The effect of CPP-ACP and Nd:YAG laser on the bond strength of softened dentin

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Longitudinal evaluation of bond strength to enamel of dental adhesive systems associated with Nd:YAG laser

Objectives: This study evaluated the durability of bond strength to enamel using total-etch (Single Bond/SB) and self-etch (Clearfil SE Bond/CSEB) adhesives associated with neody-mium: yttrium-aluminu- garnet (Nd:YAG) laser irradiation through the uncured adhesives.Methods: Bovine incisors were worn to expose an area of enamel and were divided into four groups: group 1 (control) SB + polymerization; group 2 (control) CSEB + polymerization; group 3 (laser) - B + Nd:YAG laser (174.16 J/cm(2)) + polymerization; and group 4 (laser) CSEB + Nd:YAG (174.16 J/cm(2)) + polymerization. Blocks of composite were fabricated and stored for 24 hours or 12 months, sectioned into beams, and submitted to microtensile tests. Results were analyzed by three-way analysis of variance (ANOVA) (adhesive, technique, and storage time) and Tukey tests.Results: ANOVA revealed significant differences for adhesive 3 technique and technique 3 storage time (p<0.05). The mean values (MPa) for interaction adhesive x technique (standard deviation) were as follows: SB/control = 35.78 (6.04)a; SB/laser = 26.40 (7.25)b, CSEB/control = 26.32 (5.71)b, CSEB/laser = 23.90 (7.49)b. For interaction technique x storage time the mean values were as follows: control/24 hours = 32.58 (6.49)a; control/12 months = 29.52 (8.38)a; laser/24 hours = 29.37 (5.71)a; laser/12 months = 20.92 (6.5)b. Groups with the same letters showed no statistically significant differences.Conclusion: Scanning electron microscope analysis showed evident areas of micromorphological alterations in lased samples after 12 months of water storage. Nd: YAG laser irradiation of enamel through unpolymerized totaletch adhesive significantly reduced bond strength compared with the control. Bond strength decreased when enamel samples irradiated with Nd: YAG laser through unpolymerized adhesives were stored in water for 12 months.

Influência do espaçamento do feixe de laser Nd: YAG na obtenção de óxidos e nitretos na superfície do titânio em pressão atmosférica

Neste trabalho investigou-se a modificação de superfície do titânio pela irradiação com feixe de Laser Nd:YAG. Os parâmetros do laser como a potência, o comprimento de onda, a frequência, a velocidade de varredura e a área de exposição foram mantidos constantes, exceto o espaçamento da matriz, o qual foi de 0,01 e 0,02 mm. A caracterização da superfície foi realizada por Microscopia Eletrônica de Varredura (MEV) e Difração de Raios X (DRX), sendo que os espectros foram refinados pelo método Rietveld. Pela análise de MEV, observou-se uma mudança na topografia, obtendo uma superfície rugosa produzida pelo fenômeno de ablação. As análises por Rietveld dos espectros de difração de raios X detectaram TiN, Ti2N, TiO2 (anatásio e rutilo), sendo que a amostra com espaçamento 0,01 mm apresentou uma maior quantidade de óxidos e nitretos. Isso pode ser devido à sobreposição do feixe, induzindo à formação de uma superfície com maior estabilidade termodinâmica. Os óxidos e nitretos obtidos são de grande importância, pois são responsáveis por produzir uma maior interação entre o osso-implante.

Treatment of hemangioma of the glans penis using Nd:Yag laser. Apropos of a case

Hemangioma of urinary tract are unusual, being about 2% of all hemangiomas. We present a case of a glans penis hemangioma. There is controversy concerning their treatment and outcome. Our patient was treated with a Neodymium: Yag laser irradiation, with complete morphological recuperation.

