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Lukač M, Košir J, Žel T, Kažič M, Šavli D, Jezeršek M. Influence of tissue desiccation on critical temperature for thermal damage during Er:YAG laser skin treatments. Lasers Surg Med 2024; 56:107-118. [PMID: 37974375 DOI: 10.1002/lsm.23739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Erbium lasers have become an accepted tool for performing both ablative and non-ablative medical procedures, especially when minimal invasiveness is desired. Hard-tissue desiccation during Er:YAG laser procedures is a well-known phenomenon in dentistry, the effect of which is to a certain degree being addressed by the accompanying cooling water spray. The desiccation of soft tissue has attracted much less attention due to the soft tissue's high-water content, resulting in a smaller effect on the ablation process. MATERIALS AND METHODS In this study, the characteristics of skin temperature decay following irradiations with Er:YAG laser pulses were measured using a fast thermal camera. RESULTS The measurements revealed a substantial increase in temperature decay times and resulting thermal exposure times following irradiations with Er:YAG pulses with fluences below the laser ablation threshold. Based on an analytical model where the skin surface cooling time is calculated from the estimated thickness of the heated superficial layer of the stratum corneum (SC), the observed phenomena is attributed to the accelerated evaporation of water from the SC's surface. By using an Arrhenius damage integral-based variable heat shock model to describe the dependence of the critical temperature on the duration of thermal exposure, it is shown that contrary to what an inexperienced practitioner might expect, the low-to-medium level fluences may result in a larger thermal damage in comparison to treatments where higher fluences are used. This effect may be alleviated by hydrating the skin before Er:YAG treatments. CONCLUSION Our study indicates that tissue desiccation may play a more important role than expected for soft-tissue procedures. It is proposed that its effect may be alleviated by hydrating the skin before Er:YAG treatments.
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Affiliation(s)
- Matjaž Lukač
- Jožef Stefan Institute, Complex matter, Ljubljana, Slovenia
- Faculty of Mathematics and Physics, Medical Physics, University of Ljubljana, Ljubljana, Slovenia
- Fotona d.o.o., Lasers, Ljubljana, Slovenia
| | - Jure Košir
- Fotona d.o.o., Lasers, Ljubljana, Slovenia
- Faculty of Mechanical Engineering, Laboratory for Laser Techniques, University of Ljubljana, Ljubljana, Slovenia
| | - Tilen Žel
- Fotona d.o.o., Lasers, Ljubljana, Slovenia
| | | | - Dominik Šavli
- Faculty of Mechanical Engineering, Laboratory for Laser Techniques, University of Ljubljana, Ljubljana, Slovenia
| | - Matija Jezeršek
- Faculty of Mechanical Engineering, Laboratory for Laser Techniques, University of Ljubljana, Ljubljana, Slovenia
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Marković L, Ivanišević A, Matijević J, Chan RSM, Tsoi JKH, Šnjarić D, Gjorgievska E. Micro-CT analysis and leakage of bioceramic retrofillings after ultrasonic and Er:YAG laser cavity preparations: an in vitro study. Lasers Med Sci 2023; 38:145. [PMID: 37347307 DOI: 10.1007/s10103-023-03809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
The purpose of the study was to determine the influence of preparation techniques on marginal adaptation and sealing of Biodentine™ and TotalFill® RRM bioceramic retrograde fillings. Fifty-two single-root teeth extracted for periodontal reasons were used. Root canals were instrumented using Reciproc Blue #25 and obturated using a single cone technique with an AH Plus® root canal sealer. Retrograde cavities were prepared with Piezomed device (Piezo), Er:YAG laser in short-pulse(SP) and quantum square pulse(QSP) modes and filled with Biodentine™ (BD) or TotalFill® RRM (TF). There were 6 groups (n=8): (1) Piezo BD, (2) Piezo TF, (3) SP BD, (4) SP TF, (5) QSP BD, and (6) QSP TF, and positive and negative controls (n=2). Micro-CT analysis was performed on two samples from each group. Percentage volumes of internal and external voids in apical 1.5 mm were determined. Rhodamine B dye leakage was done on six samples. The samples were cut longitudinally and examined under a stereomicroscope. Digital recordings were analyzed in ImageJ software. The deepest penetration of color in mm was recorded. The data were statistically analyzed using ANOVA and Duncan's test at the level of significance α=0.05. TotalFill® RRM performed significantly better than Biodentine™ in terms of sealing (p<0.05) and marginal adaptation, as evaluated by micro-CT. Sealing was significantly better in SP compared to QSP mode preparations (p<0.05). Differences between Piezomed and laser modes were not significantly different (p>0.05). Sealing was statistically significantly better with TotalFill® RRM compared to Biodentine™ and in Er:YAG SP preparations compared to Er:YAG QSP.
