusal and gingival margins, comparison of microleakage between groups 1, 2, 3, 4, and 5 showed no significant differences (p = 1) and group 6 had a significant difference with other groups (p ˂ 0.001).

CONCLUSIONS

Microleakage of composite resin in the dentin surface was not affected significantly using either bromelain or papain 10% enzymes or erbium laser. However, CO2 laser had a negative effect on the enamel and dentin margins and increased the microleakage. Erbium laser showed a better effect than enzymes on microleakage.

Effects of Er:YAG and Er,Cr:YSGG laser irradiation and adhesive systems on microtensile bond strength of a self-adhering composite

This study was aimed to evaluate the effects of Er:YAG and Er,Cr:YSGG laser irradiation and adhesive systems on the microtensile bond strength of Fusio Liquid Dentin (FLD) which is a self-adhering composite (SAC). Twenty-four freshly extracted human molar teeth were collected, and the enamel was removed from the occlusal surface to obtain a flat dentin surface. Twenty-four teeth were randomly divided into eight groups: Group 1: only Fusio Liquid Dentin (FLD) (Petron Clinical, Orange, California, USA) was applied to the dentin surface; Group 2: 37% Phosphoricacid (i-GEL, Medicinos Linija UAB, Lithuania) + FLD; Group 3: Single Bond Universal (SBU) (3 M ESPE, Germany) + FLD; Group 4: Adper Easy One (AEO) (3 M ESPE, Germany) + FLD; Group 5: Er:YAG laser + AEO + FLD; Group 6: Er:YAG laser + SBU + FLD; Group 7: Er,Cr:YSGG laser + AEO + FLD; and Group 8: Er,Cr:YSGG laser + SBU + FLD. After thermocycling, 1 × 1 mm2 sticks were used for the µTBS test (n = 10). Two sticks per group were used for SEM analysis. Fractured sample surfaces were evaluated using a stereomicroscope. Group 8 showed the highest µTBS value (13.70 MPa), whereas Group 1 showed the lowest μTBS value (5.60 MPa). There were no significant differences between Groups 2, 3, and 4 (P = 0.324), but Groups 5-8 showed statistically significant results that were higher than Groups 1-4 (P = 0.012). Adhesive failure mode was predominant followed by mixed failure. The evaluation of bonding of the FLD to dentin showed that the combined use of Er:YAG and Er,Cr:YSGG lasers with SBU and AEO on dentin surfaces improved the dentinal bond strength of the FLD.

Mechanical and antibacterial efficacy of photo-sonodynamic therapy via methylene blue-loaded nanoparticles over dental implants for treating peri-implantitis

AIM

This study aimed to evaluate the mechanical (i.e., flexural modulus [FM], flexural strength [FS], and surface roughness [R_a]) and antibacterial efficacy of photo-sonodynamic therapy via methylene blue-loaded poly(D,L-lactide-co-glycolide) nanoparticles (MB-loaded PLGA NPs) over dental implants for potential treatment of peri-implantitis.

METHODS

PLGA NPs were synthesized via a solvent displacement method. After the synthesis and confirmation of MB-loaded PLGA NPs via physical (Scanning Electron Microscope [SEM]) and chemical characterization (Fourier transform infrared spectroscopy [FTIR]), the mature dental biofilm of Porphyromonas gingivalis was produced over the surfaces of dental implants. Then, the bacterial viability assessment of the following five study groups was performed: group-I (diode laser treatment); group-II (PDT/MB-loaded PLGA NPs treatment; group-III (ultrasound treatment); group-IV (ultrasound/PLGA NPs-MB treatment); and group-V: control group included the samples without any treatment. Finally, the FS, FM, and R_a of the samples was assessed.

RESULTS

Under the SEM, the NPs were spherical homogeneous particles having round morphology ranging approximately 100 nm in size without aggregation. The FTIR spectra of PLGA NPs and MB-loaded PLGA NPs demonstrated absorption peaks at approximately 1000 cm^-1 to 1200 cm^-1 and around 1500 cm^-1 to 1750 cm^-1. The greatest level of P. gingivalis killing was exhibited by ultrasound/MB-loaded PLGA-NPs-treated samples. The FS was statistically significantly greater for control group samples than any other group (i.e., 100.28 MPa; p<0.05). The FM and R_a ranged between 3.31 and 3.58 GPa and between 0.18 and 0.20 µm without any statistically significant difference between the control and experimental groups (p>0.05), respectively.

