Effectiveness of laser-assisted gingival troughing and conventional gingival displacement methods in fixed prosthodontics: A systematic review.

STATEMENT OF PROBLEM: High-level evidence that gingival troughing using dental lasers has better outcomes for the management of gingival tissue surrounding prepared teeth compared with conventional gingival displacement methods is lacking. PURPOSE: The purpose of this systematic review was to review in vivo studies on gingival troughing using dental lasers to compare achieved gingival displacement, influence on periodontal health, and other relevant clinical parameters with different existing gingival displacement methods. MATERIAL AND METHODS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and identified studies through January 2022. An electronic search was conducted on the digital databases PubMed/MEDLINE, Web of Science, Scopus, and Embase to identify relevant studies with no limit on publication year. RESULTS: Nine studies were included in this systematic review. Five studies measured achieved horizontal gingival displacement, where lasers show the highest pooled mean of 0.53 mm, among all other displacement methods. Six of the 9 included studies measured periodontal health parameters, with a follow-up time up to 1 year, and other clinically relevant parameters: hemorrhagic control, time needed, ease of use, tooth mobility, pain, and tooth hypersensitivity. CONCLUSIONS: Gingival displacement and bleeding control appeared to be better achieved using lasers. The time needed to achieve gingival displacement was shortest and easiest with lasers. Lasers resulted in either less or comparable gingival recession, lower impact on tooth hypersensitivity, and less pain during the procedure than other methods.

Removal of lithium disilicate veneers with Er,Cr:YSGGL laser: now? Or after ageing?

This study was purposed to assess the impact of ageing and resin cements polymerized with different modes on the removal time of lithium disilicate (LiSi) ceramics using Er,Cr:YSGG laser. Ninety LiSi slabs (6 × 6 × 1 mm) were cemented to freshly extracted bovine teeth using cements polymerized with different modes (light-curing (LC), dual-curing (DC), self-curing (SC)). The specimens were divided into subgroups according to ageing conditions (no thermal cycling, 5000 or 30,000 thermal cycling). After that, Er,Cr:YSGG laser was applied until LiSi slabs were debonded; the removal time was recorded. Vickers microhardness test, SEM and EDS analyses were performed for specimens with the longest exposure time to laser application in the groups. One uncemented sample was also used as a control. Data were analyzed with two-way ANOVA and Tukey post hoc test. Ageing and cement polymerization mode significantly affected the removal time of LiSi specimens. The removal time for the self-curing resin cement group (22.67 ± 12.68 s) was significantly longer than for cements polymerized with other methods (LC = 10.833 ± 7.28 s, DC = 12.0 ± 7.96 s). Removal time was significantly reduced after ageing in all polymerization modes; however, there were no significant differences between 5000 (11.83 ± 7.52 s) and 30,000 (11.83 ± 7.26 s) thermal cycling groups. Self-curing resin cements had prolonged the laser-aided removal time for LiSi ceramics. It can be concluded that Er,Cr:YSGG laser-aided removal of LiSi veneers after clinical use can be done more faster than its immediate removal.

The effect of artificial accelerated aging on the color stability, microhardness, and surface roughness of different dental laminate veneer materials.

OBJECTIVE: This study aimed to evaluate the effect of artificial accelerated aging (AAA) on color stability, surface roughness, and microhardness of three laminate veneer (LV) materials. MATERIALS AND METHODS: Specimens of ceramic LV (CLV-IPS E.max Press), hand-layered composite LV (hand-layered laminate veneer [HLV]-Tetric N-Ceram), and prefabricated composite LV (prefabricated laminate veneer [PLV]-Componeer Coltene) were prepared as discs (n = 10). CIE L*, a*, and b* color coordinates, the Vickers microhardness, and surface roughness were measured 24 hours after preparation and reevaluated after aging for 300 hours in an ultraviolet (UV)-AAA system (Ci35 Weather-Ometer). Color difference (CIEDE2000 [ΔE00 ]) was calculated. Data were statistically analyzed with the Shapiro-Wilk test and the Kruskall-Wallis test followed by the Mann-Whitney U tests (α = .05). RESULTS: All of the LV groups showed significant differences in ΔE00 after AAA (P < .001). Comparing the color changes of the HLVs with the PLVs, no significant difference could be found (P = .705). There was a statistically significant difference in the means of changes in microhardness among the LVs materials (P < .001). The changes in surface roughness results showed a significant difference after AAA in all the LVs (P < .001). CONCLUSIONS: Within the limitations of this in vitro study, the color stability, the microhardness, and surface roughness of tested LVs were influenced by AAA. CLINICAL SIGNIFICANCE: The prefabricated composite LV system does not replace the individualized ceramic LV technique, but rather offers an alternative to hand-layered LVs, which is delicate and time-consuming technique.

