Effect of Er:Yag laser on dentin demineralization around restorations.

The aim of this study was to evaluate the effect of cavity preparation with Er:YAG laser on dentin adjacent to restorations submitted to cariogenic challenge in situ, by subsuperficial microhardness analysis. Bovine incisors were sectioned, flattened, and polished, resulting in 40 dentin slabs. The slabs were randomly assigned to four groups (n = 10), according to the cavity preparation method: I-high-speed handpiece (control); II-Er:YAG laser (160 mJ; 3 Hz); III-Er:YAG laser (260 mJ; 3 Hz); IV-Er:YAG laser (300 mJ; 3Hz). Cavities were restored with composite resin, and the specimens were fixed in intra-oral appliances, which were worn by 10 volunteers for 14 days for simulating cariogenic challenge in situ. During the experimental period, 20% sucrose solution was dripped over each specimen 6 times a day. Samples were removed, sectioned, and examined for subsuperficial Knoop microhardness at 100, 200, and 300 µm from the restoration and at 30 µm from dentin surface. Split-plot analysis of variance showed no significant difference among the cavity preparation techniques (p = 0.1129), among distances (p = 0.9030), as well as no difference in the interaction between the main factors (p = 0.7338). It was concluded that the cavity preparation with Er:YAG laser did not influence on dentin microhardness submitted to cariogenic challenge in situ.

How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2?

Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.

Chemical and morphological changes of femtosecond laser-irradiated enamel using subablative parameters.

Chemical composition of dental enamel has a great relationship with the prevention of caries. The objective of the present work was to evaluate the chemical and morphological changes of femtosecond laser-irradiated enamel with subablative parameters using Raman spectroscopy, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM). Bovine incisor teeth were used to obtain 30 enamel specimens (5 × 5 mm2 ). The chemical composition of the control sample was analyzed by Raman spectrometry to acquire the absorption spectrum, delimiting the areas under the carbonate and phosphate bands. This analysis was used to evaluate the change in the chemical composition of the sample after irradiation. The specimens were irradiated (IRR) with a Ti:Sapphire laser system (pulsed and focused modes, femtosecond regime 70 fs, average power of 1 W and exposure time of 15 s). After irradiation, the areas under the carbonate and phosphate absorption bands were delimited in each specimen. Raman spectrometry data were analyzed using Student's t-test (α = 5%). By comparing the spectra of the IRR and non-irradiated (NI) specimens, the results showed a significant increase in the area value for the phosphate peaks and a significant reduction in the area value for the carbonate peak and the carbonate:phosphate ratio. CLSM and SEM analyses did not reveal structural alterations in the subsurface nor morphological alterations in the IRR enamel surface, respectively. It was concluded that femtosecond laser irradiation using subablative parameters reduced the carbonate content and the carbonate/phosphate ratio without altering the structure and morphology of the dental enamel.

Effect of erbium:yttrium-aluminum-garnet laser energies on superficial and deep dentin microhardness.

This study evaluated the microhardness of superficial and deep dentin irradiated with different erbium:yttrium-aluminum-garnet (Er:YAG) laser energies. Seventy-two molars were bisected and randomly assigned to two groups (superficial dentin or deep dentin) and into six subgroups (160 mJ, 200 mJ, 260 mJ, 300 mJ, 360 mJ, and control). After irradiation, the cavities were longitudinally bisected. Microhardness was measured at six points (20 microm, 40 microm, 60 microm, 80 microm, 100 microm, and 200 microm) under the cavity floor. Data were submitted to analysis of variance (ANOVA) and Fisher's tests (alpha = 0.05). Superficial dentin presented higher microhardness than deep dentin; energy of 160 mJ resulted in the highest microhardness and 360 mJ the lowest one. Values at all points were different, exhibiting increasing microhardness throughout; superficial dentin microhardness was the highest at 20 microm with 160 mJ energy; for deep dentin, microhardness after irradiation at 160 mJ and 200 mJ was similar to that of the control. The lowest energy increased superficial dentin microhardness at the closest extent under the cavity; deep dentin microhardness was not altered by energies of 160 mJ and 200 mJ.

