Argon and Nd:YAG Lasers for Caries Prevention in Enamel

Objective: The aim of this study was to investigate the effect of Nd:YAG and argon laser irradiations on enamel demineralization after two different models to induce artificial caries. Background data: It is believed that the use of the high-intensity laser on the dental structure can lead to a more acid-resistant surface. Materials and methods: Twenty-one extracted human third molars were sectioned into tooth quarters. The quarters were distributed in three groups: Group I (control), untreated; Group II, Nd:YAG laser (60 mJ, 15 pps, 47.77 J/cm(2), 30 sec); and Group III, argon laser (250mW, 12 J/cm(2), 48 sec). Tooth quarters from each group were subjected to two different demineralization models: cycle 1, a 14 day demineralization (pH 4.5; 6 h) and remineralization (pH 7.0; 18 h) solutions, 37 degrees C and cycle 2, 48 h in demineralization solution (pH 4.5). Samples were prepared in slices (60-100 mu m thick) to be evaluated under polarized light microscopy. Demineralization areas were measured (mm(2)) (n = 11). Data were analyzed by ANOVA and Tukey's test (p < 0.05). Results: Means followed by different letters are significantly different: 0.25 A (control, cycle 48 h); 0.18 AB (control, cycle 14 days); 0.17 AB (Nd:YAG, cycle 14 days); 0.14 BC (argon, cycle 48 h); 0.09 BC (Nd:YAG, cycle 48 h), and 0.06 C (argon, cycle 14 days). Conclusions: The argon laser was more effective for caries preventive treatment than Nd: YAG laser, showing a smaller demineralization area in enamel.

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I4 Hz; II6 Hz, and III10 Hz. Specimens in group B were submitted to a pH-cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal-Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin. Microsc. Res. Tech., 2011. (c) 2011 Wiley Periodicals, Inc.

Thermal effects and morphological aspects of human dentin surface irradiated with different frequencies of Er:YAG laser

This study reports the effects on micromorphology and temperature rise in human dentin using different frequencies of Er:YAG laser. Sixty human dentin fragments were randomly assigned into two groups (n = 30): carious or sound dentin. Both groups were divided into three subgroups (n = 10), according to the Er:YAG laser frequency used: 4, 6, or 10 Hz (energy: 200 mJ; irradiation distance: 12 mm; and irradiation time: 20 s). A thermocouple adapted to the tooth fragment recorded the initial temperature value (degrees C); then, the temperature was measured after the end of the irradiation (20 s). Morphological analysis was performed using images obtained with scanning electron microscope. There was no difference between the temperatures obtained with 4 and 6 Hz; the highest temperatures were achieved with 10 Hz. No difference was observed between carious and sound dentin. Morphological analyses revealed that all frequencies promoted irregular surface in sound dentin, being observed more selectively ablation especially in intertubular dentin with tubule protrusion. The caries dentin presented flat surface for all frequencies used. Both substrates revealed absence of any signs of thermal damage. It may be concluded that the parameters used in this study are capable to remove caries lesion, having acceptable limits of temperature rise and no significant morphological alterations on dentin surface. Microsc. Res. Tech. 2012. (c) 2012 Wiley Periodicals, Inc.

Treatment of peri-implantitis using an Er:YAG laser or an air-abrasive device: a randomized clinical trial

Non-surgical peri-implantitis therapies appear to be ineffective. Limited data suggest that ER:YAG laser therapy improves clinical conditions. The present study aimed at comparing the treatment effects between air-abrasive (AM) and Er:YAG laser (LM) mono-therapy in cases with severe peri-implantitis.

Er:YAG laser treatment in supportive periodontal therapy

To assess clinical and microbiological outcomes of an Er:YAG laser in comparison with sonic debridement in the treatment of persistent periodontal pockets in a prospective randomized controlled multicentre study design.