CONCLUSION

Within the limitations of this study, the application of photo-sonodynamic therapy via MB-loaded PLGA NPs demonstrated the greatest antibacterial activity against P. gingivalis without deteriorating the surfaces and compromising the mechanical properties of dental implants.

Clinical effects of laser-based cavity preparation on class V resin-composite fillings

The aim of the present clinically controlled two-year study was to investigate the influence of laser-based cavity preparation on the long-term performance of Class V resin-composite fillings. Class V non-carious lesions (n = 75) were randomly assigned to two test and one control group. Cavities in both test groups were prepared using an Er,Cr:YSGG laser (Waterlase MD, Biolase, Irvine, California, USA). The device was operated at 3 W (150 mJ, 30 J/cm²), 50% water, 60% air, 30 Hz in H mode. Subsequently, laser-prepared tooth surfaces in test group I (n = 21) were additionally conditioned by acid etching (etch-and-rinse). Laser-prepared cavities of test group II (n = 21) received no additional acid conditioning. After application of an adhesive, all cavities were restored using the resin-composite Venus®. For cavities in the control group (n = 33) conventional diamond burs were used for preparation which was followed by an etch-and-rinse step, too. The fillings were evaluated immediately (baseline) and after 6, 12 and 24 months of wear according to the C-criteria of the USPHS-compatible CPM-index. The results showed that after 24 month of wear, laser-preparation was associated with fillings of high clinical acceptability. Compared to conventional bur-based treatment, laser-based cavity preparation resulted in fillings with high marginal integrity and superior marginal ledge configurations (p = 0.003). Furthermore, laser-preparation combined with additional acid-conditioning (test group I) resulted in fillings with the best marginal integrity and the lowest number in marginal discoloration, especially at the enamel-composite margins (p = 0.044). In addition, total loss of fillings was also less frequently observed in both laser groups as compared to the control. The results clearly demonstrate that laser-based cavity preparation will benefit the clinical long-time performance of Class V resin-composite fillings. Furthermore, additional acid-conditioning after laser preparation is of advantage.

Effect of different types of adhesive systems on the bond strength and marginal integrity of composite restorations in cavities prepared with the erbium laser-a systematic review

There are inconclusive results regarding etching and bonding protocol to achieve optimal bond strength and marginal integrity of adhesive composite resin restorations in erbium laser prepared cavities. This systematic review aimed to consider which adhesive system protocol may be optimal in achieving the bond strength and marginal integrity in erbium laser-prepared cavities, comparable to that obtained with conventional method of cavity preparation. This review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement with literature search based on all publications during the period January1, 2000-October 10, 2020, in three databases: MEDLINE, Google Scholar and ScienceDirect. The necessary information was extracted by two independent authors. The search resulted in 139 articles from all databases, and a total of thirty-one articles met the inclusion criteria. The results indicated that the selection of adhesives depending on their pH and composition and the laser pulse duration and pulse energy used plays an important role in predicting the adhesion and marginal integrity. The 10-MDP containing moderate self-etch adhesives has demonstrated predictable outcomes. Longer pulse durations used for cavity preparations may indicate the use of etch-and-rinse (EnR) or moderate self-etch adhesives (SEA) to allow better resin infiltration in deep craters formed due to laser irradiation. However, further studies with more standardizations in relation to adhesives and laser parameters are needed.

Does Er,Cr:YSGG reduce the microleakage of restorations when used for cavity preparation? A systematic review and meta-analysis

Background

As the member of erbium laser family, Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) has obtained the approval for caries removal and cavity preparation by Food and Drug Administration (FDA). However, there is still controversy over the beneficial effects of Er,Cr:YSGG preparations on microleakage. The present study is the first systematic review and meta-analysis to compare the microleakage of cavities prepared by Er,Cr:YSGG lasers with that by traditional burs. In addition, the effect of acid etching on the adhesive potential of self-etch and etch-and-rinse adhesives was assessed after laser preparation.

Methods

An electronic search was performed in Pubmed, EBSCO, Embase, and the Cochrane Controlled Register of Trials (CENTRAL).

Results

Totally, 357 articles were identified. Finally, 13 met the inclusion criteria, of which 11 were selected for meta-analysis. All the included studies exhibited a moderate risk of bias. Based on the meta-analysis, no significant difference was observed between the Er,Cr:YSGG and traditional bur groups in terms of the incidence of microleakage. Self-etch adhesives, in combination with prior acid etching, showed less microleakage than those without acid etching in the laser-prepared cavities.