Effect of thermo-mechanical cycling and chlorhexidine on the bond strength of universal adhesive system to dentin.

OBJECTIVES: This study evaluated the influence of thermo-mechanical cycling (TMC) on the bond strength (BS) of a universal adhesive system (UAS - Adper Single Bond Universal, 3M ESPE) to dentin treated or not with 0.2% chlorhexidine (CHX). METHODS: Eighty human molars were flattened until reach the dentin and separated into 4 groups according to the bonding protocol: ENR Group: 37% phosphoric acid + 3-step etch-and-rinse adhesive system (ENR); UAS Group: UAS in self-etch mode; ENR + CHX Group: 37% phosphoric acid + CHX + ENR; UAS + CHX Group: CHX + UAS in self-etch mode. After treatments, teeth were restored (Filtek Z350, 3M ESPE). Samples (n = 10) were submitted to aging process: stored in distilled water at 37°C/30 days or TMC (ERIOS - 98N/1.6Hz + thermal cycling 5/37/55 °C - 1,200,000 cycles). Specimens were sectioned into sticks (1.0 mm2) and submitted to the microtensile test (Mechanical Test Machine - 0.5 mm/min). Fracture patterns and hybrid layer integrity were analyzed under Stereomicroscope and Scanning Electron Microscopy (SEM). RESULTS: The BS results (3-way ANOVA, Bonferroni's test, α = 5%) showed that groups treated with CHX presented higher BS values than control groups; significant in all cases (p < .05), except for ENR submitted to TMC (p > .05). When CHX was applied and samples were cycled, UAS revealed higher BS (p < .05) than ENR. After TMC, cohesive fractures increased for UAS, regardless of CHX application. SEM analysis demonstrated different hybridization patterns for the adhesive systems tested. CONCLUSION: The performance of the universal adhesive system used in self-etch mode was better than that of the 3-step etch-and-rinse adhesive system. CLINICAL SIGNIFICANCE: Universal adhesive systems have been developed in order to simplify the dentin hybridization protocol. It is important to determine the longevity of the adhesive interface using these bonding materials after chewing.

Effect of Methods of Biosilicate Microparticle Application on Dentin Adhesion.

Restorative procedures associated with bioglasses have shown to be a strategy to satisfy the contemporary concept of minimally invasive dentistry. Thus, the aim of this study was to evaluate bond strength to dentin treated by two different methods of biosilicate microparticle application. Dentin surfaces from 30 sound human molars were exposed and randomly assigned into three groups (n = 10) according to the surface treatment: (1) blasting with biosilicate microparticles (distance = 1 cm/pressure = 5 bar/time = 1 min); (2) 10% biosilicate microparticles paste; and (3) control (no treatment). After, dentin surfaces were restored with self-etch adhesive (Adper Easy Bond) and nanofilled composite (Filtek Z350). Specimens were sectioned perpendicularly to the adhesive interface to obtain sticks (cross-section area = 1 mm²), which were submitted to microtensile test (0.5 mm/min; 50 kgf). Data were analyzed by ANOVA and Tukey's test (α = 5%). Dentin/adhesive interfaces were morphologically analyzed by scanning electron microscopy (SEM). Data analysis showed that biosilicate-treated groups reached similar results (p > 0.05) and both of them demonstrated higher values (p < 0.05) than control group. SEM micrographs revealed hybridization with clear resin tags and no separation between resin-dentin adhesive interfaces. Within the limitations of this study, surface treatment with biosilicate positively influenced the adhesion to dentin and does not alter the morphology of the adhesive interface.

Adhesion to Er:YAG laser-prepared dentin after long-term water storage and thermocycling.