Comparison of surface roughness and color stainability of 3-dimensionally printed interim prosthodontic material with conventionally fabricated and CAD-CAM milled materials.

STATEMENT OF PROBLEM: Studies on the surface roughness and color stainability of interim prostheses produced with 3-dimensional-printing technology are lacking. PURPOSE: The purpose of this in vitro study was to investigate the effect of different surface treatments on the surface roughness and stainability of 3-dimensionally printed, computer-aided design and computer-aided manufacturing (CAD-CAM) milled and conventional interim materials. MATERIAL AND METHODS: A total of 320 specimens were fabricated from autopolymerizing polymethyl methacrylate, bis-acryl composite resin, CAD-CAM polymethyl methacrylate resin (milled), and 3-dimensionally printed composite resin (printed) (n=80). A group of each material was divided into 2 groups (n=40) as per the applied surface treatment procedure: conventional polishing (C) or coated with a surface sealant (B). Surface roughness values were measured with a profilometer. Each group of specimens was then divided into 4 subgroups (n=10) and stored for 1 day, 7 days, and 30 days at 37 °C in different solutions: distilled water, cola, coffee, and red wine. Color parameters were measured with a spectrophotometer before and after each storage period, and color differences (CIEDE2000 [ΔE00]) were calculated. Data were statistically analyzed with the Shapiro-Wilk test, Kruskal-Wallis test, and Mann-Whitney U test followed by the Friedman test (α=.05). RESULTS: The highest surface roughness values were determined for the polymethyl methacrylate -C, and the lowest were observed in the printed-B. After 30 days, the highest mean ΔE00 values were observed in polymethyl methacrylate-C for all staining solutions (P=.001). The highest ΔE00 for all materials was observed in the red wine group. Color change increased significantly with storage duration (P=.001). CONCLUSIONS: All tested materials had a surface roughness higher than the plaque accumulation threshold (0.2 µm). The surface roughness values of coated materials were significantly lower than those of their conventionally polished groups, except for the printed groups. The application of a surface sealant agent significantly decreased the staining of the materials.

Evaluation of bond strength of resin cement to Er:YAG laser-etched enamel and dentin after cementation of ceramic discs.

The purpose of this study was to investigate the shear bond strength (SBS) of ceramic discs luted to differently etched enamel and dentin surfaces. Occlusal surfaces of 64 carious-free human molars and vestibule surfaces of 64 first maxillary incisors were ground to get flat superficial dentin and flattened enamel respectively. After generating 4 groups according to the surface etching method (37% orthophosphoric acid, Er:YAG laser-contact handpiece/scanning handpiece (1 or 2 times of scanning)), ceramic discs were luted to the surfaces with adhesive resin cement (Variolink N, Vivadent Ets., Schaan/Liechtenstein). After etching and cementation, thermocycling of 5000 cycles (Sd Mechatronik Gmbh, Feldkirchen-Westerham, Germany) and SBS test (Servopulser EHFFD1; Shimadzu, Kyoto, Japan) were performed respectively. The surface morphologies of 2 specimens, etched enamel and dentin, prepared for each group were examined with SEM analysis. Failure modes were determined under a USB digital microscope. Data were analyzed with one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). SBS values in dentin surfaces showed statistically significant differences (p < 0.05) among tested groups. The highest SBS among dentin groups was determined in the group which had 2 times etching by Er:YAG laser (11.42 MPa) by a scanning handpiece. No statistical differences were observed in the other dentin or enamel groups. Laser etching seems to be a viable alternative to acid etching on both enamel and dentin surfaces while double etching of dentin with a scanning handpiece can improve the adhesion.

Correction to: Temporary materials: comparison of in vivo and in vitro performance.

A Correction to this paper has been published: https://doi.org/10.1007/s00784-021-04067-4.

Temporary materials: comparison of in vivo and in vitro performance.