Conclusions

Current studies do not support the beneficial effects of Er,Cr:YSGG preparations on microleakage. Additional acid etching with self-etching adhesives is recommended after Er,Cr:YSGG preparations. Further high-quality studies are needed to draw a convincing conclusion in the future.

Efficacy of antimicrobial photodynamic therapy for elimination of Aggregatibacter actinomycetemcomitans biofilm on Laser-Lok titanium discs

BACKGROUND

Antimicrobial Photodynamic therapy (aPDT) is a novel modality suggested for treatment of peri-implantitis. This study aimed to assess the effect of aPDT with toluidine blue (TBO) and indocyanine green (ICG) and 635 nm and 808 nm diode laser on Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) biofilm formed on Laser-Lok titanium discs.

MATERIALS AND METHODS

Eighty sterile Laser-Lok titanium discs were inoculated with A. actinomycetemcomitans to form biofilm and were randomly divided into 8 groups (n = 10) of control, chlorhexidine (CHX), TBO, ICG, 635 nm diode laser with 220 mW power, 808 nm diode laser with 250 mW power, 100 μg/mL TBO+635 nm diode laser and ICG+808 nm diode laser. Number of colony forming units (CFUs) on the surface of each disc was counted after the intervention. Data were analyzed using the Kruskal-Wallis test.

RESULTS

Significant differences were noted in colony count among the eight groups after the intervention (P = 0.001). Pairwise comparisons with adjusted P value test showed that aPDT with TBO+635 nm laser and ICG+808 nm laser caused significant reduction of bacterial biofilm compared to the control group (P = 0.0001). TBO alone caused significant reduction of biofilm compared to the control group (P = 0.004). No other significant differences were noted (P > 0.05).

CONCLUSION

Within the limitations of this study, the results showed that aPDT is a potential modality for decontamination of implant surface and reduction of A. actinomycetemcomitans biofilm in vitro. In this study, aPDT with TBO+635 nm diode laser and ICG+808 nm diode laser decreased the bacterial load on titanium discs.

The Effect of Er,Cr:YSGG and Diode Laser Applications on Dental Implant Surfaces Contaminated with Acinetobacter Baumannii and Pseudomonas Aeruginosa

Treatment of peri-implantitis through several implant surface decontamination techniques have been reported, however, some of them can negatively alter the implant surface or enhance more bacterial resistance. The aim of this in vitro study was to evaluate implant surface decontamination by means of Er,Cr:YSGG and diode lasers. Fifty micro-textured (MTX) dental implants were contaminated with Acinetobacter baumannii (n = 25) and with Pseudomonas aeruginosa (n = 25). All implants were then divided into five groups for the decontamination procedure. In group I (GI), decontamination was done with an Er,Cr:YSGG laser (2780 nm), while in group II (GII) decontamination was performed using photodynamic therapy (a 650 nm diode laser). In Group III (GIII) decontamination was performed with photodynamic therapy (an 808 nm diode laser), and in group IV (GIV) decontamination was performed with 0.12% chlorhexidine. Group V (GV) was the control group with no decontamination. After decontamination, colony forming units (CFU) were counted and implants were prepared for SEM analysis. A significant difference (p < 0.001) was observed for GI compared to the other groups, and also for GIV compared to both GII and GIII. The Er,Cr:YSGG laser (GI) showed the best results in decontaminating the implant surface. Chlorhexidine (GIV), proved to be better in decontaminating the implant surface than photodynamic therapy GII and diode laser GIII. No significant difference was found between group GII and GIII. The SEM analysis showed no significant change in the implant surface topography. The results of this study suggest that the Er,Cr:YSGG laser can be considered as an effective technique for reducing bacteria contamination on implant surfaces.

Efficacy of Caries Removal by Carie-Care and Erbium-doped Yttrium Aluminum Garnet Laser in Primary Molars: A Scanning Electron Microscope Study

Aim

To compare and evaluate morphological changes and bacterial deposits in primary carious molars after caries excavation with Carie-Care, erbium-doped yttrium aluminum garnet (Er:YAG) laser, and round tungsten carbide bur.

Materials and methods

Thirty human carious primary molars extracted for therapeutic reasons were sectioned mesiodistally. These sectioned samples were allocated into three groups (20 samples each): group I: Carie Care, group II: Er:YAG laser, and group III: round tungsten carbide bur. After caries excavation, all samples were processed and examined under conventional light microscope to examine for bacterial deposits. Representative samples from each group were processed and analyzed to examine the morphology of caries-excavated tissue by scanning electron microscope (SEM). Statistical analysis was done using Fisher’s exact test, Kruskal–Wallis test, and Mann-Whitney U test.