This in vitro study evaluated the microtensile bond strength of a resin composite to Er:YAG-prepared dentin after long-term storage and thermocycling. Eighty bovine incisors were selected and their roots removed. The crowns were ground to expose superficial dentin. The samples were randomly divided according to cavity preparation method (I-Er:YAG laser and II-carbide bur). Subsequently, an etch & rinse adhesive system was applied and the samples were restored with a resin composite. The samples were subdivided according to time of water storage (WS)/number of thermocycles (TC) performed: A) 24 hours WS/no TC; B) 7 days WS/500 TC; C) 1 month WS/2,000 TC; D) 6 months WS/12,000 TC. The teeth were sectioned in sticks with a cross-sectional area of 1.0-mm2, which were loaded in tension in a universal testing machine. The data were subjected to two-way ANOVA, Scheffé and Fisher's tests at a 5% level. In general, the bur-prepared group displayed higher microtensile bond strength values than the laser-treated group. Based on one-month water stbrage and 2,000 thermocycles, the performance of the tested adhesive system to Er:YAG-laser irradiated dentin was negatively affected (Group IC), while adhesion of the bur-prepared group decreased only within six months of water storage combined with 12,000 thermocycles (Group IID). It may be concluded that adhesion to the Er:YAG laser cavity preparation was more affected by the methods used for simulating degradation of the adhesive interface.

Effect of energy and pulse repetition rate of Er: YAG laser on dentin ablation ability and morphological analysis of the laser-irradiated substrate.

OBJECTIVE: The aim of this study was to assess the effect of energy and pulse repetition rate of the Er:YAG laser (2.94 microm) on dentin ablation ability and substrate morphology. BACKGROUND DATA: Previous studies have demonstrated the ability of the Er:YAG laser for ablating dentin substrate. METHODS: Fifteen crowns of molars were sectioned in four fragments, providing 60 samples, which were ground to expose dentin. Initial mass was obtained by weighing the fragments. Twelve groups were randomly formed, according to the combination of laser energies (200, 250, 300, and 350 mJ) and pulse repetition rates (2, 3, and 4 Hz), usually advised for cavity preparation. The final mass was obtained, and dentin mass loss was calculated by the difference between the final and initial mass. Afterwards, specimens were prepared for scanning electron microscopy (SEM). Data were submitted to analysis of variance (ANOVA) and Scheffé test (p < 0.05). RESULTS: Pulse repetition rate of 4 Hz was statistically similar to 3 Hz, and laser energy of 350 mJ was statistically similar to 300 mJ. Increased pulse repetition rates provided higher ablation depth and slight enlargement of dentinal tubules, whereas increased energies yielded greater ablation of intertubular dentin. CONCLUSION: The ablation ability of the Er:YAG laser on dentin raised with the increase of energy and/or pulse repetition rate, the latter exhibiting a stronger influence on mass loss rate and on morphological alterations.

Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions.

This study evaluated the effect of a bioactive glass ceramic for the control of erosion and caries lesions. Fragments (n=10) of bovine enamel and root dentin received daily application of different treatments (Biosilicate; Acidulated Phosphate Fluoride- APF; Untreated - control) during the performance of erosive cycles. Surfaces were analyzed with 3D optical profilometry to quantify the superficial loss in four periods (1, 7, 14 and 21 days), as well as the lesion depth with confocal laser scanning microscopy. For caries progression assessment, initial Knoop microhardness was measured on enamel bovine fragments. Initial carious lesions were developed and specimens were divided into three groups (n=10), according to the daily topical application (Biosilicate; APF; no application - control), during the de-remineralization cycles for 14 days. Final microhardness was obtained to calculate the change of surface microhardness. Subsurface demineralization was analyzed using cross-sectional microhardness (depths 10, 30, 50, 70, 90, 110 and 220 µm). Data were tested using ANOVA and Tukey's test (a=5%). Results of erosive evaluation showed that Biosilicate promoted the lowest (p<0.05) values of surface loss, regardless of time, for both enamel and dentin; APF promoted lower (p<0.05) surface loss than control; analyzing different periods of time, APF did not show difference (p>0.05) between 14 and 21 days of demineralization. Results of enamel caries assessment showed that Biosilicate resulted in higher (p<0.05) surface and subsurface microhardness than both APF and control-applications. It may be concluded that Biosilicate application showed a higher potential to reduce surface loss and development of erosion and caries lesions.

Influence of Er:YAG laser irradiation distance on the bond strength of a restorative system to enamel.

