Laser irradiation prevents root caries: Microhardness and scanning electron microscopy analysis.

Context: A promising option for the prevention of dental caries is the use of laser irradiation. Aims: Evaluate the effects of Er:YAG, Nd:YAG, and CO2 laser irradiation, associated or not to 2% sodium fluoride (2% NaF), on root caries prevention. Material and Methods: One hundred and four human root dentin samples were divided in eight groups (n = 13). A 9-mm2-area on each dentin sample was delimited and treated as follows: G1: no treatment (control); G2: 2% NaF; G3: Er:YAG; G4: 2% NaF + Er:YAG; G5: Nd:YAG; G6: 2% NaF + Nd:YAG; G7: CO2; G8: 2% NaF + CO2. When used, the 2% NaF was applied before irradiation for 4 min. The samples were subjected to a 2-week cariogenic challenge, consisted of daily immersion in de-remineralizing solutions for 6 h and 18 h, respectively. Knoop hardness (KHN) were evaluated (10 g and 20 s) at different depths from the dentin surface. The samples (n = 3) were prepared for scanning electron microscopy (SEM). Microhardness data were analysed by one-way analysis of variance (ANOVA) and Fisher's test (α = 5%). Results: The Er:YAG laser group (KHN = 41.30) promoted an increase in acid resistance of the dentin (P < 0.05) when compared to all groups. There was no synergism between laser irradiation and 2% NaF application. Morphological changes were observed after irradiation with all lasers; carbonization and cracks were also observed, except when Er:YAG were used. Conclusions: Er:YAG laser irradiation can safely increase the acid resistance of the dentin surface of the root, since it promoted a significant increase in surface hardness. The application of 2% NaF did not result in a synergistic effect.

Development of Streptococcus mutans biofilm in the presence of human colostrum and 3'-sialyllactose.

AIM: To evaluate the initial adhesion and formation of Streptococcus mutans biofilm in vitro in the presence of saliva, human colostrum and 3'-sialyllactose. METHODS: Human colostrum and salivas were collected from 30 mothers and newborn postpartum. Eighteen hours culture of S. mutans was treated with colostrum or 3'-sialyllactose in three different moments: before, during, and after 24 h from the microbial inoculation. Salivas were also tested in conjunction with colostrum. The assays were realized in sterile 96-well flat-bottom microtiter plates for 24 h. The biofilms were fixed, washed, stained with crystal violet, and extracted. Absorbance was measured to evaluate biofilm growth mass. RESULTS: Colostrum applied after and during the inoculation decreased biofilm formation when compared with the control (p < .05). The presence of saliva increased the biofilm biomass (p < .05). The application of 3'-sialyllactose reduced biofilm formation independently of moments of application (p < .05). CONCLUSION: Saliva contributed to the proliferation of biofilm and colostrum did not prevent the initial adhesion, but interfered in the accumulation and development of microorganisms in biofilms. 3'-sialyllactose significantly decreased biofilm formation. This information expands the importance of colostrum as a potent oral antimicrobial biofluid.

Influence of Er,Cr:YSGG laser on dentin acid resistance after erosive challenge.

PURPOSE: To evaluate the influence of the Er,Cr:YSGG laser with or without the 5% fluoride varnish on the acid resistance of dentin after erosive challenge. METHODS: 36 incisors were selected and sectioned, obtaining 72 specimens of 4 mm × 4 mm and randomly divided into eight groups (n = 9). In G1: application of Er,Cr:YSGG (0.1W; 5Hz, air 55%); G2: laser (0.25W; 5Hz, air 55%); G3: fluoride varnish + laser (0.1W; 5Hz, air 55%); G4: fluoride varnish + laser (0.25W, 5Hz, air 55%); G5: fluoride varnish + laser (0.1W; 5Hz, without air); G6: fluoride varnish + laser (0.25W, 5Hz, without air); G7: fluoride varnish and G8: no treatment. When used, the laser was irradiated without water cooling, scanning mode during 10 seconds. The surface roughness data were subjected to ANOVA. For wear profile, we used Kruskal-Wallis test and Dunn post-hoc, all with α= 0.05. RESULTS: The results showed no statistically significant difference when comparing the groups as regards to the surface roughness (P> 0.05). Regarding the percentage of lost volume, the G5 and G6 groups presented the best results (G5 = 7.8% and G6 = 8.5%), with the lowest loss of dentin volume compared to other groups (P< 0.05). The G8 group (no treatment) had the highest lost volume (G8 = 39.1% followed by the G7 group (fluoride varnish), which had 25.9%. CLINICAL SIGNIFICANCE: The use of Er,Cr:YSGG laser and fluoride varnish can be an effective method to increase the acid resistance of dentin after erosive challenges, and limit problems related to hypersensitivity.

