Effect of Nd:YAG Irradiation and Fluoride Application on Dentine Resistance to Erosion in Vitro

Objective: In this paper we evaluated the effect of two fluoridated agents and Nd:YAG irradiation separately and in combination on dentine resistance to erosion. Background Data: The morphological changes in dentin induced by laser treatment may reduce the progression of erosive lesions. Due to the possibility of a synergistic effect of laser with fluoride, this study was conducted. Materials and Methods: Eighty bovine dentine samples (4 x 4 mm) were randomly divided into eight groups, according to the following treatments: G1: untreated (control); G2: acidic phosphate fluoride gel (APF 1.23%) for 4 min; G3: fluoride varnish (NaF 2.26%) for 6 h; G4: 0.5 W Nd: YAG laser (250 mu sec pulse, 10 Hz, 35 J/cm(2), 30 sec); G5: 0.75 W Nd: YAG laser (52.5 J/cm(2)); G6: 1.0 W Nd: YAG laser (70 J/cm(2)); G7: APF + 0.75 W Nd: YAG laser; and G8: NaF + 0.75 W Nd: YAG laser. After the treatments, half of each dentine surface was protected with nail varnish. The samples were stored in artificial saliva (30 mL/sample) for 24 h and submitted to four erosive 1-min cycles. Between the erosive attacks, the blocks were maintained in artificial saliva for 59 min. The erosive wear was evaluated by profilometry. Results: The mean wear (+/- SD, mu m) was: G1: 1.20 +/- 0.20; G2: 0.47 +/- 0.06; G3: 0.81 +/- 0.11; G4: 1.47 +/- 0.32; G5: 1.52 +/- 0.24; G6: 1.49 +/- 0.30; G7: 0.49 +/- 0.11; and G8: 1.06 +/- 0.31 (Tukey's test, p < 0.05). Conclusions: Laser irradiation was not able to reduce dentine erosion. However, fluoride application was able to increase the dentine's resistance to erosion, and APF showed better results than fluoride varnish.

Comparison of dentin root canal permeability and morphology after irradiation with Nd:YAG, Er:YAG, and diode lasers

The aim of this study was to compare the effects of Nd:YAG, Er:YAG, and diode lasers on the morphology and permeability of root canal walls. The three laser wavelengths mentioned interact differently with dentin and therefore it is possible that the permeability changes caused will determine different indications during endodontic treatment. Twenty-eight human single-rooted teeth were instrumented up to ISO 40 and divided into four groups: group C, control (GC), non-laser irradiated; group N (GN), irradiated with Nd:YAG laser; group E (GE), with Er:YAG laser and group D (GD) with diode laser. After that, the roots were filled with a 2% methylene blue dye, divided into two halves and then photographed. The images were analyzed using Image J software and the percentage of dye penetration in the cervical, middle, and apical root thirds were calculated. Additional scanning electron microscopy (SEM) analyses were also performed. The analysis of variance (ANOVA) showed significant permeability differences between all groups in the middle and cervical thirds (p < 0.05). The Tukey test showed that in the cervical third, GN presented means of dye penetration statistically significantly lower than all of the other groups. In the middle third, GE and GD showed statistically higher dye penetration means than GC and GN. SEM analysis showed melted surfaces for GN, clean wall surfaces with open dentinal tubules for GE, and mostly obliterated dentinal tubules for GD. Er:YAG (2,094 nm) laser and diode laser (808 nm) root canal irradiation increase dentinal permeability and Nd:YAG (1,064 nm) laser decreases dentin permeability, within the studied parameters.

