Diode Laser Irradiation Effects on the Sealing Ability of Root Canal Sealers

This study aimed to test the hypothesis that dentine alterations induced by 810 nm-diode laser may affect the interaction between root canal sealers and the dentin wall. Seventy-two single root human teeth were selected and root canals were enlarged with K-files. Dentine was treated with 0.5% NaOCl and 17% EDTA-T and irradiated (laser group) by diode laser (810 nm/P = 2.5W/I = 1989 W/cm(2)) or remained non-irradiated (control group). Six samples per group were analyzed by scanning electron microscopy (SEM). The remaining samples of each group were divided into three subgroups (n = 10) and sealed with one of the tested sealers (N-Rickert/AHPlus (TM)/Apexit (R)). Apical leakage was estimated by evaluating penetration of 0.5% methylene-blue dye. SEM analysis revealed that dentine at the apical third in irradiated samples was melted and fusioned whereas non-irradiated samples exhibited opened dentinal tubules. Despite the morphological changes induced by irradiation, laser did not affect the sealing ability of N-Rickert and AHPlus (TM) sealers. However, the length of apical leakage in roots filled with Apexit (R) was lower in irradiated root canals than in non-irradiated samples (p < 0.05). Morphological changes of root canal walls promoted by diode laser irradiation may improve de sealing ability of Apexit (R), a calcium hydroxide-based sealer, suggesting that improved sealing promoted by irradiation may represent an additional factor contributing to the endodontic clinical outcome.

Micro-hardness evaluation of a micro-hybrid composite resin light cured with halogen light, light-emitting diode and argon ion laser

This in vitro study aimed to determine whether the micro-hardness of a composite resin is modified by the light units or by the thickness of the increment. Composite resin disks were divided into 15 groups (n = 5), according to the factors under study: composite resin thickness (0 mm, 1 mm, 2 mm , 3 mm and 4 mm) and light units. The light activation was performed with halogen light (HL) (40 s, 500 mW/cm(2)), argon ion laser (AL) (30 s, 600 mW/cm(2)) or light-emitting diode (LED) (30 s, 400 mW/cm(2)). Vickers micro-hardness tests were performed after 1 week and were carried out on the top surface (0 mm-control) and at different depths of the samples. Analysis of variance (ANOVA) and Tukey tests (P a parts per thousand currency signaEuro parts per thousand 0.05) revealed no statistically significant difference among the light units for the groups of 0 mm and 1 mm thickness. At 2 mm depth, the AL was not statistically different from the HL, but the latter showed higher micro-hardness values than the LED. In groups with 3 mm and 4 mm thickness, the HL also showed higher micro-hardness values than the groups activated by the AL and the LED. Only the HL presented satisfactory polymerization with 3 mm of thickness. With a 4 mm increment no light unit was able to promote satisfactory polymerization.

Effect of defocused infrared diode laser on salivary flow rate and some salivary parameters of rats

This study aims to investigate whether infrared diode low-level laser therapy (LLLT) increased salivary flow rate and altered pH value, protein concentration, and peroxidase and amylase activities in saliva of rats. Wistar rats were used and divided into three groups. Experimental groups (A and 13) had their parotid, submandibular and sublingual glands submitted to diode laser, 808-nm wavelength, on two consecutive days. The dose results were 4 and 8 J/cm(2), respectively. A red guide light was used to visualize the irradiated area. Group C was irradiated only with red pilot beam and served as control. The saliva samples were collected after each irradiation step (first and second collection days) and 1 week after the first irradiation (seventh day). Statistical analysis was performed, and differences were observed according to different days of salivary collection. The results showed that salivary flow rate for groups A and B was higher on the seventh day if it is compared to data obtained for the first day (p<0.05). LLLT applications on salivary glands are a therapy procedure that requires further studies.

