Influence of the power level of an ultra-sonic system on dental cavity preparation

The aim of this study was to evaluate the shape of dental cavities made with the CVDentus® system using different ultrasound power levels. One standard cavity was made on the buccal aspect of 15 bovine incisors with a CVDentus® cylindrical bur (82142). The sample was divided into three groups: G1 - ultrasound with power II; G2 - ultrasound with power III; and G3 - ultrasound with power IV. A standardizing device was used to obtain standardized preparations and ultrasound was applied during one minute in each dental preparation. The cavities were sectioned in the middle, allowing observation of the cavity's profile with a magnifying glass, and width and depth measurement using the Leica Qwin program. The Kruskal-Wallis (p < 0.05) and Dunn statistical analyses demonstrated differences between the dental cavity shapes when powers III and IV were used. However, the cavities that were made with power III presented dimensions similar to those of the bur used for preparation. We concluded that the power recommended by the manufacturer (III) is the most adequate for use with the CVDentus® system.

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.

Influence of cavity preparation and curing method on the marginal seal of resin composite restorations: an in vitro evaluation.

OBJECTIVE: To evaluate the influence of cavity design and photocuring method on the marginal seal of resin composite restorations. METHOD AND MATERIALS: Seventy-two bovine teeth were divided into 2 groups: group 1 received box-type cavity preparations, and group 2 received plate-type preparations. Each group was divided into 3 subgroups. After etching and bonding, Z250 resin composite (3M Espe) was applied in 2 equal increments and cured with 1 of 3 techniques: (1) conventional curing for 30 seconds at 650 mW/cm2; (2) 2-step photocuring, in which the first step was performed 14 mm from the restoration for 10 seconds at 180 mW/cm2 and the second step was performed in direct contact for 20 seconds at 650 mW/cm2; or (3) progressive curing using Jetlite 4000 (J. Morita) for 8 seconds at 125 mW/cm2 and then 22 seconds at 125 mW/cm2 up to 500 mW/cm2. The specimens were thermocycled for 500 cycles and then submitted to dye penetration with a 50% silver nitrate solution. Microleakage was assessed using a stereomicroscope. Data were analyzed using analysis of variance and Tukey test (5% level of significance). RESULTS: A statistically significant difference was found between groups when a double interaction between photocuring and cavity preparation was considered (P = .029). CONCLUSIONS: No one type of cavity preparation or photocuring method prevented micro-leakage. The plate-type preparation showed the worst dye penetration when conventional and progressive photocuring methods were used. The best results were found using the 2-step photocuring with the plate-type preparation.

Evaluation of the dentin-pulp complex after cavity preparation with ultrasonic diamond tip

The aim of this paper was to compare the dentin-pulp complex response to cavity preparation in human teeth using ultrasonic chemical vapor deposition (CVD) diamond tip and high-speed diamond bur. Class V buccal cavities were randomly prepared in 40 premolars from 14 patients aged 11 to 15 years. The cutting time was recorded and the cavities had the axial walls protected with gutta-percha and were filled with glass ionomer cement. The teeth were extracted at intervals of 0, 5, 10 and 20 days, and were decalcified, sectioned and stained by Hematoxylin & Eosin, Masson's Trichrome and Brown & Brenn techniques. The inflammatory response and cell disorganization were blindly evaluated by two examiners. The remaining dentin thickness (RDT) was measured by a linear scale using computer software. Statistical analysis by one-way ANOVA showed no statistically significant difference (P≤0.05) among the cavities prepared with either type of instrument, with mean RDT of 1132.50 mm. Cutting time and the pulp-dentin complex responses were analyzed statistically by Kruskal-Wallis and Dunn tests (P≤0.05). The ultrasonic CVD diamond tip took 5 times longer to prepare the cavities and there were no typical inflammatory pulp responses in cavities prepared with either type of cutting instrument, only mild to moderate cell disorganization was present. Even taking longer to cut the dental substrate, the ultrasonic CVD diamond tip produced similar pulp response compared to the conventional high-speed diamond bur.