Effect of Nd:YAG Irradiation and Fluoride Application on Dentine Resistance to Erosion in Vitro

Objective: In this paper we evaluated the effect of two fluoridated agents and Nd:YAG irradiation separately and in combination on dentine resistance to erosion. Background Data: The morphological changes in dentin induced by laser treatment may reduce the progression of erosive lesions. Due to the possibility of a synergistic effect of laser with fluoride, this study was conducted. Materials and Methods: Eighty bovine dentine samples (4 x 4 mm) were randomly divided into eight groups, according to the following treatments: G1: untreated (control); G2: acidic phosphate fluoride gel (APF 1.23%) for 4 min; G3: fluoride varnish (NaF 2.26%) for 6 h; G4: 0.5 W Nd: YAG laser (250 mu sec pulse, 10 Hz, 35 J/cm(2), 30 sec); G5: 0.75 W Nd: YAG laser (52.5 J/cm(2)); G6: 1.0 W Nd: YAG laser (70 J/cm(2)); G7: APF + 0.75 W Nd: YAG laser; and G8: NaF + 0.75 W Nd: YAG laser. After the treatments, half of each dentine surface was protected with nail varnish. The samples were stored in artificial saliva (30 mL/sample) for 24 h and submitted to four erosive 1-min cycles. Between the erosive attacks, the blocks were maintained in artificial saliva for 59 min. The erosive wear was evaluated by profilometry. Results: The mean wear (+/- SD, mu m) was: G1: 1.20 +/- 0.20; G2: 0.47 +/- 0.06; G3: 0.81 +/- 0.11; G4: 1.47 +/- 0.32; G5: 1.52 +/- 0.24; G6: 1.49 +/- 0.30; G7: 0.49 +/- 0.11; and G8: 1.06 +/- 0.31 (Tukey's test, p < 0.05). Conclusions: Laser irradiation was not able to reduce dentine erosion. However, fluoride application was able to increase the dentine's resistance to erosion, and APF showed better results than fluoride varnish.

Effects of Nd : YAG and Er : YAG lasers on the sealing of root canal fillings

Objective: the ability of the laser irradiation to promote the cleaning and disinfection of the radicular canal system has become this type of treatment in a viable and real alternative in endodontics. The purpose of this study was to evaluate the apical marginal sealing of root canal fillings after the irradiation with the laser of Nd:YAG or of Er:YAG. Materials and Methods: Forty-two human, extracted single-rooted teeth had their crowns sectioned and the root canals prepared with a no. 70 K-file. Then, they were dried and divided into three groups according to canal wall treatment: group 1: the canals were filled with EDTA for 3 min, followed by irrigation with 1% sodium hypochlorite solution; group 2: the canal walls were irradiated with Nd:YAG laser; and group 3: the canal walls were irradiated with Er:YAG laser. Afterwards, the root canals were obturated by the lateral condensation technique. The roots were externally waterproof, except in the apical foramen and immerged in 2% methylene blue aqueous solution during 48 hours. Results: the results showed that the largest infiltrations happened in the group 3-Er:YAG (7.3 mm), proceeded by the group 1-EDTA (1.6 mm) and by the group 2-Nd:YAG (0.6 mm). The group Er:YAG differed statistically of the others (p < 0.05). Conclusion: It was concluded that the Er:YAG laser intracanal irradiation previously to the root canal filling must be used with caution until future research is define the best parameters for it's use.

Effect of dental surface treatment with Nd:YAG and Er:YAG lasers on bond strength of resin composite to recently bleached enamel

The aim of this work is to evaluate the effect of surface treatment with Er:YAG and Nd:YAG lasers on resin composite bond strength to recently bleached enamel. In this study, 120 bovine incisors were distributed into two groups: group C: without bleaching treatment; group B: bleached with 35% hydrogen peroxide. Each group was divided into three subgroups: subgroup N: without laser treatment; subgroup Nd: irradiation with Nd:YAG laser; subgroup Er: irradiation with Er:YAG laser. The adhesive system (Adper Single Bond 2) was then applied and composite buildups were constructed with Filtek Supreme composite. The teeth were sectioned to obtain enamel-resin sticks (1 x 1 mm) and submitted to microtensile bond testing. The data were statistically analyzed by the ANOVA and Tukey tests. The bond strength values in the bleached control group (5.57 MPa) presented a significant difference in comparison to the group bleached and irradiated with Er:YAG laser (13.18 MPa) or Nd:YAG (25.67 MPa). The non-bleached control group presented mean values of 30.92 MPa, with statistical difference of all the others groups. The use of Nd:YAG and Er:YAG lasers on bleached specimens was able to improve the bond strengths of them.