Results

The Er:YAG laser showed best results with no smear layer followed by chemomechanically excavated surfaces with Carie-Care. Amount of bacterial deposits was observed to be more in group I while least in group II (p-value < 0.001). Mann-Whitney U test and Fisher’s exact test revealed that there was statistically significant difference among all the three groups.

Conclusion

Among the three different methods of caries excavation, Er:YAG laser was found to be more effective compared with Carie-Care and round tungsten carbide bur.

Clinical significance

Laser-induced caries excavation by Er:YAG laser and chemomechanical method of caries removal by Carie-Care can be considered as future of noninvasive pediatric and preventive dentistry.

How to cite this article: Prabhakar A, Lokeshwari M, Naik SV, Yavagal C. Efficacy of Caries Removal by Carie-Care and Erbium-doped Yttrium Aluminum Garnet Laser in Primary Molars: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2018;11(4):323-329.

Comparison of Er,Cr:YSGG Laser Handpieces for Class II Preparation and Microleakage of Silorane- or Methacrylate-Based Composite Restorations

OBJECTIVE

The aim of this study was to evaluate the influence of cavity preparation with different Er,Cr:YSGG laser handpieces on microleakage of different posterior composite restorations.

METHODS

Fifty-four extracted intact human premolars were randomly assigned to three groups according to cavity preparation method: Bur Group: high-speed diamond bur (Diatech), MD Group: Er,Cr:YSGG laser Waterlase MD handpiece (Biolase Millennium II), and Turbo Group: Er,Cr:YSGG laser Waterlase MD TURBO handpiece (Biolase Millennium II). One hundred eight Class II slot cavities were prepared on the mesial and distal proximal surfaces of each tooth, and the cavity preparation times required were determined. The groups were then subdivided according to the restorative systems used (n = 12): a conventional methacrylate-based microhybrid composite (Filtek P60+Adper Single Bond 2/3M); a silorane-based resin composite (Filtek Silorane+Silorane System Adhesive/3M); and a nanohybrid methacrylate-based composite (Kalore+G-Bond/GC). The restorative systems were applied according to the manufacturers' recommendations. Following thermocycling (X5000; 5°C-55°C), the teeth were coated with nail varnish except the restoration margins, immersed in 0.5% basic fuchsin dye solution, and sectioned in a mesiodistal direction. Dye penetration was evaluated under a light microscope for occlusal and cervical margins. Data were analyzed with one-way ANOVA and chi-square tests (p < 0.05).

RESULTS

The cavity preparation time (mean ± SD) required for Bur, MD, and Turbo group was 31.25 ± 3.82, 222.94 ± 15.85, and 92.5 ± 7.42 sec, respectively, and the differences among the groups were statistically significant (p < 0.05). Comparing the occlusal and cervical microleakage scores, no statistically significant differences were found among the groups and subgroups (p > 0.05).

CONCLUSIONS

Er;Cr:YSGG laser cavity preparation with the Turbo handpiece needed shorter time than the MD handpiece, although it needed longer time than the conventional diamond bur. The use of different handpieces of Er,Cr:YSGG laser did not differ from conventional preparation with diamond bur in terms of microleakage with the tested methacrylate- and silorane-based posterior composite restorative systems.

Influence of gamma radiation on microshear bond strength and nanoleakage of nanofilled restoratives in Er, Cr:YSGG laser-prepared cavities

Objective:

To evaluate the effect of gamma radiation on microshear bond strength and nanoleakage of nanofilled restoratives in laser-prepared cavities.

Materials and Methods:

Twenty-eight flat buccal dentin surfaces were prepared for microshear bond strength test. Er, Cr:YSGG laser was used to prepare another 28 Class V cavities on the buccal surfaces of the molars. All teeth were divided into four groups; 1^st group: Application of Filtek Z350 nanocomposite material, 2^nd group: As the 1^st group and then exposure to gamma radiation, 3^rd group: Application of Ketac N100 nanoglass ionomer, and the 4^th group: As the 3^rd group and then gamma irradiated. The bond strength test was performed after storage in artificial saliva for 24 h. For the nanoleakage test, teeth were submerged in a solution of ammoniacal silver nitrate, sectioned, and then examined under a scanning electron microscope. The collected data were statistically analyzed.