Análise in vitro da morfologia e da resistência de união da resina composta à dentina erodida e irradiada com laser de Er:YAG com largura de pulso super curta

Lesões dentais por erosão têm sido cada vez mais presentes na prática clínica. A restauração direta com resina composta é uma das opções de tratamento para lesões severas, em que há comprometimento estético/funcional. Com o aprimoramento da tecnologia, a utilização do laser para pré-tratamento da superfície dentinária, antes do condicionamento ácido, tem sido considerada como método alternativo para melhorar a adesão das resinas compostas às superfícies erodidas. Assim, o objetivo deste estudo in vitro foi avaliar a influência da irradiação com laser de Er:YAG (2,94 ?m), de pulso super-curto, na adesão da resina composta à superfície dentinária erodida. Quarenta e seis discos de dentina foram obtidos a partir de 46 dentes terceiros molares humanos. A dentina oclusal planificada de 40 molares humanos teve metade de sua face protegida com fita UPVC (dentina hígida), enquanto na outra metade foi produzida uma lesão de erosão através da ciclagem em ácido cítrico (0,05 M, pH 2,3, 10 minutos, 6x/dia) e solução supersaturada (pH 7,0, 60 minutos entre os ataques ácidos). Metade das amostras foi irradiada com o laser de Er:YAG (50 ?s, 2 Hz, 80 mJ, 12,6 J/cm2) e a outra não (grupo controle). Em cada grupo de tratamento (laser ou controle) (n=10), um sistema adesivo autocondicionante foi utilizado e, então, confeccionados 2 cilindros de resina composta, tanto do lado erodido como no hígido (total de 4 cilindros), os quais foram submetidos à avaliação da Resistência de União através do ensaio de microcisalhamento (1 mm/min), após armazenamento em saliva artificial por 24 h. A análise do padrão de fratura foi realizada em microscópio óptico (40x). Por meio da Microscopia Eletrônica de Varredura (MEV), a morfologia das superfícies dentinárias hígida e submetida ao desafio erosivo, antes e após o tratamento com laser de Er:YAG (n=3), foi avaliada. Os valores obtidos de resistência de união (MPa) foram submetidos ao teste ANOVA e de comparações múltiplas de Tukey (p<0,05) e as análises das eletromicrografias foram feitas de forma descritiva. A análise morfológica da superfície mostrou alterações significativas na dentina hígida irradiada e na submetida à ciclagem erosiva, irradiada ou não. Quanto à resistência de união, houve diferença entre os 4 substratos analisados, sendo: dentina hígida irradiada (12,77±5,09 A), dentina hígida não irradiada (9,76±3,39 B), dentina erodida irradiada (7,62±3,39 C) e dentina erodida não irradiada (5,12±1,72 D). Houve predominância de padrão de fratura do tipo adesiva. Com base nos resultados e nos parâmetros de irradiação utilizados neste estudo, pode-se concluir que a erosão reduz a adesão em dentina e que o tratamento da superfície dentinária com laser de Er:YAG de largura de pulso super curta aumenta a adesão no substrato erodido ou hígido.

Effect of Pre-Heating Resin Composite and Light-Curing Units on Monomer Conversion

The purpose of this study was to evaluate the effect of pre-heating resin composite photo-cured with light-curing units (LCU) by FT-IR. Twenty specimens were made in a metallic mold (4 mm diameter x 2 mm thick) from composite resin-Tetric Ceram (R) (Ivoclar/Vivadent) at room temperature (25 degrees C) and pre heated to 37, 54, and 60 degrees C. The specimens were cured with halogen curing light (QTH) and light emitted by diodes (LED) during 40 s. Then, the specimens were pulverized, pressed with KBr and analyzed with FT-IR. The data were submitted to statistical analysis of variance and Kruskal-Wallis test. Study data showed no statistically significant difference to the degree of conversion for the different light curing units (QTH and LED) (p > 0.05). With the increase of temperature there was significant increase in the degree of conversion (p < 0.05). In this study were not found evidence that the light curing unit and temperature influenced the degree of conversion.