Evaluation of the shear bond strength of a composite resin in sound, demineralized and hypermineralized bovine dentin after irradiation with Er:YAG and Nd:YAG lasers, employing a self-etching adhesive system

Background and Objectives. The adhesion of dental materials is important for the success of treatment. The aim of this study is to evaluate the bond strength of a composite resin applied with a self-etching adhesive system in different dentins after irradiation with Er:YAG and Nd:YAG lasers, observing their morphologic pattern using Scanning Electronic Microscopy (SEM). Materials and Methods. The buccal surface of 72 bovine incisors was worn until exposure of medium depth dentin. The specimens were divided into three groups; GI: normal, GII: demineralized and GIII: hypermineralized dentin. These were also divided into two subgroups; A-irradiated for 30 s with Er:YAG laser in noncontact mode at 40 mJ and 6 Hz and B- irradiated for 30 s with Nd:YAG laser in contact mode at 60 mJ and 10 Hz. The adhesive system Clearfil SE. Bond (Kuraray) and composite resin Tetric Ceram (Vivadent) were applied on the irradiated area by the incremental technique. After storage for 24 h in distilled water at 37 degrees C, the specimens were submitted to the shear strength test in a universal testing machine (EMIC) at a crosshead speed of 1.0 mm/min. Other specimens were made to be analyzed by SEM. Results. The results were statistically analyzed by Analysis of Variance and the Tukey test. Regardless of the type of dentin, the bond strength of specimens irradiated with the Nd:YAG laser (8,94 +/- 2,07) was higher compared to specimens irradiated with the Er:YAG laser (7,03 +/- 2,47); the highest bond strength was obtained for the group of hypermineralized dentin irradiated with the Nd:YAG laser. The SEM analysis showed that the Er:YAG laser caused opening of tubules and the Nd:YAG laser produced areas of fusion as well as regions of opening of dentinal tubules. Conclusions. The dentin showed different morphological patterns and the laser promote alterations on their surfaces, influencing the bond strength of the composite resin. (C) 2010 Laser Institute of America.

Resistência à cárie de esmalte dental irradiado por lasers de Er:YAG e Nd:YAG, avaliada através da morfologia e proporção Ca/P

Pós-graduação em Ciências Odontológicas - FOAR

Effect of Dental Surface Treatment with Nd:YAG and Er:YAG Lasers on Bond Strength to Recently Bleached Dentin

The objective of this study was to evaluate the effect of surface treatment with Er:YAG and Nd:YAG lasers on resin composite bond strength to recently bleached dentin. A total of 120 bovine incisors were distributed into two groups: C- without bleaching; and B- bleached with 35% hydrogen peroxide. Each group was divided into three subgroups: N- without laser treatment; Nd- Nd:YAG laser irradiation; and Er- Er:YAG laser irradiation. The adhesive system (Adper Single Bond 2) was applied and composite build-ups were constructed with Filtek Supreme (3M/ESPE). The teeth were sectioned to obtain dentin-resin sticks (1x1mm(2)) and tested by microtensile bond testing. The bond strength values in group B, subgroup N (16.1 +/- 3.5MPa) presented no significant difference compared with group B, subgroup Er (14.7 +/- 6.1MPa). Group C, subgroup N (26.8 +/- 7.4MPa) presented no significant difference compared with group B, subgroup Nd (28.8 +/- 5.6MPa). Group C, subgroup Nd (36.1 +/- 7.9MPa) presented a significant increase in bond strength compared with the other groups. The Er:YAG laser did not influence the bond strength of bleached specimens, and the use of the Nd:YAG laser on bleached specimens was able to reverse the immediate effects of bleaching, obtaining bond strength values similar to those of the control group.

