Evaluation of surface roughness and bond strength of quartz fiber posts after various pre-treatments

Effect of Er:YAG laser on removal of fibre posts from root canal

The aim of this study was to evaluate the efficiency of Er:YAG laser in translucent fibre post removal. 60 human single-rooted anterior teeth were divided into three groups (n = 20) according to post diameters (Exacto1-E1, Exacto2-E2, Exacto3-E3) and subdivided according to laser application. Fibre posts were cemented to endodontically treated teeth, and the specimens were sliced with a thickness of 1.0 ± 0.2 mm. Er:YAG laser was applied and the push out bond strength test was performed. Two-way analysis of variance was used to perform the statistical analysis. Push out bond strengths at apical area were significantly lower in all test groups (p < 0.05). Laser application caused increase in all radicular thirds, but it was significant for E1 and E3 groups. Laser application to the post-dentine interface enhances the connection between post and dentine.

The combined treatment of fiber post and root canal by the Er:YAG laser enhances the bond strength of composite reconstruction

Fiber post bonding failure remains an issue during crown restoration procedures. This experiment examines the bonding effect of combined Er:YAG laser treatment on both root canal and fiber post. Sixty extracted mandibular first premolars were randomly selected and divided into 6 groups (n = 10 per group): G1 (control group): root canal with 2.5% NaClO treatment, no treatment of fiber post; G2: root canal with 2.5% NaClO treatment and fiber post with airborne-particle abrasion; G3: root canal with Er:YAG laser treatment and fiber post with airborne-particle abrasion; G4: root canal with Er:YAG laser treatment, no treatment of fiber post; G5: root canal with 2.5% NaClO treatment, fiber post with Er:YAG laser irradiation; G6: combined Er:YAG laser irradiation of both root canal and fiber post. An Er:YAG laser with a wavelength of 2940 nm was used to treat the fiber post (4.5 W, 450 mJ, 10 Hz for 60 s at 100-μs pulse duration with 100% water cooling) and the root canal (1.5 W, 150 mJ, 10 Hz for 60 s at 100-μs pulse duration with 100% water cooling). When the root canal was treated with the laser, the fiber tip was inserted into the root canal to make a spiral reciprocating motion. Bond strength was analyzed by a micro push-out test. Data were analyzed using both the Tukey test and two-way ANOVA (α = 0.05). Failure modes were observed and counted through a stereo microscope. The root canal and fiber post surface analysis was performed using SEM. The bond strength of G3 and G6 were significantly enhanced compared to those of the other groups (p < 0.05). The SEM analysis showed that the smear layers of groups with root canals subjected to Er:YAG laser irradiation were significantly reduced compared to those of the control group (G1). In groups with fiber posts treated with Er:YAG laser irradiation, the surfaces of the fiber posts exhibited greater surface roughness and a certain degree of epoxy matrix removal. Through the combined Er:YAG laser irradiation of both root canal and fiber post, the bond strength between them was significantly enhanced, which was superior to the individual treatment of either fiber posts or root canal.

Influence of Contemporary Photoactivated Disinfection on the Mechanical Properties and Antimicrobial Activity of PMMA Denture Base: A Systematic Review and Meta Analysis

PURPOSE

The present study aimed to perform a systematic review and meta-analysis to investigate the effectiveness of the contemporary photoactivated disinfection methods on the mechanical features and/or antimicrobial activity of polymethyl methacrylate (PMMA) dentures bases.

METHODS

THE FOCUSED RESEARCH QUESTION WAS: : "What is the effect of contemporary photoactivated disinfection methods as compared to conventional disinfection protocols on the mechanical features and/or antimicrobial activity of PMMA dentures bases?". An electronic literature search was carried out by the author and a senior librarian specialized in health sciences on Web of Science, PubMed, and Scopus. In vitro investigations evaluating the antimicrobial and/or mechanical effects of photoactivated disinfectants as compared to conventional chemical disinfectants on the microbes formed on PMMA denture bases were included. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval.

RESULTS

Four out of eight studies concluded that photoactivated disinfectants, including riboflavin-mediated photodynamic therapy (PDT), hematoporphyrin-mediated PDT, poly-L-glycolic acid loaded with methylene blue, Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser, erbium-doped yttrium-aluminum-garnet (Er:YAG) laser, and chitosan-mediated PDT, demonstrated a significant reduction in colony-forming unit per milliliter (CFU/mL) of exposed viable colonies of Escherichia coli (E. coli), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Candida albicans (C. albicans) comparable to the conventionally used chemical disinfectants of PMMA denture bases. Contrarily, two studies concluded that the PMMA denture base colonized with C. albicans and disinfected with conventional chemical disinfectants showed the greatest anti-fungal efficaciousness. All the included studies concluded that the application of photoactivated disinfectants does not negatively impact the mechanical features of the PMMA denture bases colonized with microbes including E. coli, S. mutans, S. aureus, and C. albicans. The meta-analysis revealed statistically significant reduction in C. albicans counts (CFU/mL [Log10]) (p < 0.00001) and improvement in the flexural strength (p = 0.0002) of PMMA-based denture base after the application of conventional disinfectants, while a statistically significant improvement in the fracture strength of PMMA-based denture base was observed after the application of photoactivated disinfectants (p = 0.03).