Penetration of 35% hydrogen peroxide into the pulp chamber in bovine teeth after LED or Nd:YAG laser activation

This aim of the present study was to evaluate the pulp chamber penetration of 35% hydrogen peroxide activated by LED (light-emitting diode) or Nd:YAG laser in bovine teeth, after an in-office bleaching technique. Forty-eight bovine lateral incisors were divided into four groups, acetate buffer was placed into the pulp chamber and bleaching agent was applied as follows: for group A (n = 12), activation was performed by LED; for group B (n = 12), activation was performed by Nd:YAG laser (60 mJ, 20 Hz); group C (n = 12) received no light or laser activation; and the control group (n = 12) received no bleaching gel application or light or laser activation. The acetate buffer solution was transferred to a glass tube and Leuco Crystal Violet and horseradish peroxidase were added, producing a blue solution. The optical density of this solution was determined spectrophotometrically and converted into microgram equivalents of hydrogen peroxide. The results were analysed using ANOVA and Tukey's test (5%). It was verified that the effect of activation was significant, as groups activated by LED or laser presented greater hydrogen peroxide penetration into the pulp chamber (0.499 +/- 0.622 microg) compared with groups that were not (0.198 +/- 0.218 microg). There was no statistically significant difference in the penetration of hydrogen peroxide into the pulp chamber between the two types of activation (LED or laser). The results suggest that activation by laser or LED caused an increase in hydrogen peroxide penetration into the pulp chamber.

Influence of Nd:YAG or Er:YAG laser surface treatment on microtensile bond strength of indirect resin composites to resin cement. Lasers surface treatment of indirect resin composites

This study evaluated the influence of the surface pretreatment of indirect resin composite (Signum, Admira Lab and Sinfony) on the microtensile bond strength of a resin cement. Sixty samples made of each brand were divided into 6 groups, according to surface treatment: (1) control; (2) controlled-air abrasion with Al2O3; (3) Er:YAG Laser 200 mJ, 10 Hz, for 10s; (4) Er: YAG Laser 300 mJ, 10 Hz, for 10 s; (5) Nd:YAG 80 mJ, S15Hz for 1 min; (6) Nd:YAG 120mJ, 15 Hz for 1 min. After treatments, all the groups received an application of 37% phosphoric acid and adhesive. The pair of blocks of the same brand were cemented to each other with dual resin cement. The blocks were sectioned to obtain resin-resin sticks (1 x1 mm) and analyzed by microtensile bond testing. The bond strength values were statistically different, irrespective of the surface treatment performed, with highest values for Sinfony (43.81 MPa) and lowest values for Signum (32.33 MPA). The groups treated with the Nd:YAG laser showed the lowest bond strength values and power did not interfere in the results, both for Nd:YAG laser and Er:YAG. Controlled-air abrasion with Al203 is an efficient surface treatment method and the use of the Nd:YAG and Er:YAG lasers reduced bond strength, irrespective of the intensity of energy used.

Influence of Nd:YAG laser on intrapulpal temperature and bond strength of human dentin under simulated pulpal pressure

The aim of this study was to evaluate the effects of simulated pulpal pressure (SPP) on the variation of intrapulpal temperature (ΔT) and microtensile bond strength (μTBS) to dentin submitted to an adhesive technique using laser irradiation. One hundred sound human molars were randomly divided into two groups (n = 50), according to the presence or absence of SPP (15 cm H2O). Each group was divided into five subgroups (n = 10) according to Nd:YAG laser energy (60, 80, 100, 120, 140 mJ/pulse). The samples were sequentially treated with the following: 37 % phosphoric acid, adhesive (Scotchbond Universal), irradiation with Nd:YAG laser (60 s), and light curing (10 s). ΔT was evaluated during laser irradiation using a type K thermocouple. Next, a composite resin block was build up onto the irradiated area. After 48 h, samples were submitted to microtensile test (10 kgf load cell, 0.5 mm/min). Data were analyzed by two-way ANOVA and Tukey tests (p = 0.05). ANOVA revealed significant differences for ΔT and TBS in the presence of SPP. For ΔT, the highest mean (14.3 ± 3.23 °C)(A) was observed in 140 mJ and without SPP. For μTBS, the highest mean (33.4 ± 4.15 MPa)(A) was observed in 140 mJ and without SPP. SPP significantly reduced both ΔT and μTBS during adhesive procedures, lower laser energy parameters resulted in smaller ΔT, and the laser parameters did not influence the μTBS values.

