Clinical Efficiency of Low-Level Diode Laser in Reducing Dentin Hypersensitivity

Dentin hipersensitivity (DH) is a relatively common clinical condition, especially in periodontal patients after treatment. In this study it was evaluated 28 teeth who presented dentin hypersensitivity. The teeth were subjected to clinical and radiographic exams and were divided into groups following the treatment and the time of examination after application proposed: GI: PO 3% (Potassium Oxalate-group control)/Baseline; GII: PO 3%/3 days after first session; GIII: PO 3%/6 days; GIV: PO 3%/30 days; GV: PO 3%/60 days; GVI: PO 3%/90 days; GVII: Laser (Low-level diode laser with 110 mW/cm(2))/Baseline; GVIII: Laser/7 days after first session; GIX: Laser/14 days; GX: Laser/30 days; GXI: Laser/60 days; and GXII: Laser/90 days. The groups I-VI, the teeth were subjected to 3 applications (GI-GIII) of desensitizing agent at regular intervals of seven days. The Groups VII-XI, each tooth was subjected to three applications (GVII GIX) in three different points (mesial, meddle and distal surfaces) with an interval of 72 h. The time of application in each point was of 33 s and the patients from both groups were followed up to 90 days. The nonparametric test Friedman (alpha = 0.05) was applied and the test of Mann Whitney (alpha = 0.05) was used to compare the time of examination between groups. The application of Laser was effective 6 days after first session and to PO was 30 days. It was observed that both treatments were effective for the reduction of dentin hypersensitivity, however the laser presented better effectiveness.

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.

Influence of prior 810-nm-diode intracanal laser irradiation on hydrophilic resin-based sealer obturation

Dentin wall structural changes caused by 810-nm-diode laser irradiation can influence the sealing ability of endodontic sealers. The objective of this study was to evaluate the apical leakage of AH Plus and RealSeal resin-based sealers with and without prior diode laser irradiation. Fifty-two single-rooted mandibular premolars were prepared and divided into 4 groups, according to the endodontic sealer used and the use or non-use of laser irradiation. The protocol for laser irradiation was 2.5W, continuous wave in scanning mode, with 4 exposures per tooth. After sample preparation, apical leakage of 50% ammoniacal silver nitrate impregnation was analyzed. When the teeth were not exposed to irradiation, the Real Seal sealer achieved the highest scores, showing the least leakage, with significant differences at the 5% level (Kruskal-Wallis test, p = 0.0004), compared with AH Plus. When the teeth were exposed to the 810-nm-diode laser irradiation, the sealing ability of AH Plus sealer was improved (p = 0282). In the Real Seal groups, the intracanal laser irradiation did not interfere with the leakage index, showing similar results in the GRS and GRSd groups (p = 0.1009).

Pulpal temperature increase with high-speed handpiece, ER : YAG laser and ultrasound tips

The aim of this study was to compare intrapulpal temperature increase produced by high-speed handpiece, Er:YAG laser and CVDentus ultrasound tips during cavity preparation. Thirty bovine mandibular incisors with an enamel/dentin thickness of 4 mm at buccal surface had their roots amputated and were allocated to the following groups (n=10): Group I- high-speed handpiece; Group II- noncontact Er:YAG laser (250 mJ/4Hz); and Group III- CVDentus ultrasouns tips. All devices were used with water cooling. Class V cavities were prepared to a depth of 3.5 mm, measured with a periodontal probe. A type T thermocouple was placed inside the pulp chamber to determine the temperature increase (degrees C), which was recorded by a data acquisition system ADS 2000 IP (Lynx Technology) linked to a notebook computer. Data were analyzed statistically by oneway ANOVA and Tukey's test (p=0.05). The mean temperature rises were: 1.10 degrees C ( 0.56) for Group 1, 0.84 degrees C (0.55) for Group II, and 3.00 degrees C (1.34) for Group III. There were no statistically significant differences (p > 0.05) between Groups I and II, but both of them differed significantly from Group III (p < 0.05). In conclusion, the use of Er:YAG laser and high-speed handpiece for cavity preparation resulted in similar temperature increase. Although ultrasound tips generated significantly higher intrapulpal temperature increase, it remained below the critical value of 5.5 degrees C and may be considered safe for use.