Results:

Nanocomposite showed higher bond strength values than nanoglass ionomer. Despite the fact that gamma radiation did not decrease nanocomposite bond strength, it decreased nanoglass ionomer bond strength. Nanoglass ionomer-restored cavities showed higher silver ion penetration than nanocomposite in both control and gamma-irradiated groups.

Conclusion:

Gamma radiation has no effect on bond strength and nanoleakage of nanocomposite so that it can be placed before radiotherapy. On the other hand, the bond strength of nanoglass ionomer was adversely affected by gamma radiation.

Assessment of microleakage of class V restored by resin composite and resin-modified glass ionomer and pit and fissure resin-based sealants following Er:YAG laser conditioning and acid etching: in vitro study

Aim

The aim of this study was to make a comparison between microleakage of conventionally restored class V cavities using acid etchant and the ones conditioned by erbium-doped yttrium aluminum garnet (Er:YAG) laser, and also to assess and compare the effectiveness of enamel surface treatments of occlusal pits and fissures by acid etching and conditioned by Er:YAG laser-etch.

Materials and methods

Seventy-two extracted third molars were used in this study. The samples were divided into two major groups: class V cavities and pit and fissure sealants. Each subgroup was divided into conventional acid etching, Er:YAG laser conditioning and conventional acid etching, and combination with Er:YAG laser conditioning (n=12). The teeth were placed in 2% methylene blue dye solution, were sectioned, and were evaluated according to the dye penetration criteria. Two samples per subgroup were chosen for scanning electron microscopic (SEM) analysis.

Results

There was a significant difference between occlusal and cervical margin groups. Laser conventional composite cementum group showed more microleakage values compared to other groups. There was no significant difference between occlusal margin groups. However, there was a significant difference between cervical margin groups in terms of microleakage. In sealant groups, there was a significant difference between laser and conventional with/without laser treatment groups in terms of microleakage.

Conclusion

Based on the results reported in this study, it can be concluded that the application of the Er:YAG laser beneath the resin composite, the resin-modified glass ionomers (GIs), and the fissure sealant placement may be an alternative enamel and dentin etching method to acid etching.

In vitro microleakage of class v composite restorations prepared by Er,Cr:YSGG laser and carbide bur

Background: The aim of this in vitro study was to compare the degree of microleakage on enamel and dentin margins of class V cavities prepared with either a high-speed drill or an Er,Cr:YSGG laser (2780 nm) and to associate their use with a beveling method for the margin. Method and Materials: Sixty bovine incisors were randomly distributed into three groups. Group 1 (G1) cavities were laser prepared and bur beveled, group 2 (G2) cavities were bur prepared and beveled, while cavities of group 3 (G3) were laser prepared and beveled. Cavities were restored with selective enamel etching, using the same bonding agent and nano-hybrid resin composite for all groups. After thermocycling, microleakage was assessed using a methylene blue dye penetration method. Results: Statistical analysis (Mann-Whitney, Kruskal-Wallis and post-hoc Dunn’s multiple comparison tests) demonstrated significantly higher microleakage for dentin compared to enamel margins in G1. Enamel margin microleakage was found to be significantly higher at G3 compared to G1 (p=0.032) and G2 (p=0.001), while no significant differences were found between G1 and G2 (p=0.850). Regarding dentin margins, G2 group performed significantly better than G1 and G3 (p<<0.001), while there was no significant difference among G1 and G3 scores (p=1.000). Conclusions: The conventional cavity preparation method seems to perform better in terms of microleakage than the Er,Cr;YSGG laser. Laser-prepared cavities could perform better in terms of microleakage if an additional step of enamel bur-beveling is performed prior to restoration.

Assessment of Microleakage of a Composite Resin Restoration in Primary Teeth Following Class III Cavity Preparation Using Er, Cr: YSGG laser: An In Vitro Study