Surface roughness and bacterial adhesion on root dentin treated with diode laser and conventional desensitizing agents.

The treatments for dentin hypersensitivity (DH) may change the surface roughness of the root dentin, which can lead to biofilm accumulation, increasing the risk of root caries. The aim was to compare the surface roughness of root dentin after different treatments of DH and the biofilm formation on those surfaces. After initial surface roughness (Sa) assessment, 50 bovine root fragments received the following treatments (n = 10): G 1-no treatment; G2-5% sodium fluoride varnish; G3-professional application of a desensitizing dentifrice; G4-toothbrushing with a desensitizing dentifrice; and G5-diode laser application (908 nm; 1.5 W, 20 s). The Sa was reevaluated after treatments. Afterward, all samples were incubated in a suspension of Streptococcus mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted using a stereoscope, and the results were expressed in CFU/mL. The one-way ANOVA and the Tukey's tests compared the roughness data and the results obtained on the bacterial adhesion test (α = 5%). G2 (2.3 ± 1.67%) showed similar Sa variation than G1 (0.25 ± 0.41%) and G5 (5.69 ± 0.99%), but different from group G3 (9.05 ± 2.39%). Group 4 showed the highest Sa variation (30.02 ± 3.83%; p < 0.05). Bacterial adhesion was higher in G4 (2208 ± 211.9), suggesting that bacterial growth is greater on rougher surfaces. The diode laser and the conventional treatments for DH may change the surface roughness of the root dentin, but only brushing with desensitizing dentifrice induced a higher bacteria accumulation on root dentin surface.

Evaluation of Surface Roughness and Bacterial Adhesion on Tooth Enamel Irradiated With High Intensity Lasers.

The aim was to evaluate the surface roughness and bacterial adhesion on enamel irradiated with high intensity lasers, associated or not to a fluoride varnish. Eighty fragments of bovine enamel were equally divided in 8 groups (n=10). Group 1 was not treated and Group 2 received only a 5% fluoride varnish application. The other groups were irradiated with an Er:Cr:YSGG (8.92 J/cm2), an Nd:YAG (84.9 J/cm2) and a diode laser (199.04 J/cm2), associated or not to a 5% fluoride varnish. The surface roughness was measured before and after treatments. Afterward, all samples were incubated in a suspension of S. mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted by a stereoscope and the results were expressed in CFU/mm2. One-way ANOVA and the Tukey´s test compared the roughness data and the Student´s test compared the results obtained in the bacterial adhesion test (a=5%). The results showed that the irradiated samples without varnish presented the same roughness and the same bacterial adhesion that the non-irradiated samples. However, samples irradiated in the presence of fluoride varnish showed higher surface roughness and higher bacterial adhesion than the non-irradiated samples and those irradiated without varnish. Presence of pigments in the varnish increased the lasers' action on the enamel surface, which produced ablation in this hard tissue and significantly increased its surface roughness. For this reason, the enamel's susceptibility to bacterial adhesion was higher when the irradiation of the samples was made in presence of fluoride varnish.

Evaluation of Surface Roughness and Bacterial Adhesion on Tooth Enamel Irradiated With High Intensity Lasers

Abstract The aim was to evaluate the surface roughness and bacterial adhesion on enamel irradiated with high intensity lasers, associated or not to a fluoride varnish. Eighty fragments of bovine enamel were equally divided in 8 groups (n=10). Group 1 was not treated and Group 2 received only a 5% fluoride varnish application. The other groups were irradiated with an Er:Cr:YSGG (8.92 J/cm2), an Nd:YAG (84.9 J/cm2) and a diode laser (199.04 J/cm2), associated or not to a 5% fluoride varnish. The surface roughness was measured before and after treatments. Afterward, all samples were incubated in a suspension of S. mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted by a stereoscope and the results were expressed in CFU/mm2. One-way ANOVA and the Tukey´s test compared the roughness data and the Student´s test compared the results obtained in the bacterial adhesion test (a=5%). The results showed that the irradiated samples without varnish presented the same roughness and the same bacterial adhesion that the non-irradiated samples. However, samples irradiated in the presence of fluoride varnish showed higher surface roughness and higher bacterial adhesion than the non-irradiated samples and those irradiated without varnish. Presence of pigments in the varnish increased the lasers’ action on the enamel surface, which produced ablation in this hard tissue and significantly increased its surface roughness. For this reason, the enamel’s susceptibility to bacterial adhesion was higher when the irradiation of the samples was made in presence of fluoride varnish.

