Influence of laser irradiation on fiber post retention

The purpose of this in vitro study was to compare the bond strength between fiber post and laser-treated root canals. Forty single-rooted bovine teeth were endodontically treated and randomly divided into four groups of equal size according to the root canal treatment: group 1 conventional treatment (without laser irradiation); group 2 Nd:YAG laser (1.5 W, 10 Hz, 100 mJ); group 3 Er,Cr:YSGG laser (0.75 W, 20 Hz); and group 4 Nd:YAG + Er,Cr:YSGG lasers. The fiber posts were cemented with an adhesive system + resin cement, in accordance with the manufacturer`s instructions. A mini acrylic pipe was fixed on the coronal section of the post using a light-polymerized resin. Specimens were mounted on an acrylic pipe with a self-polymerized resin. Retention forces were determined using a universal testing machine (0.5 mm/min). Data were analyzed using one-way ANOVA and Tukey tests (p < 0.05). The post retention force in group 2 was found to be lower than that in the other experimental groups. Fractures were observed at the interface between the dentin and the resin in all groups. High-intensity lasers can be used in conventional endodontic treatment; however, root canal surface irradiation using the Nd:YAG laser was shown to negatively affect the post retention force.

Influence of etching time on bond strength in dentin irradiated with erbium lasers

The purpose of this in vitro study was to evaluate the effect of etching time on the tensile bond strength (TBS) of a conventional adhesive bonded to dentin previously irradiated with erbium:yttrium-aluminum-garnet (Er:YAG) and erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers. Buccal and lingual surfaces of 45 third molars were flattened until the dentin was exposed and randomly assigned to three groups (n = 30) according to the dentin treatment: control (not irradiated), irradiated with Er:YAG (1 W; 250 mJ; 4 Hz; 80.6 J/cm(2)) laser or Er,Cr:YSGG (4 W; 200 mJ; 20 Hz; 71.4 J/cm(2)) laser, and into three subgroups (n = 10) according to acid etching time (15 s, 30 s or 60 s) for each experimental group. After acid etching, the adhesive was applied, followed by the construction of an inverted cone of composite resin. The samples were immersed in distilled water (37A degrees C for 24 h) and subjected to TBS test [50 kilogram-force (kgf), 0.5 mm/min]. Data were analyzed by analysis of variance (ANOVA) and Tukey statistical tests (P a parts per thousand currency signaEuro parts per thousand 0.05). Control group samples presented significant higher TBS values than those of all lased groups. Both irradiated groups exhibited similar TBS values. Samples subjected to the different etching times in each experimental group presented similar TBS. Based on the conditions of this in vitro study we concluded that Er:YAG and Er,Cr:YSGG laser irradiation of the dentin weakens the bond strength of the adhesive. Moreover, increased etching time is not able to modify the bonding strength of the adhesive to irradiated dentin.

Micromorphology of Resin-Dentin Interfaces Using One-Bottle Etch&Rinse and Self-Etching Adhesive Systems on Laser-Treated Dentin Surfaces: A Confocal Laser Scanning Microscope Analysis

Background and Objectives: This study evaluated the hybrid layer (HL) morphology created by three adhesive systems (AS) on dentin surfaces treated with Er:YAG laser using two irradiation parameters. Study Design: Occlusal flat dentin surfaces of 36 human third molars were assigned into nine groups (n = 4) according to the following ASs: one bottle etch&rinse Single Bond Plus (3M ESPE), two-step Clearfil Protect Bond (Kuraray), and all-in-one S3 Bond (Kuraray) self-etching, which were labeled with rhodamine B or fluorescein isothiocyanate dextran and were applied to dentin surfaces that were irradiated with Er:YAG laser at either 120 (38.7 J/cm(2)) or 200 mJ/pulse (64.5 J/cm(2)), or were applied to untreated dentin surfaces (control group). The ASs were light-activated following MI and the bonded surfaces were restored with resin composite Z250 (3M ESPE). After 24 hours of storage in vegetable oil, the restored teeth were vertically, serially sectioned into 1-mm thick slabs, which had the adhesive interfaces analyzed with confocal laser microscope (CLSM-LSM 510 Meta). CLSM images were recorded in the fluorescent mode from three different regions along each bonded interface. Results: Non-uniform HL was created on laser-irradiated dentin surfaces regardless of laser irradiation protocol for all AS, while regular and uniform HL was observed in the control groups. ""Stretch mark""-like red lines were found within the HL as a result of resin infiltration into dentin microfissures, which were predominantly observed in 200 mJ/pulse groups regardless of AS. Poor resin infiltration into peritubular dentin was observed in most regions of adhesive interfaces created by all ASs on laser-irradiated dentin, resulting in thin resin tags with neither funnel-shaped morphology nor lateral resin projections. Conclusion: Laser irradiation of dentin surfaces at 120 or 200 mJ/pulse resulted in morphological changes in HL and resin tags for all ASs evaluated in the study. Lasers Surg. Med. 42:662-670, 2010. (C) 2010 Wiley-Liss, Inc.