Dentin bond strength: Influence of laser irradiation, acid etching, and hypermineralization

Objective: the purpose of the present study was to investigate the effects of ND:YLF laser irradiation (1.31 J/cm(2); 250 mJ per pulse), acid etching, and hypermineralization on the shear bond strength (SBS) of the Scotchbond Multi-Purpose Plus (3M Dental Products) bonding system. Summary Background Data: Previous studies had shown that the pretreatment of the dentin substrate with laser irradiation can influence the SBS, Methods: Sixty bovine incisors were selected and stored at -18 degrees C, Dentinal buccal surface was exposed and radiographs were taken to control dentin thickness, the specimens were separated into 2 groups: (1) the control, which was kept in distilled water at 4 degrees C; (2) the hypermineralized, which was kept in hypermineralizing solution at 4 degrees C for 14 days, Each group was divided into 3 subgroups according to the type of dentin pretreatment used: M (acid etching + primer + bond); AL (acid etching + primer + bond + laser); and LA (laser + acid etching + primer + bond). A standard composite resin cylinder (Z100-3M) was bonded to the dentinal surface and the SBS performed on an Instron machine (500 Kg load cell at 0.5 mm/min), followed by scanning electron microscopy (SEM) and x-ray diffraction analysis. Results: Analysis of variance (ANOVA) determined that the pretreatments influenced the SBS values (p < 0.05): AL (9.96 MPa), M (7.28 MPa), and LA (4.87 MPa), the interaction between the group and pretreatment factors also influenced the SBS (p < 0.05). The highest values were obtained for the interaction control/AL (11.64 MPa), Conclusion: the results suggested that dentin treatment with laser after the application of the adhesive system is efficient in achieving higher bond strength and is promising as a possible new adhesive substrate.

Reactionary dentinogenesis after applying restorative materials and bioactive dentin matrix molecules as liners in deep cavities prepared in nonhuman primate teeth

Objective: the aim of this in vivo study was to evaluate the response of the pulp-dentin complex following application of resin-modified glass-ionomer cement, calcium hydroxide hard-setting cement and EDTA-soluble preparation of dentine matrix proteins (ESDP) in deep cavities prepared in non-human primate teeth. Methods: Eighteen deep Class V buccal cavities were prepared in premolars of four capuccin monkeys. In Groups 1 and 2, the cavity floor was lined with ESDP or a resin-modified glass-ionomer cement (Vitrebond - 3M ESPE), respectively. In Group 3 (control), the cavity was lined with a hard setting calcium hydroxide cement (Dycal - Dentsply). The cavities were subsequently filled with amalgam. After 6 months, the animals were sacrificed and the teeth were prepared for microscopic assessment. Six-micron thick serial sections were stained with H/E, Masson's trichrome and Brown & Brenn techniques. Results: No inflammatory pulpal response was observed for all experimental and control Groups. However, the amount of reactionary dentin deposition differed between groups in the rank order ESDP (Group 1) > calcium hydroxide (Group 3) > resin-modified glass-ionomer (Group 2). These differences were statistically significant. Conclusions: All materials were biocompatible when applied in deep cavities. ESDP stimulated higher deposition of reactionary dentin matrix than Vitrebond and Dycal.

Comparative ablation rate from a Er : YAG laser on enamel and dentin of primary and permanent teeth

This study was conducted to analyze the ablation rate and micromorphological aspects of microcavities in enamel and dentin of primary and permanent teeth using a Er:YAG laser system. Micromorphological evaluation has been performed in terms of permanent teeth; however, little information about Er: YAG laser interaction with primary teeth can be found in the literature. Because children have been the most beneficiary patients with laser therapy in our offices, it is extremely necessary to compare the effects of this kind of laser system on the enamel and dentin of permanent and primary teeth. In this study, we used eleven intact primary anterior exfoliated teeth and six extracted permanent molar teeth. We used a commercial laser system: a Er: YAG Twin Light laser system (Fotona Medical Lasers, Slovenia) at 2940 nm, changing average energy levels per pulse ( 100, 200, 300, and 400 mJ) producing 48 microcavities in enamel and dentin of primary and permanent teeth. Primary teeth are more easily ablated than are permanent teeth, when related to enamel or dentin. However, while this laser system is capable of slowly revealing the enamel's microstructure, in dentin only the lowest laser energies permit this kind of observation, more easily decomposing the original tissue aspect, when related to primary or permanent teeth. Statistically, the only different factor at the 5% level was an energy per pulse of 400 mJ, confirming the results found in SEM. Our results showed that dentin in both primary and permanent teeth is less resistant to Er: YAG laser ablation; this fact is easily observed under SEM observation and through the ablation rate evaluation.