OBJECTIVE: The aim of this investigation was to compare clinical performance and in vitro wear of temporary CAD/CAM and cartridge crowns. This study is an approach to estimate the influence of in vivo use and laboratory simulation on temporary crowns. MATERIALS AND METHODS: A total of 90 crowns were fabricated from each temporary CAD/CAM or cartridge material. Also, 10 crowns of each material were clinically applied for 14 days, and 80 identical duplicate restorations were investigated in the laboratory after storage in water (14 days; 37 °C) and subsequent thermal cycling and mechanical loading (TCML, 240.000 × 50N ML, 600 × 5°C/55 °C). After in vivo application or in vitro aging, facture force, superficial wear (mean and maximum), surface roughness (Ra, Rz), thermal weight loss (TGA), and heat of reaction (DSC) were determined for all crowns. STATISTICS: Bonferroni post hoc test; one-way analysis of variance (ANOVA); α = 0.05). RESULTS: The fracture resistance of the temporary materials varied between 1196.4 (CAD in vivo) and 1598.3 N (cartridge crown in vitro). Mean (maximum) wear data between 204.7 (386.7 µm; cartridge in vitro) and 353.0 µm (621.8 µm; CAD in vitro) were found. Ra values ranged between 4.4 and 4.9 µm and Rz values between 36.0 and 40.8 µm. DSC and TG analysis revealed small differences between the materials but a strong influence of the aging process. CONCLUSIONS: Comparison of in vivo and in vitro aging led to no significant differences in fracture force and wear but differences in roughness, DSC, and TGA. SEM evaluation confirmed comparability. Comparison of CAD/CAM and cartridge temporary materials partially showed significant differences. CLINICAL RELEVANCE: In vitro aging methods might be helpful to estimate materials' properties before principal clinical application. CAD/CAM and cartridge temporary materials provided comparable good clinical performance.

Evaluation of strain distribution on an edentulous mandible generated by cobalt-chromium metal alloy fixed complete dentures fabricated with different techniques: An in vitro study.

STATEMENT OF PROBLEM: Fixed complete dentures (FCDs) have been used in the treatment of completely edentulous patients for over 40 years. However, few reports have investigated misfit values and strain distribution in the context of FCDs fabricated with new technologies. PURPOSE: The purpose of this in vitro study was to evaluate misfit values and strain distribution in FCDs and their relation to the fabrication technique of the cobalt-chromium (Co-Cr) metal framework. MATERIAL AND METHODS: Four implants were placed in the interforaminal region of a mandibular cast at the bone level. The Co-Cr metal alloy frameworks were fabricated using the following techniques: computer-aided design and computer-aided manufacturing (CAD-CAM), milling from hard blocks, CAD-CAM milling from soft blocks, and direct metal laser sintering (DMLS). The superstructures of equal sizes with acrylic resin bases and acrylic resin denture teeth were fabricated on the Co-Cr metal alloy framework, and a digital microscope was then used to measure the misfit between the abutments and the implants. The stress formed after the application of torque was measured with a strain-gauge stress analysis technique. Data were statistically analyzed using 1-way ANOVA and the Tukey Honestly Significant Difference test (α=.05). The correlation between the misfit and the strain values was evaluated with the Pearson Correlation test (α=.001). RESULTS: The lowest mean misfit values (99 ±17 µm) were observed in the hard block group (P<.05) and the highest in the DMLS group (139 ±29 µm). A statistically significant positive relationship was found between the misfit and the stress distribution after torque application (P<.05). Moreover, the lowest misfit group, hard blocks, had the lowest mean strain values (81.1 ±54 MPa) after torque application. CONCLUSIONS: Within the limitations of this in vitro study, the fabrication technique used for Co-Cr metal alloy frameworks appears to influence the passive fit significantly (P<.05). The hard-block technique was found to be the most precise fabrication technique for Co-Cr metal alloy frameworks. A significant relationship was observed between the amount/distribution of misfit and the strain on the FCD (P<.05).

Effects of New Generation All-Ceramic and Provisional Materials on Fibroblast Cells.

PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxic and apoptotic effects of seven new-generation all-ceramic materials for CAD/CAM (Lava Ultimate [LU], VITA Mark II [VM], InCoris TZI [IC], IPS e.max CAD [EM], VITA Suprinity [VS], Cerasmart [CS], IPS Empress CAD [EC]) and six provisional materials (Protemp 4 [PT], Telio CAD [TC], CAD-Temp [CT], Telio Lab [TL], Temdent Classic [TD], Telio CS C&B [TS]) on L929 mouse fibroblast cells. MATERIALS AND METHODS: 24 disc-shaped specimens (∅ = 5 mm, h = 2 mm) were prepared from each test material. Medium extracts were collected at the 1st, 3rd, and 7th days for each group and tested using the L929 cell line. Cytotoxicity was evaluated using XTT assay, and apoptosis was determined by Annexin-V/PI staining. Data were analyzed using one-way ANOVA, Tukey's multiple comparison tests at a significance level of p < 0.05. RESULTS: The cell viability results among all-ceramic material groups after the 1st and 7th days of incubation periods showed statistically significant differences (p < 0.05). There were significant differences within the ceramic groups in different incubation periods regarding apoptosis rate (p < 0.05). Throughout the entire test period, LU and VM from the CAD/CAM all-ceramic materials and PT and TC from the provisional restoration materials showed cell viability higher than 90%. EC and TD showed the lowest cell viability and highest apoptosis rates in their own groups. For the provisional materials, there were significant differences in cell viability and apoptosis rate in all the incubation periods for each material (p < 0.05). CONCLUSIONS: Although some new-generation CAD/CAM and provisional restoration materials display slight cytotoxicity values, the results are still within the reliable range, and they can safely be used in clinical conditions.

In vitro comparison of an Er:YAG laser-activated bleaching system with different light-activated bleaching systems for color change, surface roughness, and enamel bond strength.

To compare an Er:YAG laser-activated bleaching system with different light-activated in-office bleaching systems for color change, surface roughness, and post-bleaching enamel bond strength. 51 enamel slabs were prepared from the sound buccal enamel of extracted bovine teeth. The teeth were randomly divided into three groups according to different light-activated office bleaching systems (n = 17): diode laser (Epic, Biolase) (940 nm, 7 W, continuous mode), Er:YAG laser (LightWalker, Fotona) (2940 nm, 50 mJ, 10 Hz, 1000 µs), and LED (Radii Plus) (440-480 nm, 1500 mW/cm2). All systems were used with their compatible bleaching agents according to manufacturers' recommendations. The tooth color and surface roughness (Ra) were assessed at baseline and after bleaching using a spectrophotometer and a surface profilometer, respectively. The color change was determined by the CIE L*a*b* system (ΔE, ΔL*, Δa*, Δb*). Kruskal-Wallis test was used for color change whereas Kruskal-Wallis and Wilcoxon tests were used to analyze the roughness data. For shear bond strength test (SBS), composite cylinders were bonded on bleached enamel samples 14 days after bleaching procedures and stored in water (37 °C). Specimens were then debonded with a universal testing machine at 1 mm/min and data were analyzed by using Kruskal-Wallis test. All the tested bleaching systems were effective on color change (ΔE > 3.3) and produced similar color change (p > 0.05). There were no significant differences among the Ra values of the groups neither at baseline nor after bleaching (p > 0.05). However, comparing the baseline and after bleaching Ra values, a significant increase was observed for all tested groups (p < 0.05). Significant differences were also found among all systems for SBS (p < 0.05). The highest values were obtained in Er:YAG group, whereas the LED group revealed the lowest values (p < 0.05). All tested bleaching systems were effective on tooth whitening, whereas they all led to an increase on surface roughness. Although the current Er:YAG laser-activated bleaching system did not differ from other tested bleaching systems according to color change and surface roughness, it appears to provide better results in terms of SBS.

Color change of CAD-CAM materials and composite resin cements after thermocycling.

