Short-term clinical and immunologic effects of scaling and root planing with Er : YAG laser in chronic periodontitis

Background: Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been used for periodontal therapy. This study compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for the treatment of periodontal pockets affected with chronic periodontitis.Methods: Twenty-one subjects with pockets from 5 to 9 mm in non-adjacent sites were studied. In a split-mouth design, each site was randomly allocated to a treatment group: SRP and laser (SRPL), laser only (L), SRP only (SRP), or no treatment (C). The plaque index (PI), gingival index (GI), bleeding on probing (BOP), and interleukin (IL)-1 beta levels in crevicular fluid were evaluated at baseline and at 12 and 30 days postoperatively, whereas probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were evaluated at baseline and 30 days after treatment. A statistical analysis was conducted (P<0.05).Results: Twelve days postoperatively, the PI decreased for SRPL and SRP groups (P<0.05); the GI increased for L, SRP, and C groups but decreased for the SRPL group (P<0.05); and BOP decreased for SRPL, L, and SRP groups (P<0.01). Thirty days postoperatively, BOP decreased for treated groups and was lower than the C group (P<0.05). PD decreased in treated groups (P<0.001), and differences were found between SRPL and C groups (P<0.05). CAL gain was significant only for the SRP group (P<0.01). GR increased for SRPL and L groups (P<0.05). No difference in IL-1 beta was detected among groups and periods.Conclusion: Er:YAG laser irradiation may be used as an adjunctive aid for the treatment of periodontal pockets, although a significant CAL gain was observed with SRP alone and not with laser treatment.

Clinical and Microbiologic Follow-Up Evaluations After Non-Surgical Periodontal Treatment With Erbium:YAG Laser and Scaling and Root Planing

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparative Histopathological Analysis of Human Pulps after Class I Cavity Preparation with a High-Speed Air-Turbine Handpiece or Er:YAG Laser

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Shear bond strength of metal-ceramic repair systems

Statement of problem. When clinical fractures of the ceramic veneer on metal-ceramic prostheses can be repaired, the need for remake may be eliminated or postponed. Many different ceramic repair materials are available, and bond strength data are necessary for predicting the success of a given repair system.Purpose. This study evaluated the shear bond strength of different repair systems for metal-ceramic restorations applied on metal and porcelain.Material and methods. Fifty cylindrical specimens (9 X 3 mm) were fabricated in a nickel-chromium alloy (Vera Bond 11) and 50 in feldspathic porcelain (Noritakc). Metal (M) and porcelain (P) specimens were embedded in a polyvinyl chloride (PVC) ring and received I of the following bonding and resin composite repair systems (n=10): Clearfil SE Bond/Clearfil AP-X (CL), Bistite II DC/Palfique (BT), Cojet Sand/Z100 (Q), Scotchbond Multipurpose Plus/Z100 (SB) (control group), or Cojet Sand plus Scotchbond Multipurpose Plus/Z100 (CJSB). The specimens were stored in distilled water for 24 hours at 37 degrees C, thermal cycled (1000 cycles at 5 degrees C to 55 degrees C), and stored at 37 degrees C for 8 days. Shear bond tests between the metal or ceramic specimens and repair systems were performed in a mechanical testing machine with a crosshead speed of 0.5 mm/min. Mean shear bond strength values (MPa) were submitted to 1-way ANOVA and Tukey honestly significant difference tests (alpha=.05). Each specimen was examined under a stereoscopic lens with X 30 magnification, and mode of failure was classified as adhesive, cohesive, or a combination.Results. on metal, the mean shear bond strength values for the groups were as follows: MCL, 18.40 +/- 2.88(b); MBT, 8.57 +/- 1.00(d); MCJ, 25.24 +/- 3.46(a); MSB, 16.26 +/- 3.09(bc); and MCJSB, 13.11 +/- 1.24(c). on porcelain, the mean shear bond strength values ofeach group were as follows: PCL, 16.91 +/- 2.22(b); PBT, 18.04 +/- 3.2(ab); PCJ, 19.54 +/- 3.77(ab); PSB, 21.05 +/- 3.22(a); and PCJSB, 16.18 +/- 1.71(b). Within each substrate, identical superscript letters denote no significant differences among groups.Conclusions. The bond strength for the metal substrate was significantly higher using the Q system. For porcelain, SB, Q, and BT systems showed the highest shear bond strength values, and only SB was significantly different compared to CL and CJSB (P <.05).