Morphological assessment of dentine and cementum following apicectomy with Zekrya burs and Er:YAG laser associated with direct and indirect Nd:YAG laser irradiation

Objectives. This study aimed to assess the apical surface morphology of maxillary central incisors resected 3.0 mm from the tooth apex using Zekrya burs or Er:YAG laser, with or without subsequent direct Nd:YAG laser irradiation (apical and buccal surfaces) and indirect irradiation (palatal surface). Study design. Forty maxillary central incisors were instrumented and obturated. The roots were divided into 4 groups according to the root resection method (Zekrya bur or Er: YAG laser -1.8 W, 450 mJ, 4 Hz, 113 J/cm(2)) and further surface treatment (none or Nd: YAG laser -2.0 W, 100 mJ, 20 Hz, 124 J/cm(2)). The teeth were prepared for SEM analysis. Scores ranging from 1 to 4 were attributed to cut quality and morphological changes. The data were analyzed by the Kruskal-Wallis test and by Dunn`s test. Results. SEM images showed irregular surfaces on the apical portions resected with Zekrya burs, with smear layer and grooves in the resected dentine and slight gutta-percha displacement and plasticization. On the other hand, apicectomies carried out with Er: YAG laser showed morphological changes compatible with ablated dentine, with rough surfaces and craters. In spite of the presence of plasticized gutta-percha, with the presence of bubbles, an irregular adaptation of the filling material to the root walls was also observed. Direct Nd: YAG laser irradiation of the apical and buccal surfaces of the resected roots resulted in areas of resolidification and fusion in the dentine and cementum, with a vitrified aspect; indirect Nd: YAG laser irradiation of the palatal surfaces yielded a lower number of changes in the cementum, with irregular resolidification areas. Conclusions. There were no differences in terms of cut quality between the use of burs and Er: YAG laser or between the 2 surfaces (apical and buccal) treated with Nd: YAG laser with direct irradiation. However, morphological changes were significantly less frequent on surfaces submitted to indirect irradiation (palatal) when compared with those directly irradiated. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e77-e82)

In Vitro Microleakage of Composite Restorations Prepared by Er:YAG/Er,Cr:YSGG Lasers and Conventional Drills Associated with Two Adhesive Systems

Purpose: The objective of this in vitro study was to compare the degree of microleakage of composite restorations performed by lasers and conventional drills associated with two adhesive systems. Materials and Methods: Sixty bovine teeth were divided into 6 groups (n = 10). The preparations were performed in groups 1 and 2 with a high-speed drill (HID), in groups 3 and 5 with Er:YAG laser, and in groups 4 and 6 with Er,Cr:YSGG laser. The specimens were restored with resin composite associated with an etch-and-rinse two-step adhesive system (Single Bond 2 [SB]) (groups 1, 3, 4) and a self-etching adhesive (One-Up Bond F [OB]) (groups 2, 5, 6). After storage, the specimens were polished, thermocycled, immersed in 50% silver nitrate tracer solution, and then sectioned longitudinally. The specimens were placed under a stereomicroscope (25X) and digital images were obtained. These were evaluated by three blinded evaluators who assigned a microleakage score (0 to 3). The original data were submitted to Kruskal-Wallis and Mann-Whitney statistical tests. Results: The occlusal/enamel margins demonstrated no differences in microleakage for all treatments (p > 0.05). The gingival/dentin margins presented similar microleakage in cavities prepared with Er:YAG, Er,Cr:YSGG, and HD using the etch-and-rinse two-step adhesive system (SB) (p > 0.05); otherwise, both Er:YAG and Er,Cr:YSGG lasers demonstrated lower microleakage scores with OB than SB adhesive (p < 0.05). Conclusion: The microleakage score at gingival margins is dependent on the interaction of the hard tissue removal tool and the adhesive system used. The self-etching adhesive system had a lower microleakage score at dentin margins for cavities prepared with Er:YAG and Er,Cr:YSGG than the etch-and-rinse two-step adhesive system.