Resumo O objetivo foi avaliar a rugosidade superficial e adesão bacteriana no esmalte dental irradiado com lasers de alta intensidade, associados ou não a um verniz fluoretado. Oitenta fragmentos de esmalte foram igualmente divididos em 8 grupos (n= 10). O grupo 1 não recebeu tratamento e o grupo 2 recebeu aplicação de verniz fluoretado a 5%. Os outros grupos foram irradiados com os lasers Er,Cr:YSGG (8,92 J/cm2), Nd:YAG (84,9 J/cm2) e um laser de diodo (199,04 J/cm2), associados ou não ao verniz fluoretado. A rugosidade superficial foi medida antes e após os tratamentos. Depois, todas as amostras foram imersas em suspensão de S. mutans a 37 °C durante 24 h. As unidades formadoras de colônia (UFC) foram contadas utilizando uma lupa estereoscópica, e os resultados foram expressos em UFC/mm2. Os resultados de rugosidade foram analisados por ANOVA e pelo teste de Tukey, e a adesão bacteriana foi analisada pelo teste de Student (a=5%). As amostras irradiadas sem verniz apresentaram a mesma rugosidade superficial e a mesma adesão bacteriana que as amostras não irradiadas. No entanto, as amostras irradiadas na presença do verniz fluoretado apresentaram maior rugosidade superficial e aderência bacteriana do que as amostras não irradiadas e daquelas irradiadas sem o verniz. A presença de pigmentos no verniz aumentou a ação dos lasers na superfície do esmalte, promovendo a ablação do tecido duro e aumentando significativamente a sua rugosidade superficial. Por isso, a adesão bacteriana no esmalte foi maior quando a irradiação foi realizada na presença do verniz fluoretado.

Hipoplasia de esmalte em paciente hebiátrico: relato de caso clínico / Enamel hypoplasia in an adolescent patient: clinical case report

O objetivo deste trabalho foi relatar um caso clínico de hipoplasia de esmalte em paciente hebiátrico, assim como a reabilitação estética dos dentes acometidos. Paciente de 12 anos do sexo masculino procurou a policlínica Getúlio Vargas da Universidade de Uberaba queixando-se de alteração de cor de seus dentes permanentes. Clinicamente, observou-se nos terços médio e incisal dos caninos superiores a presença de manchasamareladas e regiões com perda de estrutura dental, sugerindo lesões de hipoplasia de esmalte. Diante das características das lesões foi proposto o tratamento restaurador dos dentes. As estruturas hipoplásicas nos dentes 13 e 23 foram desgastadas limitando-se à remoção da estrutura dentária afetada. Após o condicionamento ácido e aplicação do sistema adesivo, realizou-se a restauração com resina composta micro-híbrida pela técnicade estratificação da dentina e esmalte, seguido pelo acabamento e polimento das restaurações. O resultado clínico observado mostrou que o tratamento proposto foi capaz de restabelecer a harmonia estética, propiciando significativo impacto positivo à auto-estima do paciente.

The objective of this study was to report a case of enamel hypoplasia in an adolescent patient, as well as the aesthetic rehabilitation of the affected teeth. A 12-year-old male patient came to the Dental Clinic of the University of Uberaba complaining about the discoloration of his permanent teeth. Clinically, it was observed in the middle third of the upper canines the presence of yellow spots and surfaces with small cavities, suggesting lesions of enamel hypoplasia. In face of the characteristics of the lesions, the restorative treatment was proposed. The hypoplastic enamel lesions presented in the upper canines were removed with spherical diamond burs. After etching and application of the adhesive system, a micro-hybrid composite was used to fill the cavities. The polishing was done with silicon burs. The clinical outcomes showed that this treatment was able to restore the color and the shape of the affected teeth, providing significantpositive impact on self-esteem of the patient.

