The Effect of Photodynamic Therapy and Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on the Remineralization Rate of Non-Cavitated Root: an In-vitro Study

Using laser treatments and calcium and phosphate compounds to enhance remineralization has been investigated in this study. Seventy two premolar teeth were divided into four groups of 18: 1) control group; 2) laser therapy group; 3) CPP-ACP paste group; and 4) laser therapy and CPP-ACP group. Mineralization and remineralization of samples were investigated by Diagnodent. Data were reported using descriptive statistics (mean, standard deviation) and One Way ANOVA; they were analyzed using SPSS.16 statistical software. Statistical analysis showed that groups 3 and 4 had the highest rate of remineralization compared to groups 1 and 2. According to the results of this study, mineralization ranged decreasingly from group 4 to groups 3, 2, and 1, respectively. The antibacterial effect of laser therapy, leading to remineralization of calcium and phosphorus compounds, was the most effective on controlling root decay.

Antibacterial activity of self-adhesive resin cements against Streptococcus mutans at different time intervals

BACKGROUND AND OBJECTIVES

Self-adhesive resin cements release fluoride and have cytotoxic and preventive monomers against the bacteria in their composition. They have acidic property before their complete setting too. The antibacterial activity of three different self-adhesive resin cements against Streptococcus mutans at different time intervals was investigated in this study.

MATERIALS AND METHODS

The modified direct contact test was used to evaluate the antibacterial effect of Max-Cem, G-Cem and Bis-Cem on S. mutans after aging the samples in phosphate-buffered saline solution for one hour, 24 hours and 1 week. Data were analyzed using one-way ANOVA, repeated measurement ANOVA and Tukey HSD tests (P<0.05).

RESULTS

The differences in the mean bacterial counts between all the study groups and between the study groups and the corresponding control groups were significant at 1-hour and 24-hour intervals (P<0.001). At 1-week, only the differences between Bis-Cem and G-Cem, between Max-Cem and Bis-Cem, and between Bis-Cem and the corresponding control group were significant (P<0.001). There were significant differences between G-Cem and Max-Cem at all the time intervals (P<0.001). In addition, with the use of Bis-Cem there were significant differences between 1-hour and 1-week (P=0.01) and 24-hour and 1-week (P<0.001).

CONCLUSION

All the cements exhibited antibacterial activity after 1 hour and 24 hours. However, after 1 week, only Bis-Cem retained its antibacterial activity.

Effect of preheat repetition on color stability of methacrylate- and silorane-based composite resins

Background. The aim of this study was to investigate the effect of preheating methacrylate- and silorane-based composite resins on their color stability up to 40 times at 55‒60°C.

Methods. Seventy-six methacrylate and silorane-based composite resin samples, with a diameter of 10 mm and a height of 2 mm, were divided into 4 groups (n=19). After the samples were prepared, their color parameters were determined using a reflective spectrophotometer. The composite resin samples were separately stored in a solution of tea for 40 consecutive days. Then the samples underwent a color determination procedure again using a spectrophotometer and color changes were recorded. Finally two-way ANOVA was used to study the effect of composite temperature on its staining (P<0.05). Independent-samples t-test was used to evaluate changes in conversion rates of preheated composite resin samples compared to non-heated samples at P=0.005 and P=0.029 for silorane-based and Z250 composite resin samples, respectively.

Results. Both composite resin type (P=0.014) and preheating (P<0.001) had significant effects on ΔE.

Conclusion. Repeated preheating of methacrylate- and silorane-based composite resin samples, up to 55‒60°C for 40 rounds, resulted in more color changes compared with unheated composite resin samples. After storage in a solution of tea the color change rate in the composite resin samples of silorane-based was higher than the Z250 composite resin samples.

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

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

Reparability of giomer using different mechanical surface treatments

Background

In the repair process achieving high bond strength between the new and old resin based materials is necessary for clinical longevity. This study compared the effect of three different mechanical surface treatments (air abrasion, Nd:YAG laser and diamond bur) on the repair bond strength of giomer.

Material and Methods

In this in vitrostudy, 125 cylindrical giomer samples were used. The giomer samples were randomly assigned to 5 groups (n=25). In group 1, the samples did not undergo any surface treatment. In groups 2 to 4, the samples underwent surface treatments with air abrasion, Nd:YAG laser and a diamond bur. The samples in group 5 were prepared to measure giomer cohesive strength. Subsequently, the new giomer was bonded to the existing giomer in groups 1 to 4. Then the repair bond strength of the samples was measured. One-way ANOVA and post hoc Tukey test were used to compare the bond strength.