Influence of different light sources and photo-activation methods on degree of conversion and polymerization shrinkage of a nanocomposite resin

The purpose of this study was to evaluate the influence of different light sources and photo-activation methods on degree of conversion (DC%) and polymerization shrinkage (PS) of a nanocomposite resin (Filtek (TM) Supreme XT, 3M/ESPE). Two light-curing units (LCUs), one halogen-lamp (QTH) and one light-emitting-diode (LED), and two different photo-activation methods (continuous and gradual) were investigated in this study. The specimens were divided in four groups: group 1-power density (PD) of 570 mW/cm(2) for 20 s (QTH); group 2-PD 0 at 570 mW/cm(2) for 10 s + 10 s at 570 mW/cm(2) (QTH); group 3-PD 860 mW/cm(2) for 20 s (LED), and group 4-PD 125 mW/cm(2) for 10 s + 10 s at 860 mW/cm(2) (LED). A testing machine EMIC with rectangular steel bases (6 x 1 x 2 mm) was used to record the polymerization shrinkage forces (MPa) for a period that started with the photo-activation and ended after two minutes of measurement. For each group, ten repetitions (n = 40) were performed. For DC% measurements, five specimens (n = 20) for each group were made in a metallic mold (2 mm thickness and 4 mm diameter, ISO 4049) and them pulverized, pressed with bromide potassium (KBr) and analyzed with FT-IR spectroscopy. The data of PS were analyzed by Analysis of Variance (ANOVA) with Welch`s correction and Tamhane`s test. The PS means (MPa) were: 0.60 (G1); 0.47 (G2); 0.52 (G3) and 0.45 (G4), showing significant differences between two photo-activation methods, regardless of the light source used. The continuous method provided the highest values for PS. The data of DC% were analyzed by Analysis of Variance (ANOVA) and shows significant differences for QTH LCUs, regardless of the photo-activation method used. The QTH provided the lowest values for DC%. The gradual method provides lower polymerization contraction, either with halogen lamp or LED. Degree of conversion (%) for continuous or gradual photo-activation method was influenced by the LCUs. Thus, the presented results suggest that gradual method photo-activation with LED LCU would suffice to ensure adequate degree of conversion and minimum polymerization shrinkage.

Measurement of shrinkage of composite resin by laser speckle contrast analysis

The aim of this study was to evaluate the shrinkage of a microhybrid dental composite resin photo-activated by one LED with different power densities by means of speckle technique. The dental composite resin Filtek (TM) Z-250 (3M/ESPE) at color A(2) was used for the samples preparation. Uncured composite was packed in a metallic mold and irradiated during 20 s from 100 to 1000 mW cm(-2). For the photo-activation of the samples, it was used a LED prototype (Light Emission Diode) with wavelength centered at 470 nm and adjustable power density until 1 W cm(-2). The speckle patterns obtained from the bottom composite surfaces were monitored using a CCD camera without lens. The speckle field is recorded in a digital picture and stored by CCD camera as the carrier of information on the displacement of the tested surface. The calculated values were obtained for each pair of adjacent patterns and the changes in speckle contrast as a function of time were obtained from six repeated measurements. The speckle contrasts obtained from the bottom surface with 100 mW cm(-1) were smaller than those than the other power densities. The higher power densities provided the higher shrinkage.

FT-IR spectroscopy assessment of aesthetic dental materials irradiated with low-dose therapeutic ionizing radiation

The aim of the present study was to evaluate the effects of low-dose therapeutic ionizing radiation on different aesthetic dental materials. Forty five specimens (n = 45) of three different aesthetic restorative materials were prepared and randomly divided into five groups: G1 (control group); G2, G3, G4, G5 experimental groups irradiated respectively with 0.25, 0.50, 0.75, and 1.00 Gy of gamma radiation by the (60)Co teletherapy machine. Chemical analyses were performed using a FT-IR Nicolet 520 spectrophotometer with reflectance diffuse technique. Even a minimal exposition at ionizing radiation in therapeutic doses can provide chemical changes on light-cured composite resins. The three studied restorative materials showed changes after exposure at gamma radiation, however the increase of the radiation dose did not contribute to an increase in this effect.