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Affiliation(s)
| | - Ana Ivanišević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Jurica Matijević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Rosalind Sin Man Chan
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, SAR, Hong Kong, People's Republic of China
| | - James Kit Hon Tsoi
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, SAR, Hong Kong, People's Republic of China
| | - Damir Šnjarić
- Department for Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Elizabeta Gjorgievska
- Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, University "Ss Cyril and Methodius" Skopje, Skopje, Republic of Macedonia
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Nahas P, Houeis S, Chamboredon R, Heysselaer D, Zeinoun T, Nammour S. Assessment of the Periodontal Cementum Ablation Depth during Root Planing by an Er:YAG Laser at Different Energy Densities: An Ex Vivo Study. Dent J (Basel) 2023; 11:dj11050116. [PMID: 37232767 DOI: 10.3390/dj11050116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION An important and non-adapted delivered energy of Er:YAG laser can eliminate the total thickness of root cementum during root planing. Conversely, the preservation of a partial layer of cementum covering the roots is vital for any periodontal ligament regeneration. Thus, the assessment of the cementum ablation depth produced by each energy density of Er:YAG laser is essential before considering its use for the periodontal planing and treatment of the cementum and root surfaces. AIM OF THE STUDY Assessment of the cementum ablation depth at different energy densities of the Er:YAG laser is the aim of this study. MATERIALS AND METHODS A total of 48 human caries free molars were collected and used in this study. Areas to be irradiated were delimited by two longitudinal grooves (0.5 mm depth). Roots were divided randomly into four groups (4 × n = 12). An Er:YAG laser (2.94 µm) was used with a side-firing tip (R600T) with a 600 µm diameter and a frequency of 20 Hz combined with a cooling system of air 6 mL/min and water 4 mL/min. We used a super short pulse mode (SSP: pulse duration: 50 μs). We used a single irradiation passage backward from apex to cervical parts at 1 mm/s with a slight contact and at an angle of 15° to 30° between the tip and the root surface. Different energies were selected: 30 mJ, 40 mJ, 50 mJ, and 60 mJ. RESULTS Microscopic observations showed that the average of the ablation depth increased with the increase of the delivered energy from 30 mJ to 60 mJ. Mean values of the ablation depths were respectively as follows: 43.75 ± 4.89 µm for the energy of 30 mJ, 50.05 ± 3.72 µm for 40 mJ, 65.56 ± 10.35 µm for 50 mJ, and 74.80 ± 15.23 µm for 60 mJ. A statistically significant difference existed between the ablation depth of all groups. CONCLUSION Based on our results, the depth of cementum debridement is related to the level of the delivered energy. The lowest energy levels (30 mJ and 40 mJ) can ablate the root cementum surface for a variable depth from 43.75 ± 4.89 μm to 50.05 ± 3.72 μm.