STATEMENT OF PROBLEM: The color of resin cements and computer-aided-design and computer-aided-manufacturing (CAD-CAM) restorations may change with aging. PURPOSE: The purpose of this in vitro study was to analyze the influence of thermocycling on the color of CAD-CAM materials with underlying resin cement. MATERIAL AND METHODS: Seven different CAD-CAM materials, composite resins and glass-ceramics were cut into 0.7-mm and 1.2-mm thicknesses (n=10) and cemented with a dual-polymerizing resin cement, a light-polymerizing resin cement, and a preheated composite resin (N=420). Color values were measured by using spectrophotometry. Specimens were subjected to thermocycling (5°C and 55°C; 5000 cycles). The measured color difference (ΔE) data were analyzed by using descriptive statistics. Normality of data distribution was tested by using the Kolmogorov-Smirnov test. Three-way and 1-way ANOVA followed by the Scheffé post hoc test and unpaired 2-sample Student t test were computed to determine the significant differences among the tested parameters (α=.05). RESULTS: ΔE values were significantly influenced by the CAD-CAM material (ηp2=0.85, P<.001) and the resin composite cement (ηP2=0.03, P=.003) but were not influenced by thickness (P=.179). Significant interactions were present among thickness, cement, and CAD-CAM materials (P<.001). Vita Suprinity and GC Cerasmart showed significantly the lowest ΔE values (P<.001). The highest ΔE values were observed for IPS Empress CAD. The dual-polymerizing resin cement showed significantly lower ΔE values than the preheated composite resin (P=.003). CONCLUSIONS: Restoration materials and composite resin cement types used for cementation influence the amount of color change due to aging.

The Effect of Luting Cement and Titanium Base on the Final Color of Zirconium Oxide Core Material.

PURPOSE: To evaluate the effects of different types of luting cements and different colors of zirconium cores on the final color of the restoration that simulates implant-supported fixed partial dentures (FPDs) by using a titanium base on the bottom. MATERIALS AND METHODS: One hundred and twenty zirconium oxide core plates (Zr-Zahn; 10 mm in width, 5 mm in length, 0.5 mm in height) were prepared in different shades (n = 20; noncolored, A2, A3, B1, C2, D2). The specimens were subdivided into two subgroups for the two types of luting cements (n = 10). The initial color measurements were made on zirconium oxide core plates using a spectrometer. To create the cement thicknesses, stretch strips with holes in the middle (5 mm in diameter, 70 µm in height) were used. The second measurement was done on the zirconium oxide core plates after the application of the resin cement (U-200, A2 Shade) or polycarboxylate cement (Lumicon). The final measurement was done after placing the titanium discs (5 mm in diameter, 3 mm in height) in the bottom. The data were analyzed with two-way ANOVA and Tukey's honestly significant differences (HSD) tests (α = 0.05). RESULTS: The ∆E*ab value was higher in the resin cement-applied group than in the polycarboxylate cement-applied group (p < 0.001). The highest ∆E*ab value was recorded for the zirconium oxide core-resin cement-titanium base, and the lowest was recorded for the polycarboxylate cement-zirconium oxide core (p < 0.001). CONCLUSION: The luting cement, the presence of titanium, and the color of zirconium are all important factors that determine the final shade of zirconia cores in implant-supported FPDs.

The effect of transmitted Er:YAG laser energy through a dental ceramic on different types of resin cements.

BACKGROUND AND OBJECTIVE: The laser debonding procedure of adhesively luted all-ceramic restorations is based on the ablation of resin cement due to the transmitted laser energy through the ceramic. The purpose of this study was to determine the effect of Er:YAG laser irradiation transmitted through a dental ceramic on five different resin cements. MATERIALS AND METHODS: Five different resin cements were evaluated in this study: G-Cem LinkAce, Multilink Automix, Variolink II, Panavia F, and Rely X Unicem U100. Disc shaped resin cement specimens (n = 10) were fabricated for each group. A ceramic disc was placed between the resin cement discs and the tip of the handpiece of Er:YAG laser device. The resin cement discs were irradiated through the ceramic and the volume of the resin cement discs were measured using a micro-CT system before and after Er:YAG laser irradiation. The volume loss of the resin cement discs was calculated and analyzed with one-way ANOVA and Tukey-HSD tests. RESULTS: The highest volume loss was determined in G-Cem (1.1 ± 0.6 mm3 ) and Multilink (1.3 ± 0.1 mm3 ) (P < 0.05) groups, and the lowest volume loss was determined in Rely X (0.3 ± 0.07 mm3 ), Variolink (0.4 ± 0.2 mm3 ), and Panavia (0.6 ± 0.2 mm3 ) groups (P < 0.05). All resin cements were affected by the laser irradiation resulting in the volume loss of the cement; however, there are significant differences among different resin cements. CONCLUSIONS: All the resin cements tested in this study were effected by the Er:YAG laser irradiation and there were significant differences among the resin cements with regard to ablation volume. Lasers Surg. Med. 47:602-607, 2015. © 2015 Wiley Periodicals, Inc.