Results

There were significant differences between the different surface treatments (P<0.001); the repair bond strength in the air abrasion group was significantly higher than that in the Nd:YAG laser group, in which it was significantly higher than that in the diamond bur group, which was in turn higher than that in group 1 (no surface treatment) (P<0.001). In addition, the cohesive strength of giomer was significantly higher than the repair bond strength in the 4 other study groups (P<0.001).

Conclusions

Of all the surface treatments, air abrasion and Nd:YAG laser, in descending order, yielded the highest repair bond strength values, with the repair bond strength values of 60‒70% of the giomer cohesive strength.

Key words:Air abrasion, bond strength, giomer, Nd:YAG laser, repair, surface treatment.

Comparison of multiple rebond shear strengths of debonded brackets after preparation with sandblasting and CO2 laser

Background. Failure of orthodontic bracket bonds is a common occurrence during orthodontic treatment. Different techniques have been suggested in the literature to remove resin residues from the bracket bases and enamel surfaces to prepare the surfaces again after debonding. This study attempted to compare multiple rebond shear strengths (SBS) of debonded brackets following preparation with sandblasting and CO₂ laser.

Methods. The brackets were bonded on 30 human and bovine maxillary central incisors using self-curing composite resin. SBS was measured using Hounsfield testing machine. The brackets were rebonded for two other times after composite resin residues on their surfaces were removed, either with air abrasion or CO₂ laser. The debonded brackets and enamel surfaces were also evaluated after each debonding procedure under a stereomicroscope in order to determine adhesive remnant index (ARI). SBS of debonded brackets after each step were compared between sandblast and CO₂ laser groups.

Results. We observed significant differences in SBS values between pre-recycling and first (P = 0.04), second (P = 0.007) and third recycling (P = 0.007) with laser. Recycling with sandblasting resulted in a decrease in SBS after the first and second recycling procedure; however, the SBS increased after the third recycling procedure, with no significant differences.

Conclusion. SBS of brackets after recycling with sandblasting and laser beams was not significantly different, and both were at a favorable level. However, repeating the recycling procedure with sandblasting resulted in more favorable SBS compared to laser.

Comparative CBCT evaluation of the efficacy of Nd:YAG laser and K3 rotary system in non-surgical root canal retreatment

BACKGROUND

The aim of the present study was to compare the efficacy of Nd:YAG laser and K3 rotary system in the non-surgical root canal retreatment.

METHODS

Sixty-one rooted human teeth were divided into two groups of 30 after root canal therapy. In groups 1 and 2 root canal retreatments were carried out using K3 rotary system and Nd:YAG laser, respectively. CBCT images were used to evaluate canal transportation and root canal debridement at coronal, middle and apical canal cross-sections. In addition, the time necessary for canal debridement and the temperature on the external root surface were calculated. Mann-Whitney U test was used for statistical analysis of data with SPSS 17 after means ± SD were calculated. Shapiro-Wilk test was used to evaluate normal distribution of data. Statistical significance was defined at P<0.05.

RESULTS

The mean time necessary for the debridement of root canals in the laser group was significantly shorter than that in the K3 group (P=0.001). However, there were no significant differences in external root surface temperatures between the two groups (P=0.17). The coronal third of the canals was cleaner in the laser group significantly (p=0.01). Less canal transportation was seen in the laser group compared to the K3 group, significantly (P=0.04).

CONCLUSIONS

Nd:YAG is superior to K3 rotary system in the non-surgical root canal retreatment because it is faster and results in less canal transportation in the middle and apical thirds of the canals.