Effect of different dental composite resins on the polymerization process

Dental composite resins possess good esthetic properties, and are currently among the most popular dental restorative materials. Both organic and inorganic phases might influence the material behavior, the filler particle features and rate are the most important factors related to improvement of the mechanical properties of resin composites. Thus, the objective of this study was to evaluate the effect of three different composite resins on the polymerization process by Vickers hardness test. The samples were prepared using three different composite resins, as follow: group I-P-60 (3M/ESPE); group II-Herculite XRV (Kerr), and group III-Durafill (Heraeus-Kulzer). The samples were made in a polytetrafluoroethylene mould, with a rectangular cavity measuring 7 mm in length, 4 mm in width, and 3 mm in thickness. The samples were photo-activated by one light-curing unit based on blue LEDs (Ultrablue III-DMC/Brazil) for 20 and 40 s of irradiation times. The Vickers hardness test was performed 24 h after the photo-activation until the standardized depth of 3 mm. The Vickers hardness mean values varied from 158.9 (+/- 0.81) to 81.4 (+/- 1.94) for P-60, from 138.7 (+/- 0.37) to 61.7 (+/- 0.24) for Herculite XRV, and from 107. 5 (+/- 0.81) to 44.5 (+/- 1.36) for Durafill composite resins photo-activated during 20 s for the 1st and 2nd mm, respectively. During 40 s of photo-activation, the Vickers hardness mean values were: from 181.0 (+/- 0.70) to 15.6 (+/- 0.29) for P-60, and from 161.8 (+/- 0.41) to 11.2 (+/- 0.17) for Herculite XRV composite resins, for the 1st and 3th mm, respectively. For Durafill composite resin the mean values varied from 120.1 (+/- 0.66) to 61.7 (+/- 0.20), for the 1st and 2nd mm, respectively. The variation coefficient (CV) was in the most of the groups lower than 1%, then the descriptive statistic analysis was used. The Vickers hardness mean values for Durafill were lower than P-60 and Herculite XRV composite resins for 20 and 40 s of irradiation time. The polymerization process was greatly affected by the composition of the composite resins.

Influence of Er,Cr : YSGG laser treatment on the microtensile bond strength of adhesives to dentin

Purpose: In light of the concept of minimally invasive dentistry, erbium lasers have been considered as an alternative technique to the use of diamond burs for cavity preparation. The purpose of this study was to assess the bonding effectiveness of adhesives to Er,Cr:YSGG laser-irradiated dentin using irradiation settings specific for cavity preparation. Materials and Methods: Fifty-four midcoronal dentin surfaces, obtained from sound human molars, were irradiated with an Er,Cr:YSGG laser or prepared with a diamond bur using a high-speed turbine. One etch-and-rinse (Optibond FL/Kerr) and three self-etching adhesives (Adper Prompt L-Pop/3M ESPE, Clearfil SE Bond/Kuraray, and Clearfil S-3 Bond/Kuraray) were used to bond the composite to dentin. The microtensile bond strength (mu TBS) was determined after 24 h of storage in water at 37 degrees C. The Kruskal-Wallis test was used to determine pairwise statistical differences (p < 0.05). Prepared dentin surfaces, adhesive interfaces, and failure patterns were analyzed using a stereo microscope and Field-emission gun Scanning Electron Microscopy (Feg-SEM). Results: Significantly lower mu TBS was observed to laser-irradiated than to bur-cut dentin (p < 0.05), irrespective of the adhesive employed. Feg-SEM photomicrographs of lased dentin revealed an imbricate patterned substrate and the presence of microcracks at the dentin surface. Conclusion: Morphological alterations produced by Er,Cr:YSGG laser-irradiation adversely influence the bonding effectiveness of adhesives to dentin. Keywords: dentin, adhesion, adhesives, laser, ErCr:YSGG.