Morphological Alterations of Radicular Dentine Pretreated With Different Irrigating Solutions and Irradiated With 980-nm Diode Laser

Background: The topographical features of intraradicular dentine pretreated with sodium hypochlorite (NaOCl) or ethylenediamine tetraacetic acid (EDTA) followed by diode laser irradiation have not yet been determined. Purpose: To evaluate the alterations of dentine irradiated with 980-nm diode laser at different parameters after the surface treatment with NaOCl and EDTA. Study design: Roots of 60 canines were biomechanically prepared and irrigated with NaOCl or EDTA. Groups were divided according to the laser parameters: 1.5 W/CW; 1.5 W/100 Hz; 3.0 W/CW; 3.0 W/100 Hz and no irradiation (control). The roots were splited longitudinally and analyzed by scanning electron microscopy (SEM) in a quali-quatitative way. The scores were submitted to two-way Kruskal-Wallis and Dunn`s tests. Results: The statistical analysis demonstrated that the specimens treated only with NaOCl or EDTA (control groups) were statistically different (P < 0.05) from the laser-irradiated specimens, regardless of the parameter setting. The specimens treated with NaOCl showed a laser-modified surface with smear layer, fissures, and no visible tubules. Those treated with EDTA and irradiated by laser presented absence of smear layer, tubules partially exposed and melting areas. Conclusions: The tested parameters of 980-nm diode laser promoted similar alterations on dentine morphology, dependent to the type of surface pretreatment. Microsc. Res. Tech. 72:22-27, 2009. (C) 2008 Wiley-Liss, Inc.

Bond strength of AH Plus and Epiphany sealers on root dentine irradiated with 980 nm diode laser

Aim To evaluate the bond strength of AH Plus and Epiphany sealers to human root canal dentine irradiated with a 980 nm diode laser at different power and frequency parameters, using the push-out test. Methodology Sixty canine roots were sectioned below the cementoenamel junction to provide 4-mm-thick dentine discs that had their root canals prepared with a tapered bur and irrigated with sodium hypochlorite, ethylenediaminetetraacetic acid and distilled water. The specimens were assigned to five groups (n = 12): one control (no laser) and four experimental groups that were submitted to 980 nm diode laser irradiation at different power (1.5 and 3.0 W) and frequency (continuous wave and 100 Hz) parameters. Half of specimens in each group had their canals filled with AH Plus sealer and half with Epiphany. The push-out test was performed and data (MPa) were analysed statistically by ANOVA and Tukey`s test (P < 0.05). The specimens were split longitudinally and examined under SEM to assess the failure modes after sealer displacement. Results The specimens irradiated with the diode laser and filled with AH Plus had significantly higher bond strength values (8.69 +/- 2.44) than those irradiated and filled with Epiphany (3.28 +/- 1.58) and the nonirradiated controls (3.86 +/- 0.60). The specimens filled with Epiphany did not differ significantly to each other or to the control (1.75 +/- 0.69). There was a predominance of adhesive failures at Epiphany-dentine interface (77%) and mixed failures at AH Plus-dentine interface (67%). Conclusions The 980 nm diode laser irradiation of root canal dentine increased the bond strength of AH Plus sealer, but did not affect the adhesion of Epiphany sealer.

Effect of 980-nanometer diode laser on root canal permeability after dentin treatment with different chemical solutions

This study evaluated the effect of 980-nm diode laser at different parameters on root canal dentin permeability associated with different irrigants. Seventy-five canines were sectioned at 15 mm from the apex, prepared mechanically up to #40 .02 instrument, and irrigated with 2 mL distilled water. Final irrigation (10 mL) was used as follows: (1) distilled water; (2) 1% NaOCl; (3) 17% ethylenediaminetetraacetic acid + a cationic surfactant cetyltrimethylammonium bromide (EDTAC). Laser was applied at 1.5 or 3.0 W as either continuous wave or pulsed wave (100 Hz). The teeth were then processed histochemically, the percentage of copper ion penetration into the dentin of the canal walls was counted, and the data were analyzed statistically with the Tukey-Kramer test (alpha < .01). When laser was associated with water, an increase in permeability was found, whereas permeability decreased when associated with EDTAC. Dentin permeability after laser irradiation was directly dependent on the solution used for final irrigation.