Temperature rise in pulp and gel during laser-activated bleaching: in vitro.

The aim of this study was to evaluate the increase in temperature induced by various light sources during in-office bleaching treatment, under simulated blood microcirculation in pulp conditions. Ten freshly extracted human maxillary central incisors were used for the study. The roots of the teeth were removed from approximately 2 mm below the cementoenamel junction and fixed on an apparatus for the simulation of blood microcirculation in pulp. A J-type thermocouple wire was inserted into the pulp chamber through an artificial access at the lingual surfaces of the teeth, and another thermocouple wire was fixed on the labial surface of the teeth meanwhile. An in-office bleaching agent, intense red in color and with 30% water content, was applied to the labial surfaces of the teeth, and repeating measurements were made for each tooth using three different light sources: Er:YAG laser (40 mJ, 10 Hz, 20 s), 810-nm diode laser (4 W, 20 s, CW), and high-intensity light-emitting diodes (LED) (1,100 mW/cm(2), 20 s) as the control. Temperature increase in the pulp chamber and within the bleaching gel during light application were recorded and statistically evaluated. The highest pulp temperature increases were recorded for the diode laser group (2.61 °C), followed by the Er:YAG laser (1.86 °C) and LED (1.02 °C) groups (p < 0.05; analysis of variance (ANOVA), Tukey's honestly significant difference (HSD)). Contradictorily, the lowest gel temperature increases were recorded for diode laser (6.21 °C) and followed by LED (12.38 °C) and Er:YAG (20.11 °C) groups (p < 0.05; ANOVA, Tukey's HSD). Despite the significant differences among the groups, the temperature increases recorded for all groups were below the critical value of 5.6 °C that can cause irreversible harmful changes in pulp tissue. It can be concluded that, with regard to temperature increase, all the light sources evaluated in this study can be used safely for in-office bleaching treatment within the described parameters.

Effectiveness of occlusal splints and low-level laser therapy on myofascial pain.

The present study was designed to evaluate the effects of low-level laser (Nd:YAG) therapy and occlusal splints in patients with signs and symptoms of temporomandibular disorders (TMD) characterized with myofascial pain (MP). A total of 30 patients were selected after being diagnosed with MP according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TDM). The patients were divided into three groups. The first group was occlusal splint (OS) group A (n = 10), the second was low-level laser therapy (LLLT) group B (n = 10), and the last group C was placebo (n = 10). LLLT (1,064 nm, 8 j/cm(2), 250 mW, Fotona) was applied to the patients in the study group once a day for 10 days, for a total of ten sessions. The same parameters and application times were used for placebo group, but the patients were not irradiated. The application was on the trigger points. The patients in the OS group were instructed to wear occlusal splints 12 h/day for 3 weeks. Functional examination was based on RDC/TDM, and pressure pain values were obtained with the Visual Analog Scale. Comparisons were made between the groups before and after the treatment according to Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests. The pain score values decreased significantly after both LLLT (p < 0.05) and occlusal splint therapy (p < 0.05) compared to placebo group (p < 0.05). There was no significant difference between LLLT and OS groups after treatment (p > 0.05). OS and LLLT are effective for decreasing MP. In addition, this particular type of LLLT is as effective as occlusal splint for pain relief.

Effects of laser irradiation at different wavelengths (660, 810, 980, and 1064 nm) on transient receptor potential melastatin channels in an animal model of wound healing.