OBJECTIVES: The aim of the present study was to investigate in vitro the effect of Er:YAG laser on bonding to enamel, varying the irradiation distance. METHOD: Tensile bond strength of an adhesive restorative system to non-irradiated and irradiated enamel surfaces was evaluated. Thirty caries-free human third molars were sectioned in mesio-distal direction and embedded in acrylic resin. Enamel was flattened, and a 3-mm-diameter bonding area was demarcated. Specimens were randomly assigned into six groups: groups I-V were treated with the Er:YAG laser (80 mJ/2 Hz), varying the irradiation distance (11, 12 mm-focused, 14, 16 and 17 mm, respectively), followed by 35% phosphoric acid etching. Control group (VI) received treatment with phosphoric acid alone. Single Bond adhesive system was applied on the conditioned enamel, and composite resin cones, bonded to enamel, were fabricated with Z250. After storage, samples were tested in tensile to failure (50 kgf and 0.5 mm/min). RESULTS: Means in MPa were: I-9.67 (+/-3.44); II-13.29 (+/-2.65); III-13.33 (+/-2.22); IV-14.87 (+/-3.58); V-16.43 (+/-4.52); VI-22.90 (+/-3.03). ANOVA and Tukey test revealed statistically significant decrease of bond strength in group I (P < 0.05). Groups II-IV presented similar results, as did groups IV and V. Control group (VI) yielded the best overall performance (P < 0.05). CONCLUSION: Er:YAG laser irradiation adversely affected adhesion to enamel. However, bond strength was influenced by the irradiation distance, thus being stronger with the increase of distance to the target tissue.

Shear bond strength of glass-ionomer cements to air-abraded dentin.

PURPOSE: The aim of this in vitro study was to evaluate the shear bond strength of two conventional glass-ionomer cements to bovine dentin when using the air-abrasion technique for cavity preparation. MATERIALS AND METHODS: Forty bovine central incisors were selected, embedded in polyester resin, and ground until the dentin surface was exposed. The teeth were randomly assigned to four groups: I and II--rotating instrument with a carbide bur; III and IV--an air-abrasion system. Groups I and III were restored with Fuji IX and groups II and IV with Ketac Molar. A 3-mm-diameter bonding site was delimited and treated with 10% polyacrylic acid for 10 s in the Fuji IX subgroups and with 25% polyacrylic acid for 10 s in the Ketac Molar subgroups. After surface treatment, a glassionomer cylinder was prepared for each specimen, using a split bisected Teflon matrix. The finished specimens were submitted to the shear bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed using ANOVA and Scheffé statistical tests. The dentin bonding areas were analyzed under a stereoscopic optical magnifier (40X) to assess the type of failure. RESULTS: The mean (SD) shear bond strengths in MPa were: group I--3.49 (+/- 3.77), group II--7.17 (+/- 2.93), group III--7.55 (+/- 2.99), group IV--5.67 (+/- 3.90). Ketac Molar showed higher bond strength values in bur-prepared cavities, while on the air-abraded preparations, Fuji IX showed superior results. CONCLUSION: It can be concluded that the air-abrasion system used for cavity preparations may influence the bonding performance of conventional glass-ionomer cements to dentin.

Effect of Er:YAG laser irradiation distance on superficial dentin morphology.

PURPOSE: To assess in vitro the effect of Er:YAG laser irradiation distance on dentin surface morphology, by SEM. METHODS: 60 sound human third molars were employed to obtain discs (approximately equal to 1mm thick), that were polished to standardize the smear layer. Discs were randomly assigned to six groups (n=10) and sequentially bisected. Five groups (including both disc halves of each sample) received Er:YAG laser irradiation (80mJ/2Hz) for 20s, according to the irradiation distance (11, 12, 14, 16 or 17mm) and one was the control group. In the lased-groups, one disc half was separated for superficial analysis without subsequent acid-etching and the other half received phosphoric acid for 15 seconds. In the control group, one disc half was treated with phosphoric acid and no superficial treatment was done in the other half. Specimens were prepared for SEM. RESULTS: Er:YAG laser-irradiated specimens, regardless of the irradiation distance, showed an irregular and scaly surface, with intense ablation of the intertubular dentin, mainly when the irradiation was performed in the focused mode (12 mm). The smear layer was removed and dentin tubules were opened, however, no tubule enlargement was found, unlike the group that only received acid application. The irradiation with 17 mm resulted in a surface appearance more homogeneous than those presented with other distances closer to the focus. The subsequent acid-etching on the lased surfaces decreased the superficial irregularities with partial exposure and enlargement of dentin tubules, in all the tested irradiation distances.