Adhesion after erbium, chromium:yttrium-scandium-gallium-garnet laser application at three different irradiation conditions

The aim of this study was to investigate whether distinct cooling of low fluence erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation would influence adhesion. Main factors tested were: substrates (two), irradiation conditions (three), and adhesives (three). A 750 mu m diameter tip was used, for 50 s, 1 mm from the surface, with a 0.25 W power output, 20 Hz, energy density of 2.8 J/cm(2) with energy per pulse of 12.5 mJ. When applied, water delivery rate was 11 ml/min. The analysis of variance (ANOVA) showed that laser conditioning significantly decreased the bond strength of all adhesive systems applied on enamel. On dentin, laser conditioning significantly reduced bond strength of etch-and-rinse and one-step self-etch systems; however, laser irradiation under water cooling did not alter bonding of two-step self-etching. It may be concluded that the irradiation with Er,Cr:YSGG laser at 2.8 J/cm(2) with water coolant was responsible for a better adhesion to dentin, while enamel irradiation reduced bond strength, irrespective of cooling conditions.

Effects of Nd:YAG Laser Irradiation on the Hybrid Layer of Different Adhesive Systems

Purpose: The aim of this in vitro study was to evaluate the microtensile bond strength (mu TBS) and hybrid layer morphology of different adhesive systems, either followed by treatment with Nd:YAG laser irradiation or not. Previous studies have shown the effects of Nd:YAG laser irradiation on the dentin surface at restoration margins, but there are few reports about the significance of the irradiation on the hybrid layer. Materials and Methods: The flattened coronal and root dentin samples of 24 bovine teeth were randomly divided into 8 groups, according to the adhesive system used - Scotchbond Multi Purpose (SBMP) or Clearfil SE Bond (CSEB) - and were either irradiated with Nd:YAG or not, with different parameters: 0.8 W/10 Hz, 0.8 W/20 Hz, 1.2 W/10 Hz, 1.2 W/20 Hz. The left sides of specimens were the control groups, and right sides were irradiated. A composite crown was built over bonded surfaces and stored in water (24 h at 37 degrees C). Specimens were sectioned vertically into slabs that were subjected to mu TBS testing and observed by SEM. Results: Control groups (27.81 +/- 1.38) showed statistically higher values than lased groups (21.37 +/- 0.99), and CSEB control group values (31.26 +/- 15.71) were statistically higher than those of SBMP (24.3 +/- 10.66). There were no significant differences between CSEB (20.34 +/- 10.01) and SBMP (22.43 +/- 9.82) lased groups. Among parameters tested, 0.8 W/10 Hz showed the highest value (25.54 +/- 11.74). Nd:YAG laser irradiation caused dentin to melt under the adhesive layer of both adhesive systems tested. Conclusion: With the parameters used in this study, Nd:YAG laser irradiation of the hybrid layer promoted morphological changes in dentin and negatively influenced the bond strength of both adhesive systems.

Low-fluence CO(2) laser irradiation decreases enamel solubility

This study investigated whether subablative-pulsed CO(2) laser (10.6 mu m) irradiation, using fluences lower than 1 J/cm(2), was capable of reducing enamel acid solubility. Fifty-one samples of bovine dental enamel were divided into three groups: control group, which was not irradiated (CG); group laser A (LA) irradiated with 0.3 J/cm ; and group laser B (LB) irradiated with 0.7 J/cm(2). After irradiation, the samples were subjected to demineralization in an acetate buffer solution and were then analyzed by SEM. A finite-element model was used to calculate the temperature increase. The calcium and phosphorous content in the demineralization solution were measured with an ICP-OES. ANOVA and the t-test pairwise comparison (p < 0.016) revealed that LB showed significantly lower mean Ca and P content values in the demineralization solution than other groups. A reduction in the enamel solubility can be obtained with pulsed CO(2) laser irradiation (0.7 J/cm(2), 135 mJ/pulse, 74 Hz, 100 mu s) without any surface photomodification and a less than 2 degrees C temperature increase at a 3-mm depth from the surface.