Application of Er:YAG and Er, Cr:YSGG lasers in cavity preparation for dental tissues: a literature review

The laser has been widely used in many specialties of dentistry and several wavelengths have been investigated as a substitute for high-speed handpiece. The purpose of this paper is to review the literature about the use of Er:YAG and Er,Cr:YSGG lasers in cavity preparation for dental tissues. Despite the differences in wavelength, pulse duration and energy, the morphological characteristics of the irradiated dentin surface with these lasers are comparable, as well as its effects as methods of dental caries prevention. Thus, Er:YAG and Er,Cr:YSGG lasers prepared cavities with similar effects on the dental tissue, however, further investigations about ideal irradiation conditions are needed for both lasers.

Cavity Preparation and Influence of Restorative Materials on the Prevention of Secondary Caries

Objective: This in vitro study evaluated the influence of cavity preparation using the Er:YAG laser and restorative materials containing fluoride on preventing caries lesions. Background: It has been suggested that cavity preparation using the Er:YAG laser has a potential for improving resistance to secondary caries on enamel. Methods: Forty unerupted human third molars teeth were sectioned into 72 blocks of dental enamel and distributed into two groups to prepare cavities measuring (1.6 mm diameter) with diamond burs (DB) or Er:YAG laser (LA; 6 Hz, 300 mJ, 47 J/cm(2)). After that, each group was divided into three subgroups and restored with a glass-ionomer cement (GI), a resin-modified glass-ionomer (RM), or a composite resin (CR). Blocks were thermal cycled and submitted to a pH challenge to develop artificial caries-like lesions. Lesions were evaluated by Knoop microhardness test. An average of four indentations was used. Statistical analyses were performed by ANOVA followed by Tukey's test. Results: The results (in Knoop hardness number) for DB cavity preparation were GI, 235.5 (+/- 75.5); RM, 137.1 (+/- 64.1); and CR, 39.3 (+/- 26.5). For LA cavity preparation, the results were GI, 410.0 (+/- 129.7); RM, 310.3 (+/- 119.5); and CR, 96.4 (+/- 57.4). Conclusions: There was less development of caries lesion around LA-prepared cavities than around the DB-prepared cavities; however, no synergistic cariostatic effect was observed between the Er:YAG laser and glass ionomer cement.

A method of evaluating psychomotor tooth preparation skills in preclinical dental programs

Preclinical and clinical tooth important and significant aspect of preparation is an a dental student's education. The associated procedures rely heavily on the development of particular psychomotor skills. The most common format of instruction and evaluation in tooth preparation at many Dental Faculties, emphasizes the product (tooth preparation) and associates performance with characteristics of this product. This integrated study examines which skills should be developed and how a course of instruction can best be structured to develop the necessary skills. The skills which are identified are those necessary for tooth preparation are selected from a psychomotor taxonomy. The purpose of evaluating these skills is identified. Behavioral objectives are set for student performance and the advisability of establishing standards of performance is examined. After reviewing studies related to learning strategy for dental psychomotor the most suitable tasks as well as articles on instructor effectiveness a model is proposed. A pilot project at the University of Toronto, based on this proposed model is described. The paper concludes wi th a discussion of the implications of this proposed model.

Comparative Histopathological Analysis of Human Pulps after Class I Cavity Preparation with a High-Speed Air-Turbine Handpiece or Er:YAG Laser

The purpose of this study was to comparatively evaluate the response of human pulps after cavity preparation with different devices. Deep class I cavities were prepared in sound mandibular premolars using either a high-speed air-turbine handpiece (Group 1) or an Er: YAG laser (Group 2). Following total acid etching and the application of an adhesive system, all cavities were restored with composite resin. Fifteen days after the clinical procedure, the teeth were extracted and processed for analysis under optical microscopy. In Group 1 in which the average for the remaining dentin thickness (RDT) between the cavity floor and the coronal pulp was 909.5 mu m, a discrete inflammatory response occurred in only one specimen with an RDT of 214 mu m. However, tissue disorganization occurred in most specimens. In Group 2 (average RDT = 935.2 mu m), the discrete inflammatory pulp response was observed in only one specimen (average RDT = 413 mu m). It may be concluded that the high-speed air-turbine handpiece caused greater structural alterations in the pulp, although without inducing inflammatory processes.