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Affiliation(s)
- Paul Nahas
- Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Lebanese University, Hadath campus, Beirut 1003, Lebanon
| | - Saad Houeis
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Remi Chamboredon
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Daniel Heysselaer
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Toni Zeinoun
- Department of Oral and Maxillo-Facial Surgery, Dean of Faculty of Dental Medicine, Lebanese University, Beirut 1003, Lebanon
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
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Roessler K, Winter F, Wilken T, Pataraia E, Mueller-Gerbl M, Dorfer C. Robotic Navigated Laser Craniotomy for Depth Electrode Implantation in Epilepsy Surgery: A Cadaver Lab Study. J Neurol Surg A Cent Eur Neurosurg 2020; 82:125-129. [PMID: 33278827 DOI: 10.1055/s-0040-1720998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Depth electrode implantation for invasive monitoring in epilepsy surgery has become a standard procedure. We describe a new frameless stereotactic intervention using robot-guided laser beam for making precise bone channels for depth electrode placement. METHODS A laboratory investigation on a head cadaver specimen was performed using a CT scan planning of depth electrodes in various positions. Precise bone channels were made by a navigated robot-driven laser beam (erbium:yttrium aluminum garnet [Er:YAG], 2.94-μm wavelength,) instead of twist drill holes. Entry point and target point precision was calculated using postimplantation CT scans and comparison to the preoperative trajectory plan. RESULTS Frontal, parietal, and occipital bone channels for bolt implantation were made. The occipital bone channel had an angulation of more than 60 degrees to the surface. Bolts and depth electrodes were implanted solely guided by the trajectory given by the precise bone channels. The mean depth electrode length was 45.5 mm. Entry point deviation was 0.73 mm (±0.66 mm SD) and target point deviation was 2.0 mm (±0.64 mm SD). Bone channel laser time was ∼30 seconds per channel. Altogether, the implantation time was ∼10 to 15 minutes per electrode. CONCLUSION Navigated robot-assisted laser for making precise bone channels for depth electrode implantation in epilepsy surgery is a promising new, exact and straightforward implantation technique and may have many advantages over twist drill hole implantation.
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Affiliation(s)
- Karl Roessler
- Department of Neurosurgery, Medical University of Vienna, Wien, Austria
| | - Fabian Winter
- Department of Neurosurgery, Medical University of Vienna, Wien, Austria
| | | | - Ekaterina Pataraia
- Department of Neurological Clinic, Medical University of Vienna, Wien, Austria
| | | | - Christian Dorfer
- Department of Neurosurgery, Medical University of Vienna, Wien, Austria
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Vidas J, Snjaric D, Braut A, Carija Z, Persic Bukmir R, De Moor RJG, Brekalo Prso I. Comparison of apical irrigant solution extrusion among conventional and laser-activated endodontic irrigation. Lasers Med Sci 2019; 35:205-211. [DOI: 10.1007/s10103-019-02846-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/11/2019] [Indexed: 12/23/2022]
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Kadić S, Baraba A, Miletić I, Ionescu AC, Brambilla E, Ivanišević Malčić A, Gabrić D. Influence of different laser-assisted retrograde cavity preparation techniques on bond strength of bioceramic-based material to root dentine. Lasers Med Sci 2019; 35:173-179. [PMID: 31273570 DOI: 10.1007/s10103-019-02835-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 06/25/2019] [Indexed: 11/26/2022]
Abstract
The purposes of the study were to evaluate the bond strength of bioceramic TotalFill root repair material (RRM) in retrograde cavities prepared using Er:YAG and Er,Cr:YSGG laser and steel bur, and to analyze failure modes. The root canals of 30 single-rooted teeth were endodontically treated, their root-ends were resected using a diamond bur, and the teeth were randomly divided into three groups (N = 10) according to the retrograde cavity preparation technique: (1) Er:YAG laser, (2) Er,Cr:YSGG laser, and (3) steel bur. All retrograde cavities were filled with the TotalFill RRM which was prepared according to the manufacturers' instructions. Push-out test was performed using universal testing machine, and failure mode was analyzed using a scanning electron microscope. The data were analyzed using one-way ANOVA, post hoc analysis with Bonferroni correction, and Fisher-Freeman-Halton exact test (p < 0.05). In the Er:YAG-, Er,Cr:YSGG-, and steel bur-prepared cavities, mean bond strengths (MPa) were 12.76, 8.44, and 6.01, respectively. The bond strength of the TotalFill RRM to dentin was significantly higher in the Er:YAG laser compared with the steel bur-prepared cavities (p = 0.004). The bond strength was not significantly different between the Er:YAG and Er,Cr:YSGG cavities (p = 0.074) and between the Er,Cr:YSGG and bur cavities (p = 0.648). In the cavities prepared by the Er,Cr:YSGG laser and bur, the failure mode of the TotalFill RRM was predominantly mixed, then adhesive and cohesive. In the Er:YAG laser-prepared cavities, the most common failure mode was adhesive, followed by mixed type and no cohesive failure. The bond strength of the TotalFill RRM to dentin was highest in the group of retrograde cavities prepared by the Er:YAG laser.