Comparison of marginal microleakage of flowable composite restorations in primary molars prepared by high-speed carbide bur, Er:YAG laser, and air abrasion.

PURPOSE: The purpose of this study was to assess in vitro the influence of 3 cavity preparation devices (carbide bur, Er:YAG laser, and air abrasion) on the microleakage of flowable composite restorations in primary teeth. METHODS: Fifteen primary second molars were selected, and Class V cavities were prepared on the buccal/lingual surfaces, being assigned to 3 groups (n= 10). Group 1 (control) was prepared using a high-speed handpiece and was acid etched. Group 2 was prepared and treated with a Er:YAG laser (400mJ/4Hz and 80mJ/4Hz, respectively) and was acid etched. Group 3 was prepared and treated with an air abrasion system and was acid etched. Cavities were restored and stored for 7 days. Restorations were polished, thermocycled, immersed in 0.2% rhodamine B, sectioned, and analyzed for leakage. RESULTS: Er:YAG laser-prepared cavities showed the highest degree of infiltration. The performance of the air abrasion device was comparable to that of the high-speed handpiece. CONCLUSION: It may be concluded that the method of cavity preparation affected the microleakage of Class V cavities restored with flowable composite in primary teeth.

Effect of Brushing Time and Dentifrice Abrasiveness on Color Change and Surface Roughness of Resin Composites.

Dentifrice abrasiveness and brushing time may increase color change (∆E) and surface roughness (∆Ra) of resin composites. This study aimed to evaluate the effect of mechanical brushing time of dentifrices with different abrasiveness on ∆E and ∆Ra of nanofilled (Z350, 3M ESPE) and nanohybrid (Tetric N-Ceram, Ivoclar Vivadent) resin composites. Sixteen specimens (12 mm diameter x 2 mm thick) were fabricated using a white Teflon matrix of each resin composite and a ceramic (IPS e.max Ceram, Ivoclar Vivadent), used as control. After initial color readouts on white backgrounds (Spectrophotometer PCB 6807, Byk Gardner), with D65 standard illuminant, and surface roughness (Rugosimeter Surfcorder SE 1700, Kosalab) with cut-off=0.8 mm and speed=0.25 mm/s, specimens were assigned (n=8) according to the abrasiveness of the dentifrices: RDA* 68 (Colgate) and RDA* 180 (Colgate Total Plus Whitening). Specimens were submitted to mechanical brushing (58,400 cycles) and after every 14,600 cycles (1 year of brushing by a healthy individual), new color and surface roughness readouts were taken. Color stability was calculated by CIEDE2000. Data were analyzed by 3-way repeated measures ANOVA and Bonferroni test (p<0.05), and demonstrated that the dentifrice abrasiveness (p=0.02) and brushing time (p<0.0001) affected the ∆E of nanofilled resin composite. There was no difference on surface roughness of materials (p=0.6752) or brushing time (p=0.7997). In conclusion, the longer the brushing time and dentifrice abrasiveness, the greater the color change of the nanofilled resin composite. The surface roughness was not influenced by dentifrice abrasiveness.

Morphology of sealant/enamel interface after surface treatment with bioactive glass.

The purpose of this study was to analyze, by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), the morphology of sealant/enamel interface after surface treatment with Biosilicate. Before pits and fissures sealing, the occlusal surfaces of 10 sound human molars were sectioned perpendicularly at the fissures in order to obtain three slices for each tooth. Slices were randomly assigned into three groups (n = 10) according to sealing protocol: Group 1- Acid etching + Biosilicate + glass ionomer-based sealant (Clinpro XT Varnish, 3M ESPE); Group 2- Acid etching + glass ionomer-based sealant (Clinpro XT Varnish, 3M ESPE); Group 3- No sealing. All slices were subjected to thermal cycling (5,000 cycles; 5-55°C; dwell time: 30s). Half of the slices from each group (n = 5) were analyzed by CLSM and the other half by SEM. Groups 1 and 2 were also submitted to EDS analysis and their data were evaluated by Two-Way ANOVA e Tukey's test (α=5%). EDS data analysis showed higher amounts of silicon (Si) ions than calcium (Ca) ions in Group 1 (P < 0.05); Group 2 presented higher amounts (P < 0.05) of Ca ions than Si ions. It may be concluded that the use of Biosilicate for surface treatment did not affect the morphology of glass ionomer-based sealant/enamel interfaces.