In vitro assessment of the acid resistance of demineralized enamel irradiated with Er, Cr:YSGG and Nd:YAG lasers.

PURPOSE: This study's purpose was to evaluate the acid resistance of demineralized enamel irradiated with high-intensity lasers. METHODS: Enamel fragments were demineralized and treated as follows (N=10): Group 1-no treatment; Group 2-five percent sodium fluoride (NaF) varnish; Group 3-Er, Cr:YSGG laser (8.92 J/cm2, 0.5 W, 20 Hz, 30 seconds); Group 4-NaF and Er, Cr:YSGG laser; Group 5-Er, Cr:YSGG laser and NaF; Group 6-Nd:YAG laser (84.9 J/cm2, 0.5 W, 10 Hz, 30 seconds); Group 7-NaF and Nd:YAG laser; and Group 8-Nd:YAG laser and NaF. The samples were subjected to pH-cycling and assessed by microhardness (analysis of variance; α equals five percent) at different depths from the outer enamel surface. Samples were observed using polarized light microscopy (PLM) and scanning electron microscopy (SEM). RESULTS: There were no significant differences among the experimental groups in any of the subsurface layers evaluated. PLM observation revealed that the extent of demineralization of the irradiated samples was similar to the samples for Group 1 (control). SEM observation showed that irradiated surfaces were ablated and presented areas of melting. CONCLUSIONS: Laser irradiation, with or without applying five percent sodium fluoride, was not capable of increasing the enamel white spot lesions' acid resistance.

Effect of different root caries treatments on the sealing ability of conventional glass ionomer cement restorations.

In this study we compared the microleakage of conventional glass ionomer cement (GIC) restorations following the use of different methods of root caries removal. In vitro root caries were induced in 75 human root dentin samples that were divided in five groups of 15 each according to the method used for caries removal: in group 1 spherical carbide burs at low speed were used, in group 2 a hand-held excavator was used, and in groups 3 to 5 an Er,Cr:YSGG laser was used at 2.25 W, 40.18 J/cm(2) (group 3), 2.50 W, 44.64 J/cm(2) (group 4) and 2.75 W, 49.11 J/cm(2) (group 5). The air/water cooling during irradiation was set to 55%/65% respectively. All cavities were filled with GIC. Five samples from each group were evaluated by scanning electron microscopy (SEM) and the other ten samples were thermocycled and submitted to a microleakage test. The data obtained were compared by ANOVA followed by Fisher's test (p≤0.05). Group 4 showed the lowest microleakage index (56.65 6.30; p<0.05). There were no significant differences among the other groups. On SEM images samples of groups 1 and 2 showed a more regular interface than the irradiated samples. Demineralized dentin below the restoration was observed, that was probably affected dentin. Group 4 showed the lowest microleakage values compared to the other experimental groups, so under the conditions of the present study the method that provided the lowest microleakage was the Er,Cr:YSGG laser with a power output of 2.5 W yielding an energy density of 44.64 J/cm(2).

In vitro analysis of inhibitory effects of the antibacterial monomer MDPB-containing restorations on the progression of secondary root caries.

OBJECTIVE: This study aimed to analyze in vitro inhibitory effects of restorative materials containing the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) on the formation of artificial secondary root caries lesions. METHODS: Class V cavities (2mmx2mm) were prepared in 75 human root fragments. Specimens were randomly divided into five groups (n=15 fragments per group) and restored as follows: (I) MDPB-free adhesive system+MDPB-free composite (negative control); (II) resin modified glass ionomer (RM-GIC; positive control); (III) MDPB-free adhesive system+MDPB-containing composite (2.83% MDPB); (IV) MDPB-containing adhesive system+MDPB-free composite; (V) MDPB-containing adhesive system+MDPB-containing composite. Artificial secondary root caries lesions were produced by a biological artificial caries challenge. The restored specimens were immersed into a culture medium containing Streptococcus mutans and sucrose for 15 days. Histological slices (80+/-20 microm) of the specimens were used for measuring the mean depths of the artificial lesions produced in both margins of the restorations using polarized light microscopy. Results were expressed in percentage related to the mean depth of the negative control, considered 100%. Data were compared by ANOVA followed by the Tukey's test (p< or =0.05). RESULTS: The depths of lesions adjacent to cavities filled with RM-GIC (GII; 85.17+/-15.2%) were significantly (p<0.01) shallower than those adjacent to restorations with MDPB-free composite (GI; 100.00+/-10.04%), despite the presence of MDPB in the adhesive system (GIV; 101.95+/-21.32%). The depths of lesions adjacent to cavities restored with MDPB-containing composite (GIII; 82.68+/-12.81% and GV; 85.65+/-15.42%), despite the adhesive system used, were similar to those of RM-GIC (GII). Mean lesions depths in these groups decreased from 13% (GV) to 17% (GIII) in relation to the negative control (GI). CONCLUSIONS: MDPB-containing composite inhibits the progression of artificial secondary root caries lesions regardless of adhesive systems.