Scanning electron microscopy comparison of the cleaning efficacy of a root canal system by Nd:YAG laser and rotary instruments

This study evaluated the cleaning efficacy of a root canal system by Nd:YAG laser and rotary instruments. Sixty single-rooted human teeth were divided into four experimental groups (n=15). In the first group the teeth were prepared with a step-back technique using conventional K-files. In the second and third groups, tooth preparation was carried out using Nd:YAG laser and rotary NiTi instruments, respectively. Teeth in the fourth group were prepared by combined laser and rotary methods. The smear layer remaining on canal walls was then assessed by scanning electron microscopy in the coronal, middle, and apical portions. The comparison of smear layer removal efficacy between groups was carried out by Kruskal-Wallis and Mann-Whitney U tests. The mean grades of smear layer removal in rotary-laser, rotary, laser and step-back techniques were 1.34 ± 0.18, 2.2 ± 0.28, 1.91 ± 0.25, and 2.42 ± 0.19, respectively. On the whole, differences between rotary-laser and rotary groups, step-back, and the three other techniques (rotary, laser, and rotary-laser) were significant at p=0.034. Based on the findings of this study, the cleaning efficacy of rotary, laser, and rotary-laser techniques were better than the step-back technique and the combined laser and rotary technique was the most efficient method.

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

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

Antimicrobial efficacy of photodynamic therapy and sodium hypochlorite on monoculture biofilms of Enterococcus faecalis at different stages of development

BACKGROUND AND OBJECTIVE

As the Enterococcus faecalis biofilm ages, it is likely that bacteria in mature and old biofilms will become more resistant to commonly used antibacterial irrigants. Photodynamic therapy (PDT) has been used to kill resistant bacteria organized in a biofilm. This study aimed to investigate the antimicrobial effectiveness of 1% sodium hypochlorite (NaOCl), 2.5% NaOCl, and PDT on E. faecalis biofilm at different stages of development.

METHODS

In this study 4-, 6-, and 8-week-old E. faecalis biofilms were subjected to one of the following approaches: phosphate-buffered saline solution (PBS), PDT, or 1% and 2.5% NaOCl. Dentin chip suspensions were used for colony forming units (CFU) counting to estimate remaining E. faecalis counts.

RESULTS

PDT and 2.5% NaOCl completely eliminated E. faecalis biofilms in three stages of biofilm development, whereas 1% NaOCl resulted in 81.88%, 85.73%, and 78.62% reductions of bacterial counts in 4-, 6-, and 8-week-old biofilms, respectively, which was significantly more than PBS.

CONCLUSIONS

The bacteria in mature and old biofilms were more resistant to 1% NaOCl than were the bacteria in young biofilms. Overall survival and residual bacteria increase with biofilm aging. PDT and the 2.5% NaOCl solution were equally efficient in completely eliminating E. faecalis biofilms at all three stages.

Effect of Nd:YAG laser pulse energy on mercury vapor release from the dental amalgam

OBJECTIVE

The aim of this study was to evaluate the effect of different pulse energies of Nd:YAG laser on the amalgam ablation, and its effect on the amount of mercury vapor release from amalgam.

BACKGROUND DATA

Toxic vapor release from amalgam restorations at the laser focus site is possible.

MATERIALS AND METHODS

Forty-five amalgam samples (4 mm in diameter and 5 mm in height) were placed in sealed containers and underwent Nd:YAG laser irradiation with pulse energies of 50, 150, and 250 mJ at a distance of 1 mm from the amalgam surface for 4 sec. Subsequently, 150 mL of air was collected from the inside of the container using an Apex Pump to analyze the amount of mercury vapor in the air samples using a mercury vapor analyzer. Data were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p<0.05).

RESULTS

The amount of mercury vapor release significantly increased with an increase in the pulse energy of Nd:YAG laser (p<0.001). In addition, the amount of mercury vapor release with 250 mJ pulse energy was significantly higher compared with the standard mercury vapor concentration (50 μg/m(3)) (p<0.001). Nd:YAG laser produced cavities on the amalgam surface, which increased in size with an increase in the energy of the laser beam.

CONCLUSIONS

The amount of mercury vapor significantly increased with an increase in the pulse energy of the laser beam, and was significantly higher than the standard mercury vapor concentration with 250 mJ pulse energy.

Comparison of the Effect of Nd:YAG and Diode Lasers and Photodynamic Therapy on Microleakage of Class V Composite Resin Restorations

Background and aims

Considering the importance of disinfecting dentin after cavity preparation and the possible effect of disinfection methods on induction of various reactions between the tooth structure and the adhesive restorative material, the aim of the present study was to evaluate microleakage of composite resin restorations after disinfecting the prepared dentin surface with Nd:YAG and Diode lasers and photodynamic therapy.