Bond strength of glass-ionomer cements to caries-affected dentin.

PURPOSE: The aim of this study was to assess the tensile bond strength of a resin-modified glass-ionomer cement (a: Fuji II LC) and three traditional glass-ionomer cements (b: Ketac-fil; c: Ketac Molar; d: Fuji IX) to caries-affected dentin. MATERIALS AND METHODS: Forty human permanent molars with occlusal caries in dentin were selected, embedded in polyester resin, and ground until the carious dentin was exposed. Infected dentin was removed with curettes according to the atraumatic restorative technique (ART), and the tooth surface was smoothed with SiC paper. A bonding site, limited to 3 mm in diameter, was treated with polyacrylic acid for 10 s. After surface treatment, an inverted glass-ionomer cone was prepared for each specimen, using a split bisected Teflon matrix. The cones were immediately protected with a thin layer of nail varnish or bonding agent. Specimens were stored in distilled water at 37 degrees C for 24 h, and then bond strength to failure was tested. RESULTS: The mean (SD) bond strengths in MPa were: a: 8.33 (2.35); b: 2.46 (1.60); c: 0.83 (1.18), and d: 1.45 (1.70). The data were analyzed using ANOVA and Tukey statistical tests. Fuji II LC, a resin-modified glass-ionomer cement, showed higher bond strength values and was statistically superior to the other groups, containing traditional glass ionomer cements (p < 0.05). CONCLUSION: Findings showed that the traditional glass-ionomer cements tested in this study had lower mean bond strength values to caries-affected dentin than did the resin-modified glass-ionomer cement.

Assessing microleakage in resin composite restorations rebonded with a surface sealant and three low-viscosity resin systems.

OBJECTIVES: The aim of this study was to assess the ability of three low-viscosity resin systems (Unibond, Single Bond, and Fluorseal), used as rebonding agents, and a specific surface-penetrating sealant (Fortify) to prevent microleakage in Class V resin composite restorations. METHOD AND MATERIALS: Fifty Class V cavities with the occlusal margin in enamel and the cervical margin in dentin and cementum were prepared on both the buccal and lingual surfaces of sound extracted premolars and restored with a hybrid light-cured resin composite. After finishing and polishing, restorations were randomly assigned to one of five equal groups (n = 10): a control, without surface sealing, and four experimental groups in which margins were etched and rebonded. Specimens were thermocycled, immersed in a 50% silver nitrate solution, sectioned longitudinally, and analyzed for leakage at the occlusal and cervical interfaces. RESULTS: Statistical analysis showed significantly less leakage at the enamel margins for all groups. Fortify and Unibond were statistically similar and provided better marginal sealing at dentin and cementum interfaces. Fluorseal showed the poorest ability to prevent microleakage. CONCLUSION: The rebonding technique may substantially minimize microleakage at dentin and cementum margins of composite restorations, when a resin system with sufficiently low viscosity is used as a surface sealant, regardless of whether it has been specified for such a purpose.

In vitro evaluation of microleakage of a flowable composite in Class V restorations.