High-speed cavity preparation techniques with different water flows

Statement of problem. Cavity and tooth preparations generate heat because the use of rotary cutting instruments on dental tissues creates friction. Dental pulps cannot survive temperature increases greater than 5.5degreesC.Purpose. This study evaluated the efficiency of 3 different water flows for 2 different tooth preparation techniques to determine which are safe for use.Material and methods. Thermocouples were placed in the pulpal chambers of 30 bovine teeth, and 1 of 2 tooth preparation techniques was used: a low-load intermittent tooth preparation technique or a high-load tooth preparation technique without intervals. Water flows of 0, 30, and 45 mL/min were associated with each technique, for a total of 6 different groups. The results were analyzed with a 2-factor analysis of variance (P<.05).Results. Temperature increases with the high-load technique were 16.40&DEG;C without cooling (group 1), 11.68&DEG;C with 30 mL/min air-water spray cooling (group III), and 9.96&DEG;C with 45 mL/min cooling (group V). With the low-load tooth preparation technique, a 9.54&DEG;C increase resulted with no cooling (group II), a 1.56&DEG;C increase with 30 mL/min air-water spray cooling (group TV), and a 0.04&DEG;C decrease with 45 mL/min cooling (group VI). The low-load technique was associated with more ideal temperature changes.Conclusion. The results of this study confirm the necessity of using a low-load technique and water coolants during cavity and tooth preparation procedures.

Temperature rise during Er:YAG cavity preparation of primary enamel

This study aimed to assess in vitro thermal alterations taking place during the Er:YAG laser cavity preparation of primary tooth enamel at different energies and pulse repetition rates. Forty healthy human primary molars were bisected in a mesio-distal direction, thus providing 80 fragments. Two small orifices were made on the dentin surface to which type K thermocouples were attached. The fragments were individually fixed with wax in a cylindrical PlexiglassA (R) abutment and randomly assigned to eight groups, according to the laser parameters (n = 10): G1 -aEuro parts per thousand 250 mJ/ 3 Hz, G2 -aEuro parts per thousand 250 mJ/ 4 Hz, G3 -aEuro parts per thousand 250 mJ/ 6 Hz, G4 -aEuro parts per thousand 250 mJ/10 Hz, G5 -aEuro parts per thousand 250 mJ/ 15 Hz, G6 -aEuro parts per thousand 300 mJ/ 3 Hz, G7 -aEuro parts per thousand 300 mJ/ 4 Hz and G8 -aEuro parts per thousand 300 mJ/ 6 Hz. An area of 4 mm(2) was delimited. Cavities were done (2 mm long x 2 mm wide x 1 mm thick) using non-contact (12 mm) and focused mode. Temperature values were registered from the start of laser irradiation until the end of cavity preparation. Data were analyzed by one-way ANOVA and Tukey test (p a parts per thousand currency signaEuro parts per thousand 0.05). Groups G1, G2, G6, and G7 were statistically similar and furnished the lowest mean values of temperature rise. The set 250 mJ/10 and 15 Hz yielded the highest temperature values. The sets 250 and 300 mJ and 6 Hz provided temperatures with mean values below the acceptable critical value, suggesting that these parameters ablate the primary tooth enamel. Moreover, the temperature elevation was directly related to the increase in the employed pulse repetition rates. In addition, there was no direct correlation between temperature rise and energy density. Therefore, it is important to use a lower pulse frequency, such as 300 mJ and 6 Hz, during cavity preparation in pediatric patients.