Introduction: Marginal seal integrity is important for a successful adhesive dental restoration. Alterations caused by laser irradiation in the enamel and dentin surface can affect the marginal integrity of adhesive restorations. The aim of this study was to evaluate the microleakage of a composite resin restoration in primary teeth following laser irradiation of enamel and dentin. Methods: Forty freshly extracted sound human primary maxillary and mandibular anterior teeth were used in this study. The teeth were randomly divided into two groups (I and II), with 20 teeth in each. In group I, proximal cavities (Class III) were prepared using an airotor hand -piece and diamond bur. The cavities were etched for 15 seconds with 35% phosphoric acid gel, rinsed with water for 15 seconds, air dried and a bonding agent was applied onto the cavity surfaces and light cured for 20 seconds. The cavities were restored with composite resin and light cured for 40 seconds. In group II, proximal (Class III) cavities were prepared using Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) (Er,Cr:YSGG) (Biolaseiplus, wave length 2.78 μm). The cavity was then rinsed, air dried and without etching, a bonding agent was applied and light cured for 20 seconds. The cavities were restored in the same manner as that of group I. The treated teeth were mounted on acrylic resin blocks and were subjected to a thermocycling regimen. Following, the teeth were immersed in 2% methylene blue for 24 hours. The teeth were sectioned longitudinally in a bucco-lingual direction using a diamond disc at slow speed. The sections of all the groups were examined under a stereomicroscope for micro-leakage. Results: The mean scores for microleakage in group I was 1.95 ± 1.31 and in group II it was 1.4 ± 1.27. There was no significant difference between the two groups (P = 0.882). Conclusion: No significant difference in microleakage was noticed between the composite resin bonded to lased enamel and dentin and the teeth preparedwith conventional method.

Effect of different surface treatments on the shear and microtensile bond strength of resin-modified glass ionomer cement to dentin

OBJECTIVE

The aim of this study was to evaluate the effect of different surface treatments on the microtensile bond strength (μTBS) and shear bond strength (SBS) of resin-modified glass ionomer cement (RMGIC) to dentin.

MATERIALS AND METHODS

Fifty-two extracted human molars were flattened to obtain dentin surfaces. For SBS assessment 40 teeth were divided into four groups according to their surface treatments (acid etching, Er:YAG laser QSP mode, Er:YAG laser MSP mode and control-SiC) (n = 10). A plastic cylinder was placed over the differently treated dentin surfaces and RMGIC was placed into the rings and polymerized. Twelve teeth were used for the μTBS test. The treated dentin surfaces described above were restored with 4 mm high RMGIC and light cured; then, the specimens were sectioned into serial sticks (n = 15) and μTBS and SBS were tested for failure in a testing machine with a 1 mm/min crosshead speed. The data were analyzed by one-way ANOVA and Tukey HSD tests (α = 0.05).

RESULTS

Acid etching showed significantly higher SBS than the other groups (p < 0.05). Er:YAG QSP and MSP-treated groups showed higher SBS values than the control group, but the difference was not statistically significant (p > 0.05). Er:YAG MSP showed the highest μTBS value followed by acid etching, whereas the control group exhibited the lowest value (p < 0.05) and the differences between the control group and Er:YAG QSP were not significant (p > 0.05).

CONCLUSIONS

The application of Er:YAG MSP mode and acid etching to dentin can be used for improving the bond strength of RMGIC.

Effect of different surface treatments on the microtensile bond strength of two self-adhesive flowable composites

The aim of this study was to evaluate the effect of different surface treatments on the microtensile bond strength (μTBS) of two different self-adhesive flowable composite materials (SACs) to dentin. Forty extracted human molars were horizontally flattened to expose the dentin surfaces. The teeth were divided into eight groups according to the surface treatments (acid etching, Er:YAG laser quantum square pulse (QSP) mode, and Er:YAG laser medium-short pulse (MSP) mode at 10 Hz, 1.2 W, 120 mJ, and control-SiC) and SAC type (Vertise Flow and Fusio Liquid Dentin) (n = 5). Light cured 4-mm-high composite build-ups were made on the dentin surfaces, and the specimens were sectioned into serial sticks (n = 15). Later, the specimens were attached to microtensile testing machine and tensile force was applied at a crosshead speed of 1 mm/min until failure occurred. The failure modes were evaluated using a stereomicroscope at ×40 magnification, and one sample from each group was used for scanning electron microscopy (SEM) evaluation. The data were analyzed with two-way ANOVA and Tukey's HSD test (α = 0.05). In all surface treatment groups along with the control groups, Vertise Flow showed better μTBS than the Fusio Liquid Dentin with the exception of the Er:YAG MSP mode surface treatment (p < 0.05). Etching with phosphoric acid and the Er:YAG QSP mode surface treatment significantly increased the μTBS of Vertise Flow (p < 0.05). Etching with phosphoric acid, Er:YAG QSP mode surface treatment, and Er:YAG MSP mode surface treatment significantly increased the μTBS of Fusio Liquid Dentin (p < 0.05). The μTBS of Vertise Flow was higher than the μTBS of Fusio Liquid Dentin. The Er:YAG laser irradiation increased the μTBS of both self-adhesive flowable resin composites in two pulse modes tested (MSP or QSP). However, the highest μTBS was recorded when Vertise Flow was applied with acid etching.

