Effect of Er,Cr:YSGG laser on the surface of composite restoratives during in-office tooth bleaching

Effect of laser irradiation during in-office tooth bleaching on surface properties of resin-based restorative materials

This study evaluated the changes in surface properties of three resin-based restorative materials after two laser-assisted, in-office tooth bleaching protocols using erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) or diode (980 nm) lasers. A nanohybrid composite (Enamel Plus HRi), a Bis-GMA-free composite (Enamel Plus HRi Bio Function), and a resin-matrix CAD-CAM ceramic (Shofu Block HC) were tested. Forty specimens for each material were prepared and divided into four groups (n = 10/group). The control specimens did not undergo any bleaching treatment, whereas group 2 received bleaching with 40% hydrogen peroxide (H2O2), while groups 3 and 4 underwent the same bleaching procedure with the use of diode (980 nm) or Er,Cr:YSGG lasers, respectively. Surface microhardness and roughness measurements were conducted using a Vickers tester and an optical profilometer. Microhardness was lower in bleached specimens, with the nanohybrid composite exhibiting the largest difference from the no bleaching group. For the Bis-GMA-free composite the microhardness difference between no bleaching and laser-assisted bleaching were smaller than seen for the conventional bleaching technique. Surface roughness was higher in bleached specimens, with nanohybrid composite showing the largest differences from the control specimens. The examined laser-assisted tooth bleaching protocols were found not to impact surface microhardness and roughness of the tested resin-based specimens and they are deemed suitable for clinical use.

Effects of tooth bleaching protocols assisted by Er,Cr:YSGG and diode (980 nm) lasers on color change of resin-based restoratives

OBJECTIVE

To evaluate color change of three resin-based restorative materials after two laser-assisted in-office tooth bleaching protocols using Er,Cr:YSGG and diode (980 nm) lasers.

MATERIALS AND METHODS

A nanohybrid composite resin (EP), a Bis-GMA free composite resin (EPBio) and a resin-matrix CAD-CAM ceramic (HC) were tested. Ninety specimens were prepared and stored in artificial saliva. Group 1 received an in-office bleaching treatment using 40% H₂ O_2. The same bleaching procedure was assisted by Er,Cr:YSGG laser in Group 2 and by a diode laser (980 nm) in Group 3. Color measurements were performed using a double-beam UV-Vis spectrophotometer at four time intervals (before, 24 h, 15 and 30 days), converted to L*, a*, and b* units of the CIELAB color space and assessed on the basis of 50:50% acceptability (ΔΕ_ab * = 2.7 and ΔΕ₀₀  = 1.77) and 50:50% perceptibility (ΔΕ_ab * = 1.2 and ΔΕ₀₀  = 0.81) thresholds. Three-way ANOVA with repeated measurements was used for statistical analysis of the data.

RESULTS

Color and whiteness changes did not exceed the established 50:50% acceptability thresholds. EP presented the highest color change after the bleaching followed by EPBio and HC (p ≤ 0.05). Three-way ANOVA revealed that type of material and time interval significantly affected color change (p ≤ 0.001).

CONCLUSIONS

The tested bleaching treatments assisted by Er,Cr:YSGG and diode (980 nm) lasers did not induce unacceptable color and whiteness changes in the resin-based restorative materials.

CLINICAL SIGNIFICANCE

The tested Er,Cr:YSGG and diode (980 nm) laser-assisted tooth bleaching protocols which may be recommended to accelerate the clinical procedures cannot affect the color of the existing resin-based restorations in case they are accidentally exposed on the bleaching gel and laser irradiation.

Evaluation of Monomer Elution and Surface Roughness of a Polymer-Infiltrated Ceramic Network CAD-CAM Material After Er,Cr:YSGG Laser-assisted Tooth Bleaching

PURPOSE

The aim of this in vitro study was to examine the effect of Er,Cr:YSGG laser-assisted tooth bleaching treatment on the elution of monomers and surface roughness of a hybrid computer-aided design-computer-aided manufacturing (CAD-CAM) material, and to compare it with a resin composite for direct restorations.

METHODS AND MATERIALS

Forty specimens of a hybrid CAD-CAM material (Enamic) and forty of a conventional resin composite (Tetric) were fabricated and randomly divided into four groups (n=10). Half of the specimens of each material were stored in distilled water and the other half in artificial saliva for 7 days. At the end of this period, the storage medium was analyzed by high-performance liquid chromatography (HPLC), and the surface roughness parameters of the specimens were evaluated by optical imaging noncontact interferometric profilometry. Afterwards, half of the specimens of each tested material received a conventional in-office tooth bleaching treatment and the other half an Er,Cr:YSGG laser-assisted bleaching treatment, and then they were again incubated in distilled water and artificial saliva for an additional 7-day time period. At the end of this period, the effect of the bleaching treatments on elution of monomers and surface roughness of the tested materials was evaluated.

RESULTS

Bisphenol A (BPA), urethane dimethacrylate (UDMA), triethylene glycol dimethacrylate (TEGDMA), and bisphenol A-glycidyl dimethacrylate (BisGMA) were eluted from the conventional resin composite into both the solutions tested. Only TEGDMA was eluted from the hybrid CAD-CAM material. However, no statistically significant differences were found among the surface roughness parameters of both materials. Both the conventional and Er,Cr:YSGG laser-assisted tooth bleaching treatments affected the monomer elution from the composite resin. However, there were no statistically significant differences (p<0.05) between the treatments.

CONCLUSIONS

According to the results of this study, tooth bleaching with Er,Cr:YSGG laser or conventional technique is safe, even if the bleaching agent comes in contact with hybrid CAD-CAM restorations.

Effect of radiant heat on conventional glass ionomer cements during setting by using a blue light diode laser system (445 nm)

The aim of this in vitro study was to evaluate the effect of radiant heat on surface hardness of three conventional glass ionomer cements (GICs) by using a blue diode laser system (445 nm) and a light-emitting diode (LED) unit. Additionally, the safety of the laser treatment was evaluated. Thirty disk-shaped specimens were prepared of each tested GIC (Equia Fil, Ketac Universal Aplicap and Riva Self Cure). The experimental groups (n = 10) of the study were as follows: group 1 was the control group of the study; in group 2, the specimens were irradiated for 60 s at the top surface using a LED light-curing unit; and in group 3, the specimens were irradiated for 60 s at the top surface using a blue light diode laser system (445 nm). Statistical analysis was performed using one-way ANOVA and Tukey post-hoc tests at a level of significance of a = 0.05. Radiant heat treatments, with both laser and LED devices, increased surface hardness (p < 0.05) but in different extent. Blue diode laser treatment was seemed to be more effective compared to LED treatment. There were no alterations in surface morphology or chemical composition after laser treatment. The tested radiant heat treatment with a blue diode laser may be advantageous for the longevity of GIC restorations. The safety of the use of blue diode laser for this application was confirmed.