Bond strength of adhesive restorations to Er : YAG laser-treated dentin

Background and Objective: evaluate the adhesion of adhesive restorations with and without a base of resin-modified glass-ionomer cement (RMGIC) to dentin irradiated with Er:YAG laser.Study Design/Materials and Methods: Twenty-four human molar teeth were divided into 6 groups (n=4): G1) 37% Phosphoric acid (PA) + Adhesive system (Ad) + Composite resin (CR); G2) RMGIC + CR; G3) Laser (60mJ-5Hz-20s) + PA + Ad + CR; G4) Laser (60 mJ-5 Hz-20 s) + RMGIC + CR; G5) Laser (100mJ-5Hz-20s) + PA + Ad + CR; G6) Laser (100mJ-5Hz-20s) + RMGIC + CR. Teeth were prepared, restored and cut into specimens, according to the treatment proposed and to methodology for microtensile test. Data were submitted to ANOVA and Tukey statistical tests (alpha=5%).Results:. The mean values for adhesion (MPa) and standard deviation (+/- SD) were: G1) 26.30(+/- 4.50), G2) 5.34(+/- 2.87), G3) 21.16(+/- 6.01), G4) 5.22(+/- 1.52), G5) 22.23(+/- 4.98), G6) 5.25(+/- 3.08).Conclusion: the use of Er:YAG laser did not influence on the restorations adhesion.

Er : YAG laser: Antimicrobial effects in the root canals of dogs' teeth with pulp necrosis and chronic periapical lesions

Objective: Our goal in this study was to evaluate the antimicrobial effect of Er:YAG laser applied after biomechanical preparation of the root canals of dog's teeth with apical periodontitis. Background Data: Various in vitro studies have reported effective bacterial reduction in infected root canals using Er:YAG laser. However, there is no in vivo research to support these results. Methods: Forty root canals of dogs' premolar teeth with pulp necrosis and chronic periapical lesions were used. An initial microbiological sample was taken, and after biomechanical preparation was carried out, a second microbiological sample was taken. The teeth were divided into two groups: Group I-biomechanical preparation was taken of root canals without Er:YAG laser application; Group II-biomechanical preparation was taken of root canals with Er:YAG laser application using 140-mj input, 63-mJ output/15 Hz. After coronal sealing, the root canals were left empty for 7 days at which time a third microbiological sample was taken. The collected material was removed from the root canal with a #40 K file and placed in transport media. It was serially diluted and seeded on culture dishes selective for anaerobes, aerobes, and total streptococci. Colony-forming units per milliliter (CFU/mL) were counted. Results: Groups I and II showed an increase of CFU/mL for all microorganisms 7 days after treatment, being statistically significant for anaerobes in Group I and for anaerobes and total streptococci in Group II. When comparing CFU/mL of Groups I and II, there was a statistically significant increase after 7 d for total streptococci in Group II. Conclusion: Er:YAG laser applied after biomechanical preparation did not reduce microorganisms in the root canal system.

Microtensile bond strength of different adhesive systems in dentin irradiated with Er : YAG laser

The objective this study was to evaluate in vitro the bond strength of two etch-and-rise and one self-etching adhesive system after dentin irradiation with Er:YAG (erbium: yttrium aluminum garnet) laser using microtensile test. The results revealed that the groups treated with laser Er:YAG presented less tensile bond strength, independently to the adhesive system used. The prompt L-pop adhesive presented less microtensile bond strength compared to the other adhesives evaluated. There was no difference between single bond and excite groups. The adhesive failures were predominant in all the experimental groups. The Er:YAG laser influenced negatively bond strength values of adhesive systems tested in dental substrate.