Dentin Bond Strength: Influence of Er:YAG and Nd:YAG Lasers

The aim of this study was to investigate the effects of Er:YAG and Nd:YAG lasers on the shear bond strength of composite resin to dentin. The coronal portion of 56 human molars was divided into three parts, and the dentin thickness was standardized at 2 mm. A 3-mm hole was marked in the center of each tooth with sealing tape paper. The specimens (n = 14) were then divided into four groups: (1) acid etching + Single Bond (SB) (control), (2) acid etching + SB + Nd: YAG laser irradiation (before adhesive curing), (3) thermal etching with the Er: YAG laser + SB, and (4) thermal etching with the Er: YAG laser + SB + Nd: YAG laser irradiation (before adhesive curing). A composite resin cylinder was built into the delimited area for conducting the shear bond strength test on the universal testing machine. The means +/- standard deviations were: group 1, 17.05 +/- 4.15 MPa; group 2, 16.90 +/- 3.36 MPa; group 3, 12.12 +/- 3.85 MPa; and group 4, 12.92 +/- 2.73 MPa. Groups 1 and 2 presented significantly higher values than groups 3 and 4. It was concluded that conventional etching with 37% phosphoric acid yielded significantly higher bond strength values compared to thermal etching with the Er:YAG laser. The Nd:YAG laser did not significantly influence the bond strength.

Efeito do tratamento da superfície dental com os lasers Nd:YAG e Er: Yag na adesão da resina composta à dentina recém clareada

To evaluate the effect of surface treatment with Er:YAG and Nd:YAG laser on resin composite bond strength to recently bleached dentin. Material and Methods: In this study 120 bovine incisors were used and distributed into two groups: Group C: without bleaching treatment; Group B: with bleaching treatment (35% hydrogen peroxide). Each group was divided into three subgroups: Subgroup N: without laser treatment; Subgroup Nd: irradiation with Nd:YAG laser; Subgroup Er: irradiation with Er:YAG laser. Next, the adhesive system (Adper Single Bond 2) was applied and composite buildups were constructed with Z350 composite. The teeth were sectioned to obtain dentin-resin sticks (1x1mm) and analyzed by microtensile bond testing. The data were statistically analyzed by the ANOVA and Tukey tests. Results: The results showed that the bond strength values in the bleached control group (16.17 MPa) presented no significant difference in comparison with the group bleached and irradiated with Er:YAG laser (14.69 MPa). The non bleached control group (26.79 MPa) presented significant difference in bond strength when compared with the non bleached group irradiated with Er:YAG laser (22.82 MPa) and with the group treated by bleaching and irradiation with Nd:YAG laser (28,792 MPa). The group without bleaching treatment and irradiated with Nd:YAG (36.1 MPa) presented a significant increase in bond strength in comparison with the other groups. Conclusion: The use of Nd:YAG laser on bleached specimens was able of completely reversing the immediate effects of bleaching, obtaining bond strength values similar to those of the control group

Dentin bond strength: influence of Er:YAG and Nd:YAG lasers

The aim of this study was to investigate the effects of Er:YAG and Nd:YAG lasers on the shear bond strength of composite resin to dentin. The coronal portion of 56 human molars was divided into three parts, and the dentin thickness was standardized at 2 mm. A 3-mm hole was marked in the center of each tooth with sealing tape paper. The specimens (n = 14) were then divided into four groups: (1) acid etching + Single Bond (SB) (control), (2) acid etching + SB + Nd:YAG laser irradiation (before adhesive curing), (3) thermal etching with the Er:YAG laser + SB, and (4) thermal etching with the Er:YAG laser + SB + Nd:YAG laser irradiation (before adhesive curing). A composite resin cylinder was built into the delimited area for conducting the shear bond strength test on the universal testing machine. The means ± standard deviations were: group 1, 17.05 ± 4.15 MPa; group 2, 16.90 ± 3.36 MPa; group 3, 12.12 ± 3.85 MPa; and group 4, 12.92 ± 2.73 MPa. Groups 1 and 2 presented significantly higher values than groups 3 and 4. It was concluded that conventional etching with 37% phosphoric acid yielded significantly higher bond strength values compared to thermal etching with the Er:YAG laser. The Nd:YAG laser did not significantly influence the bond strength.