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.

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm² area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher’s LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.

Treatment of lower extremity telangiectasias in women by foam sclerotherapy vs. Nd:YAG laser: a prospective, comparative, randomized, open-label trial.

BACKGROUND Telangiectasias of the lower extremities are very common. There are no blinded, randomized, controlled clinical trials comparing laser modalities with the gold standard sclerotherapy, while the few available studies encompass small patients cohorts. OBJECTIVE This prospective, randomized, open-label trial compares the efficacy of sclerotherapy with polidocanol vs. long-pulsed neodymium-doped yttrium aluminium garnet (Nd:YAG) laser in the treatment of leg telangiectasias. PATIENTS AND METHODS Fifty-six female patients with primary leg telangiectasias and reticular veins (C1A or S Ep AS 1 PN ) were included in the study. One leg was randomly assigned to get treatment with the multiple synchronized long-pulsed Nd:YAG laser, while the other received foam sclerotherapy with polidocanol 0.5%. The patients were treated in two sessions at intervals of 6 weeks. The patients were evaluated by the handling physician after 6 weeks and 6 months. Two investigators assessed blindly at the end of the study the photographs for clearing of the vessels using a six-point scale from 1 (no change) to 6 (100% cleared). Patients reported about pain sensation and outcome satisfaction. RESULTS According to the handling dermatologist, at the last follow-up, there was an improvement of 30-40% with a median of 3 (IQR 2) and a good improvement of 50-70% with a median of 4 (IQR 2) after laser treatment and sclerotherapy respectively. In contrast, according to the blinded investigators, there was a median of 5 (IQR 1) with a very good improvement of >70% after both therapies. Improvement was achieved more quickly by sclerotherapy, although at the last follow-up visit there was no difference in clearance between the two groups as assessed by the blinded experts (P-value 0.84). The degree of patient's satisfaction was very good and similar with both therapeutic approaches. There was a significant difference (P-value 0.003) regarding pain perception between the types of therapy. Laser was felt more painful than sclerotherapy. CONCLUSION Telangiectasias of the lower extremities can be successfully treated with either synchronized long-pulsed Nd:YAG laser or sclerotherapy. The 1064-nm long-pulsed Nd:YAG laser is associated with more pain and is suitable especially in case of needle phobia, allergy to sclerosants and in presence of small veins with telangiectatic matting, while sclerotherapy can also treat the feeder veins.

Removal of fractured endodontic instruments using an Nd:YAG laser.

OBJECTIVE Fractured endodontic instruments inhibit optimal cleaning and filling of dental root canals, which may result in a less favorable prognosis for the tooth. Several techniques are available to remove fractured instruments; however, healthy tooth substance often must be destroyed in the process. This study was intended to evaluate Nd:YAG laser treatment as a method to remove fractured stainless steel instruments without destroying healthy tooth substance. METHOD AND MATERIALS Stainless steel endodontic instruments were fractured in 33 unprocessed root canals of mandibular central and lateral incisors and premolars in vitro. A brass tube charged with solder was placed at the coronal end of the fractured instrument and laser energy was used to melt the solder, connecting the fractured instrument with the brass tube. The success rates of connecting and removal of fractured instruments from the root channel were recorded for each case. RESULTS Connecting was achieved in every case in which more than 1.5 mm of the fractured instrument was tangible (22 out of 22). In cases where less than 1.5 mm was tangible, the rate for successful connection decreased to 4 out of 11 (36.4%). Fractured endodontic instruments were removed successfully in 17 out of 22 cases (77.3%) in which more than 1.5 mm was tangible. If less than 1.5 mm was tangible, the removal success rate decreased to 3 out of 11 cases (27.3%). CONCLUSION Our data support Nd:YAG laser-mediated connecting of a brass tube to a fractured endodontic instrument as a feasible and tissue conserving removal approach when more than 1.5 mm of the instrument is tangible.