Influence of Er:YAG laser on surface treatment of aged composite resin to repair restoration

The purpose of this study was to investigate the effect of Er:YAG laser on surface treatment to the bond strength of repaired composite resin after aged. Sixty specimens (n = 10) were made with composite resin (Z250, 3M) and thermocycled with 500 cycles, oscillating between 5 to 55A degrees C. The specimens were randomly separated in six groups which suffered the following superficial treatments: no treatment (GI, control), wearing with diamond bur (GII), sandblasted with aluminum oxide with 27.5 A mu m particles (GIII) for 10 s, 200 mJ Er:YAG laser (GIV), 300 mJ Er:YAG laser (GV), and 400 mJ Er:YAG laser (GVI), with the last 3 groups under a 10 Hz frequency for 10 s. Restoration repair was done using the same composite. The shear test was done into the Universal testing machine MTS-810. Analyzing the results through ANOVA and Tukey test, no significant differences were found (p-value is 0.5120). Average values analysis showed that superficial treatment with aluminum oxide presented the highest resistance to shear repair interface (8.91MPa) while 400 mJ Er:YAG laser presented the lowest (6.76 MPa). Fracture types analysis revealed that 90% suffered cohesive fractures to GIII. The Er:YAG laser used as superficial treatment of the aged composite resin before the repair showed similar results when used diamond bur and sandblasting with aluminum oxide particles.

Bond strength of an adhesive system irradiated with Nd : YAG laser in dentin treated with Er : YAG laser

The purpose of this in vitro study was to verify through micro tensile bond test the bond strength of an adhesive system irradiated with Nd:YAG laser in dentine previously treated with Er:YAG laser. Twenty caries free extracted human third molars were used. The teeth were divided in four experimental groups (n = 5): (G1) control group; (G2) irradiation of the adhesive system with the Nd:YAG laser; (G3) dentin treatment with Er:YAG laser; (G4) dentin treatment with Er:YAG laser followed by the irradiation of the adhesive system with Nd:YAG laser. The Er:YAG laser fluency parameter for the dentin treatment was of 60 J/cm(2). ne adhesive system was irradiated with the Nd:YAG laser with fluency of 100 J/cm(2). Dental restorations were performed with Adper Single Bond 2/Z250. One tooth from each group was prepared for the evaluation of the adhesive interface under SEM and bond failure tests were also performed and evaluated. The statistical analysis showed statistical significant difference between the groups G1 and G3, G1 and G4, G2 and G3, and G2 and G4; and similarity between the groups G1 and G2, and G3 and G4. The adhesive failures were predominant in all the experimental groups. The SEM analysis showed an adhesive interface with features confirming the results of the mechanical tests. The Nd:YAG laser on the adhesive system did not influence the bond strength in dentin treated or not with the Er:YAG laser.

In Vitro Study of Fracture Load and Fracture Pattern of Ceramic Crowns: A Finite Element and Fractography Analysis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Nd:YAG Laser Irradiation of Etched/Unetched Dentin Through an Uncured Two-step Etch-and-Rinse Adhesive and its Effect on Microtensile Bond Strength

Purpose: To evaluate whether Nd:YAG laser irradiation of etched and unetched dentin through an uncured adhesive affected the microtensile bond strength (pTBS).Materials and Methods: Flat dentin surfaces were created in 19 extracted human third molars. Adper Single Bond (SB) adhesive was applied over etched (groups 1 to 3) or unetched dentin (groups 4 to 6). The dentin was then irradiated with a Nd:YAG laser through the uncured adhesive, using 0.75 or 1 W power settings, except for the control groups (groups 1 and 4). The adhesive was light cured and composite crowns were built up. After 24 h, the teeth were sectioned into beams, with cross-sectional areas of 0.49 mm(2), and were stressed under tension. Data were statistically analyzed using two-way ANOVA and Tukey's test (alpha = 5%). Dentin surfaces of fractured specimens and the interfaces of untested beams were observed under scanning electron microscopy (SEM).Results: Acid etching, laser irradiation, and their interaction significantly affected bonding (p < 0.05). Laser irradiation did not improve bonding of etched dentin to resin (p > 0.05). However, higher pTBS means were found on unetched lased dentin (groups 5 and 6), but only in comparison to group 4, where neither lasing nor etching was performed. Groups 4 to 6 showed the lowest pTBS means among all groups tested (p < 0.05). Laser irradiation did not change the characteristics of the hybrid layers created, while solidification globules were observed on lased dentin surfaces under SEM.Conclusion: Laser irradiation of dentin through the uncured adhesive did not significantly improve the pTBS in comparison to the suggested manufacturer's technique.