Effects of Ultramorphological Changes on Adhesion to Lased Dentin-Scanning Electron Microscopy and Transmission Electron Microscopy Analysis

Dentin irradiation with erbium lasers has been reported to alter the composite resin bond to this treated surface. There is still a lack of studies reporting the effect of erbium lasers on dentin organic content and elucidating how laser treatment could interfere in the quality of the resin-dentin interface. This study aimed to evaluate the effect of erbium laser irradiation on dentin morphology and microtensile bond strength (lTBS) of an adhesive to dentin. Seventy-two dentin disks were divided into nine groups (n = 8): G1-Control (600-grit SiC paper); Er:YAG groups: G2-250 mJ/4 Hz; G3-200 mJ/4 Hz; G4-180 mJ/10 Hz; G5-160 mJ/10 Hz; Er, Cr:YSGG groups: G6-2 W/20 Hz; G7-2.5 W/20 Hz; G8-3 W/20 Hz; G9-4 W/20 Hz. Specimens were processed for cross-sectional analysis by scanning electron microscopy (SEM) (n = 3), transmission electron microscopy (TEM) (n = 2), and adhesive interface (n = 3). Forty-five dentin samples (n = 5) were restored and submitted to lTBS testing. ANOVA (alpha = 5%) revealed that G1 presented the highest lTBS values and irradiated groups did not differ from each other. TEM micrographs showed a superficial layer of denatured collagen fibrils. For SEM micrographs, it was possible to verify the laser effects extending to dentin subsurface presenting a rough aspect. Cross-sectional dentin micrographs of this hybridized surface revealed a pattern of modified tags with ringlike structures around it. This in vitro study showed that erbium laser irradiation interacts with the dental hard tissue resulting in a specific morphological pattern of dentin and collagen fibrils that negatively affected the bond strength to composite resin. Microsc. Res. Tech. 74:720-726, 2011. (C) 2010 Wiley-Liss, Inc.

Low Level Laser Effects On Pain to Palpation and Electromyographic Activity in TMD Patients: A Double-Blind, Randomized, Placebo-Controlled Study

The purpose of this study was to evaluate the effect of diode laser (GaAlAs - 780 nm) on pain to palpation and electromyographic (EMG) activity of the masseter and anterior temporalis muscles. The laser was applied on the temporalis and masseter muscles twice a week (four weeks). Forty-eight (48) patients with myofascial pain were randomly assigned between actual and placebo treatments and between the energetic doses of 25 J/cm(2) and 60 J/cm(2), and were evaluated using VAS before, immediately after the final application, and 30 days after the laser treatment. Surface electromyography was performed with maximum dental clenching before and after laser therapy. The results show there were no significant statistical differences in the EMG activity between the groups before and after laser treatment. With regard to the pain at palpation, although both groups presented a significant difference in the symptoms before and after the treatment, only the active doses showed statistically significant reductions in pain level in all the regions of the palpated muscles. However, there was no significant statistical difference between groups (experimental and placebo). In conclusion, low level laser did not promote any changes in EMG activity. The treatment did, however, lessen the pain symptoms in the experimental groups.

Composite filling removal with erbium:yttrium-aluminum-garnet laser: morphological analyses

Considering the increase in esthetic restorative materials and need for improvement in unsatisfactory restoration substitution with minimal inadvertent removal of healthy tissues, this study assessed the efficacy of erbium:yttrium-aluminum-garnet (Er:YAG) laser for composite resin removal and the influence of pulse repetition rate on the morphological analyses of the cavity by scanning electron microscope. Composite resin fillings were placed in cavities (1.0 mm deep) prepared in bovine teeth, and the 75 specimens were randomly assigned to five groups according to the technique used for composite filling removal (high-speed diamond bur, group I, as a control, and Er:YAG laser, 250 mJ output energy and 80 J/cm(2) energy density, using different pulse repetition rates: group II, 2 Hz; group III, 4 Hz; group IV, 6 Hz; group V, 10 Hz). After the removal, the specimens were split in the middle, and we analyzed the surrounding and deep walls to check for the presence of restorative material. The estimation was qualitative. The surfaces were examined with a scanning electron microscope. The results revealed that the experimental groups presented bigger amounts of remaining restorative material. The scanning electron microscopy (SEM) analyses showed irregularities of the resultant cavities of the experimental groups that increased proportionally with increase in repetition rate.

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.