High-power diode laser in the disinfection in depth of the root canal dentin

Objective. The objective of this study was to evaluate the disinfection degree of dentine caused by the use of diode laser after biomechanical procedures. Study design. Thirty teeth were sectioned and roots were autoclaved and incubated for 4 weeks with a suspension of Enterococcus faecalis. The specimens were randomly divided into 3 groups (n = 10): G1, instrumented with rotary files, irrigated with 0.5% sodium hypochlorite and 17% EDTA-T, and then irradiated by 830-nm diode laser at 3 W; G2, the same procedures as G1 but without laser irradiation; and G3, irrigation with saline solution (control). Dentin samples of each third were collected with carbide burs and aliquots were sowed to count viable cells. Results. The disinfection degree achieved was 100% in G1 and 98.39% in G2, when compared to the control group (G3). Conclusion. Diode laser irradiation provided increased disinfection of the deep radicular dentin in the parameters and samples tested.

Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial

The high intensity diode laser has been studied in periodontics for the reduction of subgingival bacteria in non-surgical treatment. Our study evaluated the bacterial effect as well as changes in periodontal clinical parameters promoted by root scaling and planing associated with this wavelength. Twenty-seven patients randomly assigned in two groups underwent root scaling and planing on the tested sites, and only the experimental group received the diode laser irradiation. Among the clinical parameters studied, the clinical probing depth (CPD) and the clinical attachment level (CAL) resulted in significant enhancement in the control group when compared with the experimental group (P = 0.014 and P = 0.039, respectively). The results were similar for both groups regarding the plaque index (PI) and bleeding on probing (BP). No significant difference in the microbiological parameters was observed between the control and experimental groups. It was possible to conclude that the high power diode laser adjunct to the non-surgical periodontal treatment did not promote additional effects to the conventional periodontal treatment.

Histological analyses of thermal effect caused by 1.2 W diode laser irradiation at rat periodontal pockets

The aim of this in vivo study was to evaluate the thermal effects caused by 810 nm 1.2 W diode laser irradiation of periodontal tissues. Despite all data available concerning the laser application for periodontal treatment, one of the most relevant challenges is to prevent the harmful tissue heating induced by different clinical protocols. Periodontal pockets were induced at molars in 96 rats. Several irradiation powers under CW mode were investigated: 0, 400, 600, 800, 1000, 1200 mW. The pockets were irradiated using a 300 A mu m frontal illumination fiber. The animals were killed at 4 or 10 days after irradiation. The mandible was surgically removed and histologically processed. The histological sections stained with H/E demonstrated that irradiation parameters up to 1000 mW were thermally safe for the periodontal tissues. The sections stained with Brown & Brenn technique evidenced bacteria in the periodontal tissues. Consequently, the diode laser irradiation as a unique treatment was not capable to eliminate bacteria of the biofilm present in the pockets. According to the methodology used here, it was concluded that the thermal variation promoted by a diode laser can cause damage to periodontal tissues depending on the energy density used. The 1.2 W diode laser irradiation itself does not control the bacteria present in the biofilm of the periodontal pockets without mechanical action. The knowledge of proper high intensity laser parameters and methods of irradiation for periodontal protocols may prevent any undesirable thermal damage to the tissues.