Materials and methods

Standard Class V cavities were prepared on buccal surfaces of 96 sound bovine teeth. The samples were randomly divided into 4 groups based on the disinfection method: Group 1: Nd:YAG laser; Group 2: Diode laser; Group 3: photodynamic therapy; and Group 4: the control. Self-etch bonding agent (Clearfil SE Bond) was applied and all the cavities were restored with composite resin (Z100). After thermocycling and immersing in 0.5% basic fuchsin, the samples were prepared for microleakage evaluation under a stereomicroscope. Data was analyzed with Kruskal-Wallis and Wilcoxon signed-rank tests at P<0.05.

Results

There were no significant differences in the microleakage of occlusal and gingival margins between the study groups (P>0.05). There were no significant differences in microleakage between the occlusal and gingival margins in the Nd:YAG laser group (P>0.05). In the other groups, microleakage at gingival margins was significantly higher than that at the occlusal margins (P<0.05).

Conclusion

Nd:YAG and Diode lasers and photodynamic therapy can be used to disinfect cavity preparations before composite resin restorations.

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

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

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

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

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

Bactericidal effects of Nd:YAG laser irradiation and sodium hypochlorite solution on Enterococcus faecalis biofilm

OBJECTIVE

The aim of this study was to evaluate the bactericidal effects of Nd:YAG laser on biofilm of Enterococcus faecalis.

BACKGROUND DATA

It is difficult to eliminate bacterial biofilms with routine endodontic preparation techniques. It might be possible to eliminate biofilms remaining in the root canals of teeth with lasers.

MATERIALS AND METHODS

The root canals of 60 extracted teeth were prepared and E. faecalis biofilms were formed within the root canals. Then the teeth were randomly divided into four groups of 15. Group 1 samples did not undergo any interventions, to serve as controls. Group 2 samples underwent a 3-W laser beam for 10 sec. The root canals in group 3 were irrigated with 1% sodium hypochlorite for 15 min and then irradiated with a 3-W laser beam for 10 sec. The root canals in group 4 were irrigated with 1% sodium hypochlorite for 15 min. Dentin chips were collected from the root canal walls and weighed. Then the chips were used to prepare a suspension. The classic colony-forming unit (CFU) counting technique was used to determine remaining bacterial counts.

RESULTS

The bacterial counts in groups 2 and 4 had decreased to 54% and 2.39% of the control group, respectively. In group 3 no bacterial growth was observed. There were no significant differences between groups 1 and 2 (p>0.05).

CONCLUSIONS

Based on the results of the present study, the effect of Nd:YAG laser beam on E. faecalis biofilm is less than that of sodium hypochlorite solution. A combination of laser and sodium hypochlorite results in complete elimination of E. faecalis biofilm.

Cervical Margin Integrity of Class II Resin Composite Restorations in Laser- and Bur-Prepared Cavities Using Three Different Adhesive Systems

One of the challenges in durability of posterior tooth-colored restorative materials is polymerization shrinkage, which results in gap formation between the restoration and tooth structure. The aim of the present study was to investigate marginal adaptation of Class II composite restorations using a self-etching and two etch-and-rinse adhesive systems in cavities prepared either with bur or Er,Cr:YSGG laser. A total of 45 extracted sound human premolars were selected. In each tooth, mesial and distal Class II cavities were prepared either by a diamond bur or by Er,Cr:YSGG laser with the margins 1 mm apical to the cemento-enamel junction. Then the teeth were randomly divided into three groups of 15 each, according to the type of the adhesive system used (Single Bond, Single Bond 2, and Adper Easy One adhesive systems). Subsequent to restoring the teeth, the specimens were subjected to thermal cycling between 5 ± 2°C and 55 ± 2°C for 500 cycles and were then cut longitudinally into two halves using a diamond disk. Marginal adaptation was evaluated using a stereomicroscope, and the values for gap widths were obtained in micrometers. Data were analyzed using two-factor analysis of variance and post hoc tests. There were statistically significant differences in mean marginal gap widths between the adhesive type and preparation groups (p&lt;0.05). The interfacial gap width in bur-prepared cavities was significantly less than that in laser-prepared cavities, and the lowest gap width was observed in Adper Easy One regardless of the type of the preparation.