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Affiliation(s)
- Snježana Kadić
- Department of Pediatric and Preventive Dentistry, Dental Polyclinic Zagreb, Zagreb, Croatia
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, HR-10000, Zagreb, Croatia
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, HR-10000, Zagreb, Croatia
| | | | - Eugenio Brambilla
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Ana Ivanišević Malčić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, HR-10000, Zagreb, Croatia.
| | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Nguendon Kenhagho H, Shevchik S, Saeidi F, Faivre N, Meylan B, Rauter G, Guzman R, Cattin P, Wasmer K, Zam A. Characterization of Ablated Bone and Muscle for Long-Pulsed Laser Ablation in Dry and Wet Conditions. MATERIALS 2019; 12:ma12081338. [PMID: 31022964 PMCID: PMC6515417 DOI: 10.3390/ma12081338] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 12/26/2022]
Abstract
Smart laser technologies are desired that can accurately cut and characterize tissues, such as bone and muscle, with minimal thermal damage and fast healing. Using a long-pulsed laser with a 0.5–10 ms pulse width at a wavelength of 1.07 µm, we investigated the optimum laser parameters for producing craters with minimal thermal damage under both wet and dry conditions. In different tissues (bone and muscle), we analyzed craters of various morphologies, depths, and volumes. We used a two-way Analysis of Variance (ANOVA) test to investigate whether there are significant differences in the ablation efficiency in wet versus dry conditions at each level of the pulse energy. We found that bone and muscle tissue ablated under wet conditions produced fewer cracks and less thermal damage around the craters than under dry conditions. In contrast to muscle, the ablation efficiency of bone under wet conditions was not higher than under dry conditions. Tissue differentiation was carried out based on measured acoustic waves. A Principal Component Analysis of the measured acoustic waves and Mahalanobis distances were used to differentiate bone and muscle under wet conditions. Bone and muscle ablated in wet conditions demonstrated a classification error of less than 6.66% and 3.33%, when measured by a microphone and a fiber Bragg grating, respectively.
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Affiliation(s)
- Hervé Nguendon Kenhagho
- Biomedical Laser and Optics Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland.
| | - Sergey Shevchik
- Laboratory for Advanced Materials Processing, Empa-Swiss Federal Laboratories for Materials Science and Technology, 3602 Thun, Switzerland.
| | - Fatemeh Saeidi
- Laboratory for Advanced Materials Processing, Empa-Swiss Federal Laboratories for Materials Science and Technology, 3602 Thun, Switzerland.
| | - Neige Faivre
- Laboratory for Advanced Materials Processing, Empa-Swiss Federal Laboratories for Materials Science and Technology, 3602 Thun, Switzerland.
| | - Bastian Meylan
- Laboratory for Advanced Materials Processing, Empa-Swiss Federal Laboratories for Materials Science and Technology, 3602 Thun, Switzerland.
| | - Georg Rauter
- Bio-Inspired RObots for MEDicine-Lab, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland.
| | - Raphael Guzman
- Department of Neurosurgery, University Hospital Basel, Spitalstrasse 21, 4056 Basel, Switzerland.
| | - Philippe Cattin
- Center for medical Image Analysis and Navigation, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland.
| | - Kilian Wasmer
- Laboratory for Advanced Materials Processing, Empa-Swiss Federal Laboratories for Materials Science and Technology, 3602 Thun, Switzerland.
| | - Azhar Zam
- Biomedical Laser and Optics Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland.