The effect of an erbium, chromium: yttrium-scandium-gallium-garnet laser on the microleakage and bond strength of silorane and micro-hybrid composite restorations

Objective:

The aim of this in vitro study was to compare the microleakage and bond strength of Class V silorane-based and universal micro-hybrid composite restorations prepared either with diamond bur or with an erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser.

Materials and Methods:

A total of 160 molar teeth were used for microleakage assessment and shear bond strength (SBS) test. The specimens were prepared using either diamond bur or 3 W-, 4 W- and 5 W-20 Hz Er, Cr:YSGG laser irradiation. All specimens were subjected to thermocycling (500 times at 5 ± 2°C to 55 ± 2°C, dwell time 15 s and transfer time 10 s). Microleakage was assessed using a 0.5% basic-fuchsin solution. The bond strengths were determined using a microtensile tester at a crosshead speed of 0.5 mm/min. The Kruskal Wallis test was used for the analysis of microleakage and a one-way analysis of variance test was used to analyze the SBS (P < 0.05).

Results:

No statistically significant differences were found (P > 0.05) between Er, Cr:YSGG laser and bur preparation methods regarding microleakage and bond strength values.

Conclusion:

Irradiation with Er, Cr:YSGG laser was confirmed to be as effective as conventional methods for preparing cavities before adhesive restorations.

Er,Cr:YSGG laser influence on microleakage of class V composite resin restorations

One of the most challenging issues following restoration is microleakage. The aim of this study was to investigate the effects of Er,Cr:YSGG laser with and without acid etching on microleakage of class V composite restorations. A total of 68 human intact premolars were selected, disinfected, and randomly allocated to four experimental groups (n = 16) as well as positive and negative controls (n = 2 each). Dimensionally, similar class V cavities were prepared on buccal surface of each tooth under the following conditions: group 1, bur cavity preparation and chemical etching (BE); group 2, bur cavity preparation and Er,Cr:YSGG laser conditioning (BLc); group 3, Er,Cr:YSGG laser cavity preparation and chemical etching (LE); and group 4, Er,Cr:YSGG laser cavity preparation and Er,Cr:YSGG laser conditioning (LLc). All samples were restored with composite. The teeth were sealed and immersed in 1 % methylene blue for 48 h before being sectioned. The microleakage evaluation was done under a stereomicroscope (×20). The leakage scores were recorded and Kruskal-Wallis and Mann-Whitney tests were used for statistical evaluations. The highest microleakage score was seen in gingival margins of group 4 (LLc) and the lowest in occlusal margins of group 3 (LE). The overall difference in leakage scores among the groups was statistically significant (p < 0.001) with gingival margins showing a significantly higher score than its occlusal counterparts (p < 0.001). It was noted that less microleakage could be achieved when cavities were prepared by laser compared to bur. In addition, less microleakage was seen in acid-etched cavities than laser-conditioned counterparts.

Effect of laser preparation on bond strength of a self-adhesive flowable resin

The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond strength of a self-adhesive flowable resin composite to human dentin. Eighty extracted sound human molar teeth were used for the study. The teeth were sectioned mesiodistally and embedded in acrylic blocks. The dentin surfaces were ground wet with 600-grit silicon carbide (SiC) paper. They were randomly divided into two preparation groups: laser (Er:YAG laser, with 12 Hz, 350 mJ energy) and control (SiC). Each group was then divided into two subgroups according to the flowable resin composite type (n = 20). A self-adhesive flowable (Vertise Flow) and a conventional flowable resin (Premise Flow) were used. Flowable resin composites were applied according to the manufacturer's recommendations using the Ultradent shear bond Teflon mold system. The bonded specimens were stored in water at 37 °C for 24 h. Shear bond strength was tested at 1 mm/min. The data were logarithmically transformed and analyzed using two-way analysis of variance and Student-Newman-Keul's test at a significance level of 0.05. The self-adhesive flowable resin showed significantly higher bond strength values to laser-prepared surfaces than to SiC-prepared surfaces (p < 0.001). The conventional flowable resin did not show such differences (p = 0.224). While there was a significant difference between the two flowable resin composites in SiC-prepared surfaces (p < 0.001), no significant difference was detected in laser-prepared surfaces (p = 0.053). The bond strength of a self-adhesive flowable resin composite differs according to the type of dentin surface preparation. Laser treatment increased the dentin bonding values of the self-adhesive flowable resin.