Apical Sealing Quality of In Vitro Apicectomy Procedures After Using Both Er:YAG and Nd:YAG

The aim of this study was to evaluate the apical sealing of dentinal tubules after root-end surface cutting by using Er:YAG and Nd:YAG lasers. After root-canal instrumentation and filling, apices of 50 extracted maxillary canine human teeth were resected by Er: YAG with 400 mJ, 10 Hz, for 30 sec. The samples were randomly assigned to five groups (n = 10): (GI) treated without root-end cavity, but with Nd: YAG (1.0W, 10 Hz, 20 sec) for dentinal tubules sealing; (GII) treated with root-end cavity without the use of Nd: YAG; (GIII) treated with root-end cavity and Nd: YAG application; (GIV) treated with root-end cavity made by Er: YAG with no focus and without Nd: YAG application; and (GV) treated without root-end cavity and without Nd: YAG application. The root-end cavities were performed by using Er: YAG at 300 mJ, 10 Hz, for 20 sec. Subsequently, all teeth were waterproofed and immersed in 2% methylene blue for 48 h in a vacuum environment. The samples were longitudinally sectioned, and microleakage was measured. ANOVA and the Fisher LSD test showed that GIV was less susceptible to microleakage than were the other groups (p < 0.05). Interestingly, the use of the Er: YAG with no focus showed superior dentinal tubule sealing in comparison with the other groups, even with or without root-end cavity and Nd: YAG application.

Effect of Airborne-Particle Abrasion and Mechanico-Thermal Cycling on the Flexural Strength of Glass Ceramic Fused to Gold or Cobalt-Chromium Alloy

Purpose: To evaluate the effect of airborne-particle abrasion and mechanico-thermal cycling on the flexural strength of a ceramic fused to cobalt-chromium alloy or gold alloy.Materials and Methods: Metallic bars (n = 120) were made (25 mm x 3 mm x 0.5 mm): 60 with gold alloy and 60 with Co-Cr. At the central area of the bars (8 mm x 3 mm), a layer of opaque ceramic and then two layers of glass ceramic (Vita VM13, Vita Zahnfabrick) were fired onto it (thickness: 1 mm). Ten specimens from each alloy group were randomly allocated to a surface treatment [(tungsten bur or air-particle abrasion (APA) with Al(2)O(3) at 10 mm or 20 mm away)] and mechanico-thermal cycling (no cycling or mechanically loaded 20,000 cycles; 10 N distilled water at 37 degrees C and then thermocycled 3000 cycles; 5 degrees C to 55 degrees C, dwell time 30 seconds) combination. Those specimens that did not undergo mechanico-thermal cyclingwere stored inwater (37 degrees C) for 24 hours. Bond strength was measured using a three-point bend test, according to ISO 9693. After the flexural strength test, failure types were noted. The data were analyzed using three factor-ANOVA and Tukey's test (alpha = 0.05).Results: There were no significant differences between the flexural bond strength of gold and Co-Cr groups (42.64 +/- 8.25 and 43.39 +/- 10.89 MPa, respectively). APA 10 and 20 mm away surface treatment (45.86 +/- 9.31 and 46.38 +/- 8.89 MPa, respectively) had similar mean flexural strength values, and both had significantly higher bond strength than tungsten bur treatment (36.81 +/- 7.60 MPa). Mechanico-thermal cycling decreased the mean flexural strength values significantly for all six alloy-surface treatment combinations tested when compared to the control groups. The failure type was adhesive in the metal/ceramic interface for specimens surface treated only with the tungsten bur, and mixed for specimens surface treated with APA 10 and 20 mm.Conclusions: Considering the levels adopted in this study, the alloy did not affect the bond strength; APA with Al(2)O(3) at 10 and 20 mm improved the flexural bond strength between ceramics and alloys used, and the mechanico-thermal cycling of metal-ceramic specimens resulted in a decrease of bond strength.