Long-term follow-up of topical 5-aminolaevulinic acid photodynamic therapy diode laser single session for non-melanoma skin cancer

Photodynamic therapy (PDT) is based on the association of a light source and tight sensitive agents in order to cause the selective death of tumor cells. To evaluate topical 5-aminolaevulinic acid (5-ALA) and diode laser photodynamic single session therapy single session for non-melanoma skin cancer (NMSC), a long-term follow-up was performed. Nineteen Bowen`s disease (BD) and 15 basal cell. carcinoma (BCC) lesions were submitted to 6-h topical and occlusive 20% 5-ALA plus DMSO and EDTA, and later were exposed to 630 nm diode laser, 100 or 300 J cm(-2) dose. At 3 months tumor-free rate was 91.2% (31/34) whereas at 60 months, 57.7% (15/26), slightly higher in BCC (63.6%; 7/11). The relation between the reduction of the clinical response and the increase of tumor dimension observed at 18 months was lost at 60 months. The sBCC recurrence was earlier compared to the nBCC one. ALA-PDT offered important advantages: it is minimally invasive, an option for patients under risk of surgical complications; clinical feasibility; treatment of multiple lesions in only one session or lesions in poor heating sites and superior esthetical results. However, the recurrence rate increase after ALA-PDT diode laser single session can be observed at tong-term follow-up, and the repetitive sessions, an additional. advantage of the method, is strongly recommended. The clinical response and recurrence time seem to be related to the laser light dose and NMSC types/sub-types, thickness and dimension, which must be considered for the choice of the ALA-PDT. (C) 2009 Elsevier B.V. All rights reserved.

In vitro effect of low intensity laser on the cytotoxicity produced by substances released by bleaching gel

This in vitro study aimed to analyze the effect of different parameters of phototherapy with low intensity laser on the viability of human dental pulp fibroblasts under the effect of substances released by bleaching gel. Cells were seeded into 96 wells plates (1 x 10³ cells/well) and placed in contact with culture medium conditioned by a 35 % hydrogen peroxide bleaching gel for 40 minutes, simulating the clinical condition of the in-office bleaching treatment. Cells cultured in ideal growth conditions served as positive control group (PC), and the cells grown in conditioned medium and non-irradiated served as negative control group (NC). Cells grown in conditioned medium were submitted to a single irradiation with a diode laser (40 mW, 0.04 cm²) emitting at visible red (660 nm; RL) or near infrared (780 nm; NIR) using punctual technique, in contact mode and energy densities of 4, 6 or 10 J/cm². The cell viability was analyzed through the MTT reduction assay immediately and 24 hours after the irradiation. The data was compared by ANOVA followed by the Tukey's test (p < 0.05). The cell viability increased significantly in 24 hours within each group. The PC presented cell viability significantly higher than NC in both experimental times. Only the NIR/10 J/cm² group presented cell viability similar to that of PC in 24 hours. The phototherapy with low intensity laser in defined parameters is able to compensate the cytotoxic effects of substances released by 35 % hydrogen peroxide bleaching gel.

Effect of GaAlAs Laser Irradiation on the Epiphyseal Cartilage of Rats

Objective: To study the effect of an 830-nm gallium-aluminum-arsenic (GaAlAs) diode laser at two different energy densities (5 and 15 J/cm(2)) on the epiphyseal cartilage of rats by evaluating bone length and the number of chondrocytes and thickness of each zone of the epiphyseal cartilage. Background Data: Few studies have been conducted on the effects of low-level laser therapy on the epiphyseal cartilage at different irradiation doses. Materials and Methods: A total of 30 male Wistar rats with 23 days of age and weighing 90 g on average were randomly divided into 3 groups: control group (CG, no stimulation), G5 group (energy density, 5 J/cm(2)), and G15 group (energy density, 15 J/cm(2)). Laser treatment sessions were administered every other day for a total of 10 sessions. The animals were killed 24 h after the last treatment session. Histological slides of the epiphyseal cartilage were stained with hematoxylin-eosin (HE), photographed with a Zeiss photomicroscope, and subjected to histometric and histological analyses. Statistical analysis was performed using one-way analysis of variance followed by Tukey's post hoc test. All statistical tests were performed at a significance level of 0.05. Results: Histological analysis and x-ray radiographs revealed an increase in thickness of the epiphyseal cartilage and in the number of chondrocytes in the G5 and G15 groups. Conclusion: The 830-nm GaAlAs diode laser, within the parameters used in this study, induced changes in the thickness of the epiphyseal cartilage and increased the number of chondrocytes, but this was not sufficient to induce changes in bone length.