The aim of the present study was to compare the effectiveness of four different laser wavelengths used for low-level laser therapy(LLLT) on healing of mucositis in an animal model of wound healing, by investigating expression of transient receptor potential melastatin(TRPM) ion channels. Forty-five rats were intraperitoneally injected with 100 mg/kg 5-fluorouracil on day 1 and 65 mg/kg on day 3. Superficial scratching on left cheek pouch mucosa was performed on days 3 and 5. After ulcerative mucositis was clinically detected, LLLT was started (660 nm, HELBO; 810 nm, Fotona-XD; 980 nm, ARC-Fox; and 1064 nm, Fidelis-Plus3) at 8 J/cm(2)/day from days 1 to 4. Oval excisional biopsy was performed at the wound site, and expression of TRPM2 to TRPM8 was evaluated. Student's t test was used for evaluation of significance of TRPM gene expression according to "0" value (α = 0.05). In 980-nm group, TRPM4, TRPM6, and TRPM7 were significantly higher than in the control group (p < 0.005). In 660, 810, and 1064 nm groups, only TRPM6 was significantly higher than in control group (p < 0.005). There were no significant differences between control and sham groups (p > 0.05). These findings suggest that expression of TRPM6 gene was significantly affected by irradiation with lasers at different wavelengths, whereas the TRPM4 and TRPM7 genes were only expressed in the 980-nm diode laser group. TRPM6 gene was highly expressed during LLLT, which may lead to accelerated wound healing and tissue repair. In contrast, there was some evidence that the 980-nm diode laser caused increased expression of TRPM4, TRPM6, and TRPM7 which are responsible for stimulation of Ca(2+) and Mg(2+) metabolism, as well as apoptotic pathways of controlled cell death.

Effect of femtosecond laser beam angle on bond strength of zirconia-resin cement.

Yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramic is widely used as an all-ceramic core material because of its enhanced mechanical and aesthetic properties. The bond strength of Y-TZP restorations affects long-term success; hence, surface treatment is required on ceramic boundaries. This study evaluated the effect of different laser beam angles on Y-TZP-resin cement shear bond strength (SBS). Forty plates of Y-TZP ceramics were randomly assigned to four groups (n = 10). A femtosecond amplifier laser pulse was applied on Y-TZP surface with different incidence angles (90°, 75°, 60°, 45°). The resin cement was adhered onto the zirconia surfaces. The SBS of each sample was measured using universal testing machine at crosshead speed of 1 mm/min. The SBS was analyzed through one-way analysis of variance (ANOVA)/Tukey tests. The results showed that the degree of laser beam angle affects the SBS of resin cement to Y-TZP. The laser beam was applied to a surface with a 45° angle which resulted in significantly higher SBS (18.2 ± 1.43 MPa) than other groups (at 90° angulation (10.79 ± 1.8 MPa), at 75° (13.48 ± 1.2 MPa) and at 60° (15.85 ± 0.81 MPa); p < 0.001). This study shows that decreasing of the angle between the ceramic surface and the laser beam increased the SBS between the resin cement and the ceramic material, as well as the orifice.

Assessment of the effect of laser irradiations at different wavelengths (660, 810, 980, and 1064 nm) on autophagy in a rat model of mucositis.

It is known that high-dose radiation has an effect on tissue healing, but tissue healing does not occur when low dose radiation is applied. To clarify this issue, we compare the treatment success of low dose radiation with programmed cell death mechanisms on wounded tissue. In this study, we aimed to investigate the interactions of low and high-dose radiation using an autophagic mechanism. We included 35 adult Wistar-Albino rats in this study. All animals were injected with 100 mg/kg of 5-fluorouracil (5-FU) on the first day and 65 mg/kg of 5-FU on the third day. The tips of 18-gauge needles were used to develop a superficial scratching on the left cheek pouch mucosa by dragging in a linear movement on third and fifth days. After mucositis formation was clinically detected, animals were divided into five groups (n = 7). Different wavelengths of laser irradiations (1064 nm, Fidelis Plus, Fotona, Slovenia; 980 nm, FOX laser, A.R.C., Germany; 810 nm, Fotona XD, Fotona, Slovenia; 660 nm, HELBO, Medizintechnik GmbH, Wels, Austria) were performed on four groups once daily for 4 days. The laser irradiation was not performed on the control group. To get the tissue from the left cheek at the end of fourth day from all animals, oval excisional biopsy was performed. Molecular analysis assessments of pathological and normal tissue taken were performed. For this purpose, the expression analysis of autophagy genes was performed. The results were evaluated by normalization and statistics analysis. We found that Ulk1, Beclin1, and Atg5 expression levels were increased in the rats when the Nd:YAG laser was applied. This increase showed that a 1064-nm laser is needed to activate the autophagic mechanism. However, in the diode applications, we found that Beclin1, Atg10, Atg5, and Atg7 expressions numerically decreased. Atg5 is responsible for the elongation of autophagosome. Becn1 is a control gene in the control mechanism of autophagy. The reduction of the expression of these genes leads us to think that it may depend on the effect of drug (5-FU) used to form model. Expressions of therapeutic genes increase to ensure hemostasis, but in our study, expressions were found to decrease. More detailed studies are needed.