CONCLUSION

According to the systematic review (qualitative synthesis), photoactivated disinfectants demonstrated comparable mechanical features and antimicrobial activity of PMMA dentures bases to conventional chemical disinfectants suggesting their potential to be utilized as an alternative to conventional chemical disinfectants. However, the meta-analysis (quantitative synthesis) revealed that the application of conventional disinfectants demonstrated better outcomes related to antimicrobial activity and flexural strength of PMMA-based denture based.

Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review

The utilization of lasers has been regarded as a novel technique for the purposes of clinical use in the dental field. Recently, numerous studies have been conducted on the potential applications of laser therapy in endodontics. Moreover, due to their ablation, penetrability, and disinfection capabilities, lasers have performed well with respect to endodontic treatments, including root canal treatment, vital pulp therapy (pulp capping and pulpotomy), dentinal hypersensitivity treatment, and management of dental pain related to pulp and periradicular disease. In particular, the superiorities of laser-aided pulp therapy are emphasized through condensed clinical controlled trials, and histological studies, in this review. Moreover, the ingenious use of laser applications with respect to aiding in the acceleration of root development and the extraction of foreign matters (i.e., broken files and fiber posts) in canals has quickly become the cutting-edge trend of current research. This review offers a summary and discussion of the current literature on all the aforementioned laser applications. Moreover, the characteristics of laser devices, including erbium lasers, neodymium-doped lasers, CO2 lasers, and diode lasers, are detailed and discussed here, providing useful references for laser application in endodontics. We also focus on the different wavelengths with respect to the lasers that are applied in endodontics. High-power lasers perform well as operative instruments; in addition, low-level lasers lead to the regulation of pulp inflammation, and the promotion of pulp healing. This narrative review provides a summary of the advanced applications of lasers in conjunction with various devices in the practice of endodontics, and aims to inspire innovative perspectives on lasers in the context of the treatment of dental diseases, especially pulp diseases, in the future.

Effect of Different Surface Treatments of Glass Fiber Posts on their Surface Roughness and Flexure Properties

AIM: This study aimed to assess the effect of different surface treatments on the surface roughness and flexure properties of glass fiber posts “GFPs.” MATERIALS AND METHODS: A total of 40 GFPs were divided into four groups (n = 10): GC – no surface treatment (control), GSB – sandblasted, GHF – hydrofluoric acid etched, and GL – Er: YAG laser irradiated. Surface roughness was detected using surface profilometer and the 3-points bending flexural test measured flexural strength and elastic modulus. RESULTS: GSB showed the highest mean roughness followed by GHF, then GL, while GC had lowest roughness mean value. The 3 points bending test results were calculated and recorded, GSB exhibited the highest flexure stress (MPa) compared to GHF and GL. Modulus of elasticity (GPa) showed significant differences between the tested groups, GSB showed the highest modulus of elasticity compared to GHF and GL, while GC showed insignificant differences with all tested groups. CONCLUSION: Different surface treatments postulated in this study showed alternations of GFPs surfaces without jeopardizing the mechanical properties of GFPs.

Push-out bond strength of various surface treatments on fiber post to root canal dentine using different irrigation techniques

To compare the efficacy of different surface treatments (fiber post) with laser activated irrigation (LAI) technique (various root canal solutions) on root canal dentine in terms of push-out bond strength (PBS) in a fiber post. In this study, 200 premolars were assigned into groups according to various irrigation techniques: 2.5% sodium hypochlorite (NaOCl), 17% ethylene diamine tetra acetic acid (EDTA), and 17% EDTA + LAI. In addition, the fiber posts were separated into five groups, (n = 30) according to the surface pretreatment performed: sandblasting, hydrofluoric acid (HF), Erbium, Chromium:Yttrium Scandium-Gallium-Garnet (Er,Cr:YSGG) laser, Neodymium-Doped Yttrium Aluminum Garnet (Nd,YAG) laser and as untreated surface. The posts were cemented using dual-cure resin cement and subjected to a PBS test. Data were analyzed by one way-ANOVA, Tukey, and Tamhane T2 tests. The PBS values were increased in all parts of the tooth in the EDTA and EDTA + LAI treated groups and in groups treated with Er,Cr:YSGG laser fiber posts. In groups in which EDTA and EDTA + LAI were applied, it was observed that dentinal tubules were open according to the distribution and number of dentinal tubule configurations. The improvement of the PBS between fiber post/resin cement/root dentine was observed via the use of fiber post surface treatments with different irrigation techniques.