Effect of surface treatment with sandblasting and Er,Cr:YSGG laser on bonding of stainless steel orthodontic brackets to silver amalgam

Objectives: Satisfactory bonding of orthodontic attachments to amalgam is a challenge for orthodontists. The aim of this in vitro study was to compare the shear bond strength of stainless steel orthodontic brackets to silver amalgam treated with sandblasting and Er,Cr:YSGG laser. Study Design: Fifty-four amalgam discs were prepared, polished and divided into three groups: In group 1 (the control group) the premolar brackets were bonded using Panavia F resin cement without any surface treatment; in groups 2 and 3, the specimens were subjected to sandblasting and Er,Cr:YSGG laser respectively, before bracket bonding. After immersing in distilled water at 37°C for 24 hours, all the specimens were tested for shear bond strength. Bond failure sites were evaluated under a stereomicroscope. Data was analyzed using one-way ANOVA and a post hoc Tukey test. Results: The highest and lowest shear bond strength values were recorded in the laser and control groups, respectively. There were significant differences in mean shear bond strength values between the laser and the other two groups (p<0.05). However, there were no significant differences between the sandblast and control groups (p=0.5). Conclusions: Amalgam surface treatment with Er,Cr:YSGG laser increased shear bond strength of stainless steel orthodontic brackets.

Key words: Amalgam, surface treatment, shear bond strength, sandblasting, Er,Cr:YSGG laser.

Effect of three different mouthrinses on microleakage of composite resin restorations with two adhesive systems after bleaching with 10% carbamide peroxide

AIM

The aim was to evaluate the effects of Oral-B (OB), Listerine (LN) and Rembrandt Plus (RM) mouthrinses on microleakage of composite resin restorations bonded with two adhesive systems after bleaching with 10% carbamide peroxide.

MATERIALS AND METHODS

A total of 60 Cl V cavities were prepared on human premolars. The occlusal and gingival margins were placed 1 mm occlusal to and apical to CEJ respectively. The teeth were randomly divided into two groups based on the adhesive system used: Excite (EX) and Clearfil SE Bond (CSE) groups. After composite resin restoration of cavities, thermocycling and bleaching with 10% carbamide peroxide for 2 hours daily for 14 days, the teeth in each adhesive group were further subdivided into three subgroups and were immersed for 12 hours in the three OB, RM and LN mouthrinses. The teeth were then placed in 2% basic fuschin for 24 hours. After dissecting the teeth, microleakage was evaluated under a stereomicroscope at 16×. Data was analyzed with multifactor ANOVA and Bonferroni test at p < 0.05.

RESULTS

Microleakage with EX was significantly higher than that with CSE (p = 0.009). Microleakage at gingival margins was significantly higher than that at occlusal margins (p = 0.15). Microleakage with OB was higher than that with LN (p = 0.02). However, there were no significant differences in microleakage between LN and RM (p = 1) and between RM and OB (p = 0.15). In addition, with the EX adhesive system, microleakage with OB was higher than that with LN and RM (p = 0.02).

CONCLUSION

In the present study, microleakage of composite resin restorations was influenced by the type of the adhesive system, mouthrinse type and the location of the cavity margin.

CLINICAL SIGNIFICANCE

Use of some mouthrinses, such as OB after bleaching can increase postrestoration microleakage of resin composite restorations bonded with etch-and-rinse adhesive systems.

Contamination of dental unit water and air outlets following use of clean head system and conventional handpieces

Background and aims

Dental handpiece is a source of contamination because it is in constant touch with the oral cavity. Sterilization does not seem to be sufficient to prevent penetration of microorganisms into air and water lines of the unit, because negative pressure developed by valves (which are placed in water outlets) and post shut-off inertial rotation of handpiece result in water and debris being sucked into air and water outlets of dental unit. The aim of this study was to compare dental unit contamination following use of clean head system handpieces and conventional handpieces.

Materials and methods

Twenty-two dental units in the Department of Pediatric Dentistry in Shahid Beheshti Faculty of Dentistry were used for the purpose of this study. A 1.5×108 cfu/mm3 concentration of Staphylococcus epidermis (SE) was used to contaminate the air and water outlets of dental units. Ten clean head system handpieces and 10 conventional handpieces were used for 30 seconds in the above-mentioned suspension. Microbial samples were collected from the air and water lines. Culturing and colony counting procedures were carried out. Data was analyzed by t-test; a value of p<0.01 was considered significant.

Results

Results demonstrated a significantly lower SE contamination in water outlets following the use of clean head system (p<0.01).

Conclusion

A lower tendency of clean head system handpieces to transmit SE compared to conventional system makes them a better choice for infection control.