The Effects of a 785-nm AlGaInP Laser on the Regeneration of Rat Anterior Tibialis Muscle After Surgically-Induced Injury

Objective: This study aims to investigate the effects of low-level laser therapy (LLLT) on muscle regeneration. For this purpose, the anterior tibialis muscle of 48 male Wistar rats received AlGaInP laser treatment (785 nm) after surgically-induced injury. Background Data: Few studies have been conducted on the effects of LLLT on muscle regeneration at different irradiation doses. Materials and Methods: The animals were randomized into four groups: uninjured rats (UN); uninjured and laser-irradiated rats (ULI); injured rats (IN); and injured and laser-irradiated rats (ILI). The direct contact laser treatment was started 24 h after surgery. An AlGaInP diode laser emitting 75 mW of continuous power at 785 nm was used for irradiation. The laser probe was placed at three treatment points to deliver 0.9 J per point, for a total dose of 2.7 J per treatment session. The animals were euthanized after treatment sessions 1, 2, and 4. Mounted sections were stained with hematoxylin and eosin and used for quantitative morphological analysis, in which the number of leukocytes and fibroblasts were counted over an area of 4480 mu m(2). The data were statistically analyzed by analysis of variance (ANOVA) and the Bonferroni t-test. Results: Quantitative data showed that the number of both polymorphonuclear and mononuclear leukocytes in the inflammatory infiltrate at the injury site was smaller in the ILI(1), ILI(2), and ILI(4) subgroups compared with their respective control subgroups (IN(1), IN(2), and IN(4)) for sessions 1, 2, and 4, respectively (p < 0.05). On the other hand, the number of fibroblasts increased after the fourth treatment session (p < 0.05). With regard to the regeneration of muscle fibers following injury, only after the fourth treatment session was it possible to find muscle precursor cells such as myoblasts and some myotubes in the ILI(4) subgroup. Conclusion: During the acute inflammatory phase, the AlGaInP laser treatment was found to have anti-inflammatory effects, reducing the number of leukocytes at the injury site and accelerating the regeneration of connective tissue.

Effect of Laser Phototherapy on the Release of TNF-alpha and MMP-1 by Endodontic Sealer-Stimulated Macrophages

Objective: Our aim was to analyze the effect of laser phototherapy on the secretory activity of macrophages activated by interferon-gamma (IFN-gamma) and lipopolysaccharide (LPS), and stimulated by substances leached from an epoxy resin-based sealer (AH-Plus) and a calcium hydroxide-based sealer (Sealapex). Background Data: Laser phototherapy can modulate the inflammatory process, improving wound healing. This type of therapy could be useful for modulating postoperative symptoms seen after endodontic treatment. Materials and Methods: Cytotoxicity was indirectly assessed by measuring mitochondrial activity. Macrophages were stimulated by the leached substances or not (controls), and the groups were then irradiated or not. The secretion of pro-inflammatory cytokines (TNF-alpha and MMP-1) was analyzed using ELISA. Two irradiations at 6-h intervals were done with an As-Ga-Al diode laser (780 nm, 70 mW, spot size 4.0 mm(2), 3 J/cm(2), for 1.5 sec) in contact mode. Results: The sealers were non-cytotoxic to macrophages. The production of TNF-alpha was significantly decreased by laser phototherapy, regardless of experimental group. The level of secretion of MMP-1 was similar in all groups. Conclusion: Based on the conditions of this study we concluded that in activated macrophages, laser phototherapy impairs the secretion of the pro-inflammatory cytokine TNF-alpha, but has no influence on MMP-1 secretion.