Laser Treatment of Fiber Post and Final Push-Out Bond Strength: A Systematic Review and Meta-Analysis

Purpose: This review article tries to answer this question: "What are the effects of laser surface treatment of fiber posts (FPs), compared with other surface roughening methods, on bond strength of cemented FPs?" Methods: Search was carried out in six electronic databases by focusing on defined key words. Related titles and abstracts, up to March 2019, were collected, read, and selected for quality assessments. A total of 2408 articles were included in the study at the initial stage of the searching phase. Results: Finally, seven studies were recognized to be reliable to be reviewed and meta data analysis in the study. All the studies were in vitro with a total of 340 samples. None of the Er:YAG (-0.27, 95% CI: -2.29 to 1.76; p = 0.79) and Er,Cr:YSGG (-0.04, 95% CI: -1.43 to 1.35; p = 0.95) treated samples showed any significant overall mean differences in final push-out bond strength (PBS) compared with the control groups. Conclusions: Laser pretreatment of FP surfaces might not be effective in providing high PBS. FP surface are susceptible to damage of high-level laser irradiation and might show decreased bond strength.

Mechanical properties of glass-fibre-reinforced composite posts after laser irradiation with different energy densities

The aim of the present study was to evaluate the effect of the surface treatments on flexural strengths and flexural modulus of glass-fibre-reinforced composite (GFRC) posts. Sixty-three posts were randomly divided into 9 groups (n = 7), and various surface treatments were performed. The control group was left untreated. Other groups were treated with 9% hydrofluoric acid, sandblasting with 120 µm Al₂ O₃ particles and Er,Cr:YSGG laser irradiation with different powers (1 W, 2 W, 3 W, 4 W, 5 W and 6 W). The samples were subjected to 3-point bending test, and data were calculated. Statistical analysis was performed. The flexural strengths of fibre posts treated with sandblasting, hydrofluoric acid, 1 W and 2 W laser were statistically similar with control group (P > 0.01). However, the flexural strength of fibre posts treated with 3 W, 4 W, 5 W and 6 W laser was statistically lower than control group (P < 0.01). High laser irradiations cause melting on the post surface and breaks in fibrils.

The Effect of Diode and Er,Cr:YSGG Lasers on the Bond Strength of Fiber Posts

Background: Laser irradiation modifies the topography and composition of dentin surface aiming to increase the retention of bonded posts. Objective: To assess the effect of dentin irradiation with Er,Cr:YSGG or diode lasers on the bond strength of fiber posts using self-adhesive resin cement. Materials and methods: Sixty bovine root canals were root-canal treated, post spaces were prepared, and subsequently fiber posts were cemented. The samples were distributed according to the surface treatment: distilled water (control), Er,Cr:YSGG (1.5 W, 20 sec), or diode (1.5 W, 20 sec) lasers. Bond strengths were assessed by pull-out (n = 10) or push-out testing (n = 10). Pearson's correlation was calculated. Failure mode after testing and the depth of tags in the dentinal tubules were analyzed by confocal laser microscopy. Data were submitted to analysis of variance and Tukey's test. A p < 0.05 was considered significant. Results: In the push-out test, Er,Cr:YSGG laser had significantly different higher values (5.43 ± 0.10 MPa) compared to the control (4.79 ± 0.05 MPa). Diode laser values were not significantly different from the other groups (5.12 ± 0.27 MPa). In the pull-out test, there were no significant differences between Er,Cr:YSGG (6.86 ± 2.16 MPa) and diode (8.43 ± 1.77 MPa) lasers, and both had significant differences compared to the control (4.18 ± 1.29 MPa). No correlation was found. Adhesive failures were predominant in all groups, and no significant differences in tag penetration among the groups were found. Conclusions: The Er,Cr:YSGG laser increases the bond strength of resin cement and fiber post to dentin in both tests, compared to control group without laser treatment. Diode laser only enhanced bonding for pull-out test.