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Lukač M, Lozar A, Perhavec T, Bajd F. Variable heat shock response model for medical laser procedures. Lasers Med Sci 2019; 34:1147-1158. [DOI: 10.1007/s10103-018-02704-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 12/06/2018] [Indexed: 10/27/2022]
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Advanced laser scanning for highly-efficient ablation and ultrafast surface structuring: experiment and model. Sci Rep 2018; 8:17376. [PMID: 30478282 PMCID: PMC6255863 DOI: 10.1038/s41598-018-35604-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/05/2018] [Indexed: 11/13/2022] Open
Abstract
Ultra-short laser pulses are frequently used for material removal (ablation) in science, technology and medicine. However, the laser energy is often used inefficiently, thus, leading to low ablation rates. For the efficient ablation of a rectangular shaped cavity, the numerous process parameters such as scanning speed, distance between scanned lines, and spot size on the sample, have to be optimized. Therefore, finding the optimal set of process parameters is always a time-demanding and challenging task. Clear theoretical understanding of the influence of the process parameters on the material removal rate can improve the efficiency of laser energy utilization and enhance the ablation rate. In this work, a new model of rectangular cavity ablation is introduced. The model takes into account the decrease in ablation threshold, as well as saturation of the ablation depth with increasing number of pulses per spot. Scanning electron microscopy and the stylus profilometry were employed to characterize the ablated depth and evaluate the material removal rate. The numerical modelling showed a good agreement with the experimental results. High speed mimicking of bio-inspired functional surfaces by laser irradiation has been demonstrated.
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Kallis A, Tolidis K, Gerasimou P, Dionysopoulos D. Qualitative evaluation of hybrid layer formation using Er:YAG laser in QSP mode for tooth cavity preparations. Lasers Med Sci 2018; 34:23-34. [PMID: 29982880 DOI: 10.1007/s10103-018-2575-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/27/2018] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to evaluate the thickness and qualitative characteristics of the hybrid layer after two cavity preparation methods, using Er:YAG laser in QSP mode and conventional carbide burs. Additionally, two different adhesive techniques were investigated using etch-and-rinse and self-etch adhesive systems. Sixty sound human third molars were used and were randomly divided into four groups (n = 15). In the first two groups, large (4 mm length, 3 mm wide, and 3 mm deep) class I cavities were prepared using Er:YAG laser (2.94 μm) in QSP mode, while in the other two groups, the cavities were prepared using carbide burs. After cavity preparations, two different adhesive techniques with GLUMA® 2 Bond (etch-and-rinse) and Clearfil™ Universal Bond Quick (self-etch) were applied. For the qualitative evaluation of the formed hybrid layer, photomicrographs were taken using SEM, and elemental semi-quantitative analysis was performed using EDS to confirm the extent of the hybrid layer. One-way ANOVA was applied to verify the existence of statistically significant differences, followed by Tukey test for post hoc comparisons (Bonferroni corrected), and the level of significance was set at a = 0.05. The laser-treated groups exhibited higher hybrid layer thickness than bur-treated groups (p < 0.001). Between the laser-treated groups, etch-and-rinse technique presented higher hybrid layer thickness than self-etch technique (p < 0.001), while between the bur-treated groups, no significant differences were detected (p = 0.366). Er:YAG laser cavity preparations in QSP mode may be advantageous for adhesion of composite restorations, but more data are necessary to confirm its clinical effectiveness.
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Affiliation(s)
- Antonis Kallis
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Kosmas Tolidis
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Paris Gerasimou
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Dimitrios Dionysopoulos
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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