Evaluation of subsurface dentin microhardness after Er : yttrium-aluminum-garnet and Nd : yttrium-aluminum-garnet laser irradiation

Background and objectives: To assess the microhardness of dentin subsurface after Er:yttrium-aluminum-garnet (YAG) and Nd:YAG laser irradiation. Study design/materials and methods: Twenty-four bovine incisors, without pulp, were used. The vestibular surface was worn out until the dentin was reached and divided in mesial and distal regions. The samples were divided into two groups: GI-distal, irradiated by Er: YAG laser, and GII-distal, irradiated by Nd: YAG laser. The mesial area was protected so as to not receive the laser irradiation. The measurements were made on Vickers digital microhardmeter. Results: For GI-there was no significant statistical difference, Cl(-4.59 to 0.78), between the values of irradiated (55.61 +/- 4.38) and unirradiated (57.51 +/- 4.00) areas. For GII-the values were higher for the irradiated (62.21 +/- 6.48) compared to the unirradiated (57.82 +/- 5.42) area, CI(1.65 +/- to 7.13). Conclusions: There was an increase of dentin microhardness when the Nd: YAG was used, but the Er: YAG did not cause significant alterations in dentin microhardness. (c) 2007 Laser Institute of America.

Effects of Nd : YAG laser irradiation on root canal dentin wall: A scanning electron microscopic study

Objective: the purpose of this study was to evaluate, by scanning electron microscopy (SEM), the effects of Nd:YAG laser irradiation applied perpendicular or parallel to the root canal dentin wall. Methods: Thirty human teeth were divided into two groups: Group A (20 roots), laser application with circular movements, parallel to the dentin root surface; and Group B (10 roots), roots cut longitudinally and laser applied perpendicular to the root surface. Group A was subdivided into A1 (10 roots), laser application with 100 mJ, 15 Hz and 1.5 W; and A2 (10 roots) with 160 mJ, 15 Hz, and 2.4 W. Group B was subdivided into B1 (10 hemisections) and B2 (10 hemi-sections) with parameters similar to A I and A2. Four applications of 7-sec duration were performed, with a total exposure of 28 sec. SEM evaluations were made in the cervical, middle, and apical thirds, with 500X and 2000X magnifications. Morphological changes scores were attributed, and the results were submitted to Kruskal Wallis statistical test (5%). Results: Significant statistical differences were found between groups A and B (p = 0.001). In groups A1 and A2, few areas of dentin melting were observed. In groups B1 and B2, areas of melting dentin covering dentin surface were observed. Conclusions: It was concluded that intracanal laser application with circular movements (parallel to the surface) produces limited morphological changes in root canal dentin wall.

Study of the morphological alterations to enamel and dentin in human and bovine teeth after irradiation with Er : YAG laser

Objective: the purpose of this study is to make use of scanning electron microscopy in order to comparatively analyze the morphological alterations to human and bovine enamel and dentin. Earlier data: Many a morphological study involving Er:YAG laser can be found in the literature. Still, not a single study comparing the effects of this infrared laser in human and bovine teeth has been reported. Materials and Methods: Thirty-two slices of human and bovine enamel and dentin were evenly divided into four groups. With the exception of the control group, the samples were irradiated with Er:YAG laser, focused at a distance of 12 mm and a 10-Hz frequency, with 150, 250, and 350 mJ of output energy per pulse for 10 seconds. After irradiation all specimens were observed under a scanning electron microscope. Results: There was practically no morphological difference for those samples that underwent 150 mJ/pulse irradiation. The dentin exposed to 250 mJ had a few open dentinal tubules. These were seen in enamel after a 350 mJ irradiation, in which the energy was able to reach the dentin. Conclusions: the breadth of this study allows us to state that the pattern between the species grew more heterogenous as the energy density was increased and that irradiation with 150 mJ/pulse resulted in greater likeness in human and bovine enamel and dentin.