Efeito dos lasers de Nd:YAG e de Er:YAG na adaptação das obturações de canais radiculares: análise do selamento marginal apical

Pós-graduação em Odontologia Restauradora - ICT

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.

Bleeding complications following Nd:YAG laserassisted oral surgery vs conventional treatment in cardiac risk patients: a clinical retrospective comparative study

OBJECTIVE Thermal Nd:YAG laser energy is well known for the purpose of blood coagulation. However, little is known about the bleeding frequency following laser-assisted oral surgery in patients on coumarin drugs. Therefore, the purpose of this study was to compare retrospectively the frequency of bleeding complications following Nd:YAG laserassisted versus conventional local coagulation of blood in oral surgery. METHOD AND MATERIALS In October 2002, minor oral surgical interventions were found to be indicated in a total of 45 cardiac risk patients. In Group 1, blood coagulation was yielded in 24 patients with a Nd:YAG laser system, whereas in Group 2, treatment was performed in 21 patients with conventional means of local hemostasis. All therapies were performed continuing anticoagulant therapy between November 2002 and March 2003. Clinical data were recorded retrospectively from patient charts in May 2007. RESULTS In both Groups 1 and 2, a total of two bleeding complications were recorded. However, local re-interventions were sufficient for local hemostasis. CONCLUSION These results indicate that Nd:YAG laser-assisted local hemostasis was not able to prevent bleeding complications completely. Within the limitations of this retrospective study it was concluded that in patients with anticoagulant treatment undergoing minor oral surgery, Nd:YAG laser-assisted local hemostasis is not superior to conventional methods of blood coagulation with respect to the frequency of bleeding complications.

Influence of Cavity Preparation with Er:YAG Laser on Enamel Adjacent to Restorations Submitted to Cariogenic Challenge In Situ: A Polarized Light Microscopic Analysis

Background and Objectives: Er:YAG laser has been used for caries removal and cavity preparation, using ablative parameters. Its effect on the margins of restorations submitted to cariogenic challenge has not yet been sufficiently investigated. The aim of this study was to assess the enamel adjacent to restored Er:YAG laser-prepared cavities submitted to cariogenic challenge in situ, under polarized light microscopy. Study Design/Materials and Methods: Ninety-one enamel slabs were randomly assigned to seven groups (n = 13): I, II, III-Er:YAG laser with 250 mJ, 62.5 J/cm(2), combined with 2, 3, and 4 Hz, respectively; IV, V, VI-Er:YAG laser with 350 mJ, 87.5 J/cm(2), combined with 2, 3, and 4 Hz, respectively; VII-High-speed handpiece (control). Cavities were restored and the restorations were polished. The slabs were fixed to intra-oral appliances, worn by 13 volunteers for 14 days. Sucrose solution was applied to each slab six times per day. Samples were removed, cleaned, sectioned and ground to polarized light microscopic analysis. Demineralized area and inhibition zone width were quantitatively assessed. Presence or absence of cracks was also analyzed. Scores for demineralization and inhibition zone were determined. Results: No difference was found among the groups with regard to demineralized area, inhibition zone width, presence or absence of cracks, and demineralization score. Inhibition zone score showed difference among the groups. There was a correlation between the quantitative measures and the scores. Conclusion: Er:YAG laser was similar to high-speed handpiece, with regard to alterations in enamel adjacent to restorations submitted to cariogenic challenge in situ. The inhibition zone score might suggest less demineralization at the restoration margin of the irradiated substrates. Correlation between the quantitative measures and scores indicates that score was, in this case, a suitable complementary method for assessment of caries lesion around restorations, under polarized light microscopy. Lasers Surg. Med. 40:634-643, 2008. (c) 2008 Wiley-Liss, Inc.