Coronal resistance to fracture of endodontically treated teeth submitted to light-activated bleaching

Objectives: The aim of this study was to assess the fracture resistance of endodontically treated teeth submitted to bleaching with 38% hydrogen peroxide activated by light-emitting diode (LED)-laser system. Methods: Fifty maxillary incisors were endodontically treated, received a zinc phosphate barrier and were embedded in acrylic resin until cemento-enamel junction. The specimens were distributed into five groups (n = 10) according to the number of bleaching sessions: GI, no treatment (control); GII, one session; GIII, two sessions; GIV, three sessions and GV, four sessions. The whitening gel was applied to the buccal surface of the tooth and inside the pulp chamber for three times in each session, followed by LED-laser activation. Specimens were submitted to the fracture resistance test (kN) and data were submitted to the Tukey-Kramer multiple comparisons test. Results: No significant difference (p > 0.05) was found between GI (0.71 +/- 0.30) and GII (0.65 +/- 0.13), which presented the highest strength values to fracture. Groups III (0.35 +/- 0.17), IV (0.23 +/- 0.13) and V (0.38 +/- 0.15) showed lower resistance to fracture (p < 0.01) when compared to GI and GII. Conclusions: The fracture resistance of endodontically treated teeth decreased after two sessions of bleaching with 38% hydrogen peroxide activated by LED-laser system. (c) 2008 Elsevier Ltd. All rights reserved.

Pulpal heat changes with newly developed resin photopolymerisation systems

Composite resin is a widely-used direct tooth coloured restorative material. Photoactivation of the polymerisation reaction can be achieved by visible blue light from a range of light sources, including halogen lamps, metal halide lamps, plasma arc lamps, and Light Emitting Diode (LED) lights. Concerns have been raised that curing lights may induce a temperature rise that could be detrimental to the vitality of the dental pulp during the act of photoactivation. The present study examined heat changes associated with standardised class V restorations on the buccal surface of extracted premolar teeth, using a curing time of 40 seconds. The independent effects of type of light source, resin shade and remaining tooth thickness were assessed using a matrix experimental design. When a conventional halogen lamp, a metal halide lamp and two different LED lights were compared, it was found that both LED lamps elicited minimal thermal changes at the level of the dental pulp, whereas the halogen lamp induced greater changes and the metal halide lamp caused the greatest thermal insult of all the light sources. These thermal changes were influenced by resin shade, with different patterns for LED versus halogen or halide sources. Thermal stress reduced as the remaining thickness of tooth structure between the pulp and the cavity floor increased. From these results, it is concluded that LED lights produce the least thermal insult during photopolymerisation of composite resins.

Field quantization, photons and non-Hermitean modes

Field quantization in unstable optical systems is treated by expanding the vector potential in terms of non-Hermitean (Fox-Li) modes. We define non-Hermitean modes and their adjoints in both the cavity and external regions and make use of the important bi-orthogonality relationships that exist within each mode set. We employ a standard canonical quantization procedure involving the introduction of generalized coordinates and momenta for the electromagnetic (EM) field. Three-dimensional systems are treated, making use of the paraxial and monochromaticity approximations for the cavity non-Hermitean modes. We show that the quantum EM field is equivalent to a set of quantum harmonic oscillators (QHOs), associated with either the cavity or the external region non-Hermitean modes, and thus confirming the validity of the photon model in unstable optical systems. Unlike in the conventional (Hermitean mode) case, the annihilation and creation operators we define for each QHO are not Hermitean adjoints. It is shown that the quantum Hamiltonian for the EM field is the sum of non-commuting cavity and external region contributions, each of which can be expressed as a sum of independent QHO Hamiltonians for each non-Hermitean mode, except that the external field Hamiltonian also includes a coupling term responsible for external non-Hermitean mode photon exchange processes. The non-commutativity of certain cavity and external region annihilation and creation operators is associated with cavity energy gain and loss processes, and may be described in terms of surface integrals involving cavity and external region non-Hermitean mode functions on the cavity-external region boundary. Using the essential states approach and the rotating wave approximation, our results are applied to the spontaneous decay of a two-level atom inside an unstable cavity. We find that atomic transitions leading to cavity non-Hermitean mode photon absorption are associated with a different coupling constant to that for transitions leading to photon emission, a feature consequent on the use of non-Hermitean mode functions. We show that under certain conditions the spontaneous decay rate is enhanced by the Petermann factor.