Decontamination of dental implant surfaces by means of photodynamic therapy

Several implant surface debridement methods have been reported for the treatment of peri-implantitis, however, some of them can damage the implant surface or promote bacterial resistance. Photodynamic therapy (PDT) is a new treatment option for peri-implantitis. The aim of this in vitro study was to analyze implant surface decontamination by means of PDT. Sixty implants were equally distributed (n = 10) into four groups and two subgroups. In group G1 there was no decontamination, while in G2 decontamination was performed with chlorhexidine. G3 (PDT − laser + dye) and G4 (laser, without dye) were divided into two subgroups each; with PDT performed for 3 min in G3a and G4a, and for 5 min in G3b and G4b. After 5 min in contact with methylene blue dye (G3), the implants were irradiated (G3 and G4) with a low-level laser (GaAlAs, 660 nm, 30 mW) for 3 or 5 min (7.2 and 12 J). After the dilutions, culture media were kept in an anaerobic atmosphere for 1 week, and then colony forming units were counted. There was a significant difference (p < 0.001) between G1 and the other groups, and between G4 in comparison with G2 and G3. Better decontamination was obtained in G2 and G3, with no statistically significant difference between them. The results of this study suggest that photodynamic therapy can be considered an efficient method for reducing bacteria on implant surfaces, whereas laser irradiation without dye was less efficient than PDT.

Effects of different cavity disinfectants on shear bond strength of a silorane-based resin composite

AIM

This in vitro study evaluated the effect of different cavity disinfection agents on bond strength of a silorane-based resin composite.

MATERIALS AND METHODS

Thirty-six caries-free human third mandibular molars sectioned in mesio-distal direction were mounted in acrylic resin with their flat dentin surfaces exposed. After the dentin surfaces were wet ground with # 600 silicon carbide paper, the teeth were randomly divided into 6 groups of 12 each according to the cavity disinfection agents; chlorhexidine (CHX); sodium hypochlorite (NaOCl), propolis, ozone, Er,Cr:YSGG laser and no treatment (control). After treatment of dentin surfaces with one of these cavity disinfection agents, Filtek Silorane adhesive system was applied. The silorane-based resin composite, Filtek Silorane was condensed into a mold and polymerized. After storage at 37°C for 24 hours, the specimens were tested in shear mode at a crosshead speed of 1.0 mm/minute. The results were analyzed by one-way ANOVA.

RESULTS

No statistically significant difference was observed between the groups (p>0.05).

CONCLUSION

The use of the tested cavity disinfection agents, chlorhexidine, sodium hypochlorite, propolis, ozone and Er,Cr:YSGG laser did not significantly affect the dentin bond strength of a silorane-based resin composite, filtek supreme.

CLINICAL SIGNIFICANCE

Cavity disinfectant applications did not affect the dentin bond strength of a silorane-based resin composite.

Comparison of the Er,Cr:YSGG laser with a chemical vapour deposition bur and conventional techniques for cavity preparation: a microleakage study

The aim of this study was to compare the effects of the Er,Cr:YSGG laser using chemical vapour deposition (CVD) bur cavity preparation with conventional preparation methods including a diamond bur and a carbide bur on the microleakage with two different adhesive systems. A total of 40 extracted human premolars were randomly assigned to four experimental groups according to the cavity preparation technique: group I diamond bur (Diatech); group II carbide bur (Diatech); group III Er,Cr:YSGG laser (Biolase Millennium II); and group IV CVD bur (CVDentUS). Using the different preparation techniques, Class V standardized preparations were performed on the buccal and lingual surfaces with gingival margins on the dentin and occlusal margins on the enamel. Each preparation group was randomly assigned to two subgroups (five teeth, ten preparations) according to the type of adhesive: an etch-and-rinse adhesive (Adper Single Bond), and a single-step self-etch adhesive (AdheSE One). All preparations were restored with a nanohybrid composite resin in a single increment. Following thermocycling (×500; 5-55°C), the teeth were immersed in basic fuchsin and sectioned in the orovestibular direction. Dye penetration was evaluated under a light microscope by two blinded examiners. Data were statistically analysed with the Kruskal-Wallis and Wilcoxon tests (p<0.05). There were no statistically significant differences between the preparation techniques with either of the two adhesive systems (p>0.05). Comparing the enamel and dentin leakage scores within each group, no statistically significant differences were found (p>0.05). The Er,Cr:YSGG laser cavity preparation did not differ from preparation with CVD, diamond or carbide bur in terms of microleakage with the different adhesive systems.