A Comparative Study of Laser Irradiation Versus Sandblasting in Improving the Bond Strength of Titanium Abutments

Objective: The purpose of this study was to evaluate the effects of Er,Cr:YSGG laser irradiation with different energy powers versus sandblasting for enhancing the tensile bond strength (TBS) between titanium implant abutments (IAs) and resin cements. Background data: Clinical decementation of prosthetic restorations often occurs, particularly on short IAs. Increasing the bonding area on the IA surface can enhance the function and longevity of the superstructure. Materials and methods: Fifty dental IAs were used in solid form and randomly assigned to five groups (n = 10 each) for the following different pretreatments: control group was left untreated, a laser operating at 2.78 μm wavelength with different energy powers (1, 2, and 3 W) was used for three laser groups, and 50 μm alumina particles were applied to the abutment surface for the sandblasting group. Fifty metal substructures that had an occlusal metal O-ring were cast and cemented to all abutments using dual-cure resin cement. Test specimens were then subjected to thermal cycling. TBS tests were performed with a universal testing machine. The specimens' surface topography and roughness were evaluated with scanning electron microscope, and energy dispersive spectroscopy (EDS) was used to measure the elemental profiles of each specimen. Data were analyzed using a one-way analysis of variance/Kruskal-Wallis test at a significance level of p < 0.05. Results: Surface treatments affected the surface roughness and TBS of the IA. The sandblasting group showed the highest bond strength values (510.77 ± 60.86 N) and followed by the 2 W group (279.07 ± 37.9 N). In EDS analysis, no elemental components other than titanium and oxygen were observed, except for in the sandblasting group. Conclusions: Sandblasting and 2 W laser treatment increased the surface roughness of the IA, which could contribute to the increased interfacial bond strength between the IA and resin cement.

Bonding durability of titanium tetrafluoride treated glass fiber post with resin cement

This study evaluated the effect of titanium tetrafluoride (TiF₄) solution on the bond strength of glass fiber post to resin cement. The specimens were divided into eight groups according to the method of surface treatment performed. Flexural properties and microtensile bond strength (µTBS) were determined. Data were analyzed using two-way ANOVA and Tukey's post hoc tests. The highest µTBS achieved with the TiF₄ (4 wt/v%-4 min) group compared with the other groups (p<0.05). This finding could be attributed to the effectiveness of TiF₄ (4 wt/v%-4 min) on removing the surface layer of the resin matrix of fiber posts that provides more uncovered surface areas of posts which improved the micromechanical retention of the resin cement. Surface treatments did not affect the flexural properties of fiber posts (p>0.05). Surface treatment of fiber post with TiF₄ (4 wt/v%-4 min) solution exhibited higher bond strength to resin cement compared with other surface treatments.

Bond Strength of Fiber Posts to Composite Core: Effect of Surface Treatment With Er,Cr:YSGG Laser and Thermocycling

Introduction: This study aimed to determine the bond strength of fiber post to composite core following surface treatment with Er,Cr:YSGG laser at different powers and sandblasting with and without thermocycling. Methods: In this experimental study, 30 fiber posts (Glassix, Nordin, Switzerland) were randomly divided into 5 groups of sandblasting, no treatment and laser irradiation at 1, 1.5 and 2 W powers. Following composite filling and mounting, 1-mm thick sections were made for pushout bond strength testing. Half of the samples in each group were subjected to thermocycling (n=15). Two-way analysis of variance (ANOVA) was used to analyze the bond strength values. Pairwise comparisons were made using Tukey test (P<0.05). Results: Effect of treatment method on push-out bond strength of fiber post to composite core was significant (P=0.017), while thermocycling had no significant effect on bond strength (P=0.964). Pairwise comparison of surface treatment methods revealed no significant difference in groups with and without thermocycling (P>0.05), but Er,Cr:YSGG laser irradiation with 1 W power yielded significantly higher bond strength than the control group (P=0.01). Conclusion: Irradiation of Er,Cr:YSGG laser at 1 W power increased the bond strength of fiber post to composite core. Thermocycling slightly decreased the bond strength at the fiber postcore interface.

Radiopacity of Esthetic Post Materials: Evaluation with Digital Analysis Technique

PURPOSE

To evaluate the radiopacity of five post materials using a digital image analysis method.

MATERIALS AND METHODS

Twelve specimens from each post type (two zirconia and three fiber based) of 2 mm in thickness were obtained using a diamond blade mounted on a cutting machine, and digital radiographs were taken along with aluminum step-wedge and dentin discs under standard exposure conditions. The mean gray-values of specimens were measured using a computer graphics program. Data were analyzed using one-way ANOVA followed by Holm-Sidak multicomparison test (p = 0.05).

RESULTS

The highest radiopacity was observed in custom zirconia (5.842 millimeters of equivalent Al [mmAl]), and the lowest value was detected with FRC-Postec (Ivoclar Vivadent) (1.716 mmAl). Significant differences were revealed between the radiopacity values among all groups (p < 0.05), except the Zr post materials (p = 0.56).

CONCLUSIONS

All tested post materials had higher radiopacity than dentin. Further studies will be required to clarify optimum radiopacity properties of the post materials to provide a precise clinical observation.