Diffusion of HEMA from resin cements through different dentin thicknesses in vitro.

PURPOSE: To evaluate the in vitro diffusion of 2-hydroxyethyl methacrylate (HEMA) from the resin cements through different thicknesses of dentin using high-performance liquid chromatography (HPLC) at two time intervals. METHODS: 60 freshly extracted caries- and restoration-free human third molar teeth were used in this study. Standardized box-shaped Class I inlay cavities (6 mm long, 3 mm wide and 2 mm deep) were prepared in all teeth with a high-speed handpiece mounted on a standard cavity machine. The remaining dentin thickness (RDT) between the pulpal wall of the cavity and the roof of the pulp chamber was measured at multiple points for each tooth so that two main groups of 30 teeth each were prepared with an RDT range 0.5-1.9 and 2.0-3.5 mm, respectively. Each of these main groups was divided into three subgroups (n = 10), according to the resin cements tested (RelyX ARC, Panavia F 2.0, Multilink Automix). Lithium disilicate-based ceramic inlays (IPS Empress 2) were manufactured to restore the prepared cavities. A polypropylene chamber containing 1 ml distilled water was attached to the cemento-enamel junction of each tooth. Then, ceramic inlays were cemented with resin cements according to the manufacturers' instructions. Water elutes were analyzed by HPLC at 4.32 minutes and 24 hours. HEMA diffusion amounts were analyzed using three-way ANOVA and Tukey's HSD tests (P < 0.05). RESULTS: HEMA was detected in the pulp chamber elutes of all the teeth. The amounts of released HEMA did not significantly differ between time periods. The diffused HEMA amounts were significantly different between the RDT of 0.5-1.9 and 2.0-3.5 mm (P < 0.05) and between resin cements tested (P < 0.05). Decreasing RDT substantially increased the amount of HEMA that diffused through the dentin to the pulp space.

Effects of laser irradiation at different wavelengths (660, 810, 980, and 1,064 nm) on mucositis in an animal model of wound healing.

The aim of the present study was to compare the effectiveness of four different laser wavelengths (660, 810, 980, and 1,064 nm) used for low-level laser therapy (LLLT) on the healing of mucositis in an animal model of wound healing by investigating the expression of platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-ß), and blood-derived fibroblast growth factor (bFGF). Thirty-five male Wistar albino rats with a weight of 250-300 g body mass and 5 months old were used in the study. All animals were intraperitoneally injected with 100 mg/kg of 5-fluorouracil (5-FU) on the first day and 65 mg/kg of 5-FU on the third day. The tip of an 18-gauge needle was used in order to develop a superficial scratching on the left cheek pouch mucosa by dragging twice in a linear movement on third and fifth days. After ulcerative mucositis were clinically detected on the animals' left cheek pouch mucosa, the laser therapy was started. Four different laser wavelengths (660 nm, HELBO, Bredent; 810 nm, Fotona XD, Fotona; 980 nm, ARC Fox; and 1,064 nm, Fidelis Plus 3, Fotona) used for LLLT at ED 8 J/cm(2) daily from the first to the fourth days. Oval excisional biopsy was taken from the site of the wound, and the expression of PDGF, TGF-ß, and bFGF was evaluated. The obtained data were analyzed by one2-way ANOVA, and then Tukey HSD tests were used for pairwise comparisons among groups (α = 0.05). The one-way ANOVA test indicated that expression values of the growth factors, PDGF and bFGF, were significantly affected by irradiation of different wavelengths of lasers (p < 0.001). However, expression value of the TGF-ß was not affected by irradiation of different wavelengths of lasers (p > 0.05). The highest PDGF expression was detected in neodymium-doped yttrium aluminum garnet (Nd:YAG) laser group (p < 0.05), and there were no statistically significant differences among the other groups (p > 0.05). The highest bFGF expression was detected in 980-nm diode and Nd:YAG laser groups (p < 0.05), and there were no statistically significant differences among the other groups (p > 0.05). These findings suggest that low-level Nd:YAG and 980-nm diode laser therapy accelerate the wound healing process by changing the expression of PDGF and bFGF genes responsible for the stimulation of the cell proliferation and fibroblast growth.