Morphology and bacterial colonisation of tooth/ceramic restoration interface after different cement excess removal techniques

Objectives: To evaluate the influence of different protocols for resin cement removal during cementation on biofilm formation.Methods: Twenty-eight ceramic blocks, which were injected under pressure, were placed over enamel blocks obtained from freshly extracted bovine incisors. The ceramic blocks were cemented to the enamel blocks using a dual-cured resin cement and the excess resin was removed according to the experimental group: TS: Teflon spatula; BR: brush; BR+: brush and polishing; SB+: scalpel blade and polishing. After autoclaving, the samples were colonised by incubation in a sucrose broth suspension standardised with Streptococcus mutans in microaerophilic stove. Specimens were quantitatively analysed for bacterial adherence at the adhesive interface using confocal laser scanning microscopy and counting the colony forming units, and qualitatively analysed using SEM. The roughness (Ra/Rz/RSm) was also analysed. Data were analysed by 1-way ANOVA and Tukey's test (5%).Results: The roughness values ranged from 0.96 to 1.69 mu m for Ra (p > 0.05), from 11.59 to 22.80 mu m for Rz (p = 0.02 < 0.05) and from 293.2 to 534.3 mu m for RSm (p = 0.00). Bacterial adhesion varied between 1,974,000 and 2,814,000 CFU/ml (p = 0.00). Biofilm mean thickness ranged from 0.477 and 0.556 mu m (p > 0.05), whilst the biovolume values were between 0.388 and 0.547 mu m(3)/mu m(2) (p = 0.04). Lower values for roughness, bacterial adhesion, biofilm thickness and biovolume were found with BR, whilst TS presented the highest values for most of the parameters. SEM images confirmed the quantitative values.Conclusions: The restoration margin morphology and interface roughness affects bacterial accumulation. The brush technique promoted less bacterial colonisation at the adhesive interface than did the other removal methods.Clinical significance: The brush technique seems to be a good option for removing the excess resin cement after adhesive cementation in clinical practice, as indicated by its better results with lower bacterial colonisation. (C) 2012 Elsevier Ltd. All rights reserved.

Bactericidal effects of two parameters of Er:YAG laser intracanal irradiation: ex-vivo study

The success of endodontic treatment depends on the complete elimination of microorganisms from the root canal system, thus the search for new procedures to eliminate them is justified. The aim of this study was to assess bacterial reduction after intracanal irradiation with the Er:YAG laser. The canals of 70 extracted human maxillary canines were prepared up to file #40 using 1% NaOCl, irrigated with 17% EDTA, and then washed with physiological solution activated by ultrasound. The roots were sterilized by autoclaving, inoculated with 10 mu l of a suspension containing 1.5 x 10(8) CFU/ml of Enterococcus faecalis ATCC 29212 and incubated at 37A degrees C for 72 h. The canals were irradiated with the Er:YAG laser using two energy settings: 60 mJ and 15 Hz, and 100 mJ and 10 Hz. The remaining bacteria were counted immediately and 48 h after laser irradiation. The results showed a high bacterial reduction at both time points. With 60 mJ and 15 Hz there was an immediate reduction of 99.73% and the reduction was 77.02% after 48 h, and with 100 mJ and 10 Hz there was an immediate reduction of 99.95% and the reduction was 84.52% after 48 h. Although the best results were observed with 100 mJ of energy, the difference between the two settings was not statistically significant. The count performed 48 h after irradiation showed that E. faecalis were able to survive, and can grow even from small numbers.