The efficacy of techniques for the disinfection of artificial sub-surface dentinal caries lesions and their effect on demineralization and remineralization in vitro.

OBJECTIVES: The efficacy of three techniques for the disinfection of artificial sub-surface root caries lesions and their response to subsequent episodes of de- and remineralization was investigated quantitatively in vitro. METHODS: Sub-surface dentinal lesions (n=20), cut into four experimental blocks and deliberately contaminated with Streptococcus mutans, were subject to either steam autoclaving (121 degrees C, 5min), gamma irradiation (4100Gy), immersion in 0.1% (w/v) thymol-distilled water solution (24h) or reserved as a control. Next, the lesions were incubated aerobically in sterile nutrient broth for 24h at 37 degrees C and resultant cultures plated onto blood agar and neutralisation agar. Ten blocks from each experimental group were then immersed in an acidic buffer solution or exposed to artificial saliva for 5 days. Baseline changes in the mineral content and distribution of the lesions were assessed by transverse microradiography (TMR). RESULTS: Micro-organisms were recovered from each control block and one block treated by gamma irradiation. Steam autoclaving and immersion in a thymol solution significantly decreased (p<0.05) the amount of mineral lost from the body of lesions subject to a further acid challenge. Mineral ion uptake by lesions exposed to artificial saliva was significantly increased (p<0.05) through disinfection by steam autoclaving. CONCLUSIONS: Gamma irradiation proved the most acceptable method for the disinfection of sub-surface root dentine lesions having the least adverse effect on demineralization and remineralization.

Influence of pulse frequency Er:YAG laser on the tensile bond strength of a composite to dentin.

PURPOSE: To evaluate the influence of different pulse frequencies of Er:YAG laser on the tensile bond strength of a composite to dentin. METHODS: The dentin surface treatment was performed by Er:YAG laser at 1, 2, 3 and 4Hz pulse frequencies and 80 mJ, for 20 seconds, followed by etching. The control group was etched by phosphoric acid solely. The Single Bond/Z250 system was used. The specimens were subjected to tensile strength tests in a testing machine (0.5mm/minute) after water storage (37 degrees C/24 hours). RESULTS: The averages in MPa were: 1Hz: 13.45 (+/- 5.31); 2Hz: 9.54 (+/- 2.13); 3Hz: 7.29 (+/- 1.26); 4Hz: 7.41 (+/- 2.44) and control group: 16.95 (+/- 2.57). The Kruskal-Wallis test revealed statistically significant difference. The increased frequency of the Er:YAG laser decreased the composite bond strength.

Permeability of the root canal wall and occlusion of dentinal tubules by Ag(NH3)2F: a comparison of combined use with pulsed Nd:YAG laser or iontophoresis.

OBJECTIVE: We used SEM-EDX and the Vickers hardness test to compare the penetration and hardness of silver resulting from use of either (i) pulsed Nd:YAG laser or (ii) iontophoresis, after root canal wall shaping using the standard method of coating with 38% Ag(NH3)2F solution. SUMMARY BACKGROUND DATA: There have not been any reports of penetration and hardness following the application of Ag(NH3)2F solution together with laser or iontophoresis. METHODS: We used 21 extracted human single-rooted teeth randomly divided into three groups. Group 1 was coated with Ag(NH3)2F, Group 2 was irradiated with a Nd:YAG laser after coating with Ag(NH3)2F solution, and Group 3 was iontophoresised after coating. Then we observed the permeability of silver through the root canal wall using SEM-EDX. RESULTS: The results show that iontophoresis after coating with Ag(NH3)2F solution (Group 3) resulted in the greatest and deepest penetration of silver into the root canal wall. There was no significant difference between teeth in Groups 1 and 2. For the hardness test, the 21 teeth were tested using SEM-EDX test, 7 untreated teeth were used as a control. The results show that Group 2 (laser treatment) teeth were the hardest. CONCLUSION: We therefore propose that root canals should be treated using irradiation with an Nd:YAG laser that has been coated with Ag(NH3)2F solution and that this method provides better results than either iontophoresis after coating, or coating alone.

Effect of Er:YAG laser irradiation on acid resistance to bovine dentin in vitro.

Resin bond strength to Er:YAG laser irradiated dentin has been reported to be lower than that of unlased dentin. The reasons have been much discussed, but not clarified. One hypothetical cause has been discussed that lased dentin is acid resistant, therefore, the etching effect of acid conditions decreases. The purpose of this study was to evaluate the acid resistance of laser-irradiated dentin and compare it with the dissolved mineral of Er:YAG laser irradiated dentin and unlased dentin. This experiment was a pilot study to assess the etching effect of pre-conditioner for resin bonding to lased dentin. Bovine dentin was irradiated by Er:YAG laser and immersed in 0.1 M lactic buffer solution (pH 4.0). The dissolved Ca and P in the solution were then both measured. Dissolved Ca from lased dentin was not significantly different from that coming from unlased dentin (p > 0.05). The molar ratio of Ca/P did not differ significantly between lased and unlased dentin, either (p > 0.05). Under FE-SEM view before immersion, the dentin surface was covered with a smear layer in unlased dentin, but this layer was not clearly observed in lased dentin. These results suggested that the lased dentin had little or no resistance to lactic buffer solution.

Irradiation effects on microhardness of fluoridated and non-fluoridated bovine dentin.

The objective of this study was to evaluate the effects of irradiation on microhardness of dentin. Dentin blocks from the cervical region of bovine incisors were treated as follows: (1) no irradiation; (2) irradiation of specimens up to 60 Gy (2 Gy/day, 5 days/week); (3) no irradiation, but fluoridation of specimens for 5 min/d; (4) irradiation of specimens and daily fluoridation. Knoop hardness number (KHN) of the control specimens was 62.63+/-14.75 (mean+/-SD). This was significantly different from the irradiated dentin samples (8.74+/-2.59 KHN). Hardness of the fluoridated dentin specimens was 11.19+/-1.95 KHN in the non-irradiated group and 10.03+/-2.76 KHN in the irradiated groups, respectively. Within the limitations of an in vitro study, it is concluded that dentin is severely affected by irradiation. This could be an explanation for the frequently observed side-effects of irradiation like loss of enamel, gap formation at the amelodentinal junction, and caries of the cervical region. Fluoridation with acidic gels decreases microhardness of dentin surface, and does not prevent softening due to radiation, when saliva is absent.