Effect of low-intensity laser therapy on mast cell degranulation in human oral mucosa.

Little is known about the physiological mechanisms related to low-intensity laser therapy (LILT), particularly in acute inflammation and subsequent wound healing. The objective of this study was to verify the effect of LILT on mast cell degranulation. Epulis fissuratum tissues from eight patients were used. One part of the lesion was irradiated with an AsGaAl laser (lambda = 670 nm, 8.0 J/cm(2), 5 mW, 4 min). The other part was not irradiated. Then, the specimens were immediately removed, fixed and examined by light microscopy. The number of mast cells was similar in laser-treated samples when compared with non-irradiated specimens. The degranulation indexes of the mast cells observed in the irradiated samples were significantly higher than those of controls (P < 0.05). LILT with the parameters used increased the number of degranulated mast cells in oral mucosa.

Chlorhexidine's effect on sealing ability of composite restorations following Er:YAG laser cavity preparation.

AIM: The aim of this study was to evaluate the influence of chlorhexidine on microleakage of composite restorations in class V cavities prepared with a carbide bur (CB) and a erbium:yttrium-aluminum-garnet (Er:YAG) laser. METHODS AND MATERIALS: Cavity preparations were created on the buccal surfaces of 48 bovine incisors using different methods then equally dividing them into four groups. Groups I and II were prepared with a #56 CB in a high speed handpiece while Groups III and IV were prepared with a Er:YAG laser at 350m J/4Hz on enamel and at 80.24 J/cm2 on dentin. The cavity preparations were rinsed with 2% chlorhexidine solution before the application of Clearfill SE Bond system and placement of a Z100 composite resin restoration. After 24 hours, the teeth were polished, thermocycled, and sealed with cosmetic varnish. The samples were then immersed in 2% methylene blue for four hours and sectioned in the buccolingual direction to determine the degree of microleakage. RESULTS: After statistical analysis (Kruskal-Wallis, p<0.05), no significant differences were verified among the tested groups and between the evaluated cervical or incisal margins of the restoration. CONCLUSION: The use of the chlorhexidine did not interfere with the adhesion process regardless of whether a CB or the Er:YAG laser were used to prepare class V cavities when restored with the tested self-etching adhesive system.

Intrapulpal temperature during preparation with the Er:YAG laser: an in vitro study.

OBJECTIVE: This investigation evaluated the variation of the intrapulpal temperature when dentine was irradiated by the Er:YAG laser. BACKGROUND DATA: The effect of preparation with the Er:YAG laser on the intrapulpal temperature is probably the biggest problem in using the laser for preparation of dental hard tissue. MATERIALS AND METHODS: Seventy-two bovine incisors were studied that had the enamel and dentine of the buccal surface polished to a thickness of 2.0 mm. The teeth were divided into three groups, according to the repetition rate used (Group I = 2 Hz, Group II = 4 Hz, and Group III = 6 Hz), and irradiated, with or without water cooling, using 250, 300, and 350 mJ of energy per pulse. Thermocouples were introduced inside the pulp chamber through the palatine opening of the samples and fixed to the vestibular wall of the pulp chamber using a thermal paste. RESULTS: It was verified that there was a decrease of the intrapulpal temperature for all of the parameters in the Group I irradiated with water cooling and for the parameters of 350 mJ/4 Hz with water cooling. The other irradiations showed an increase of the intrapulpal temperature, varying from 0.03 degrees to 2.5 degrees C. CONCLUSION: We conclude that the use of the Er:YAG laser promoted acceptable temperature increases inside the pulp chamber. However, we do not recommend this procedure without water cooling because macroscopic observations of the dentine irradiated without water cooling showed dark lesions, suggesting carbonization of this tissue.