The aim of this study was to evaluate microleakage around class V restorations using a flowable composite compared to a hybrid composite. Forty class V cavities were prepared on buccal and lingual surfaces of 20 human teeth, with occlusal and cervical margins at the enamel and cementum/dentin levels, respectively. Specimens were divided into 2 groups with 10 samples each. Group 1: buccal cavities received Paama 2 (conventional bonding agent) + Wave (flowable composite); lingual cavities were restored with Paama 2 + Glacier (hybrid composite). Group 2: buccal cavities received Optibond Solo (self-priming bonding agent) + Wave; lingual cavities were restored with Optibond Solo + Glacier. After being stored in distilled water and finished, the teeth were thermocycled, immersed in a 50% silver nitrate solution and embedded in resin. They were sectioned and the depth of tracer penetration was scored. The results were analyzed using Kruskal-Wallis and Wilcoxon tests. The restorations with flowable composite and those with hybrid composite from the same group showed similar results of microleakage for both occlusal and cervical margins. Optibond Solo improved the sealing of the restorations when compared with Paama 2 (p < 0.01). None of the restorative materials completely sealed the tooth/restoration interface at the cervical margins.

Bonding of self-etching and total-etch systems to Er:YAG laser-irradiated dentin. Tensile bond strength and scanning electron microscopy.

This study investigated the effect of Er:YAG laser on bonding to dentin and the interaction pattern of different adhesive systems with the lased substrate. Tensile bond strength of a self-etching [Clearfil SE Bond (CSEB)] and two total-etch [Single Bond (SB) and Gluma One Bond (GOB)] systems to lased and non-lased dentin was evaluated and the adhesive interface morphology was examined by SEM. Dentin was either treated following the manufacturers' instructions (A) or submitted to Er:YAG lasing (80 mJ; 2 Hz) + adhesive protocol (B). Resin cones were bonded to demarcated dentin sites and tested for tensile strength. For SEM, dentin discs were obtained, bisected and the halves were treated (A or B). The adhesive interfaces were examined. Means of tensile bond strength (in MPa) were: CSEB: (A) 20.65+/-1.81, (B) 14.06+/-1.88; SB: (A) 18.36+/-1.48, (B) 16.19+/-1.90; GOB: (A) 16.58+/-1.94, (B) 14.07+/-2.13. ANOVA and Tukey tests showed that lasing of dentin resulted in a significant decrease in bond strength (p<0.05). In the non-lased subgroups, CSEB had higher bond strength than the total-etch adhesives (p<0.05). Conversely, in laser-ablated specimens, CSEB had the lowest bond strength, while SB had the highest values (p<0.05). Consistent hybrid layers were observed for conventionally treated specimens, whereas either absent or scarce hybridization zones were viewed for lased subgroups. Er:YAG laser irradiation severely undermined the formation of consistent resin-dentin hybridization zones and yielded lower bond strengths. CSEB self-etching primer appeared to be the most affected by the laser ablation on the dentin substrate, resulting in the weakest adhesion.

Solubility and disintegration of new calcium aluminate cement (EndoBinder) containing different radiopacifying agents.

INTRODUCTION: The aim of this study was to evaluate the solubility and disintegration of EndoBinder (EB) containing 3 different radiopacifying agents, bismuth oxide (Bi2O3), zinc oxide (ZnO), or zirconium oxide (ZrO2), in comparison with gray mineral trioxide aggregate (GMTA) and white MTA (WMTA). METHODS: Ten specimens of each cement were made in a stainless steel matrix (20 × 1.5 mm) according to Specification no. 57 of American National Standards Institute/American Dental Association: EB + Bi2O3, EB + ZrO, EB + ZnO, WMTA, and GMTA. The specimens were weighed on an accurate analytical scale and immersed in 50 mL distilled and deionized water at 37°C for 7 days. Afterwards, specimens were dried and weighed again to determine mass loss (%). Resulting solutions were analyzed in an atomic absorption spectrophotometer for identification and quantification of chemical elements released. RESULTS: All cements presented mean values of solubility and disintegration above the American National Standards Institute/American Dental Association Specification no. 57. EB + Bi2O3 presented the lowest mass loss (5.08%) and WMTA (6.65%) the highest, with no statistically significant difference (P > .05). The release of several chemical elements was observed, mostly metal ions. Only GMTA and EB + Bi2O3 showed the presence of Cr, with significant difference (P < .05). EB + ZnO presented the highest levels of Pb, followed by WMTA (P < .05). For As, the cements presented different release levels, with EB + ZnO showing the highest and GMTA the lowest levels (P < .05). However, the amounts of As and Pb released were lower than the safe limit proposed by ISO 9917-1. CONCLUSIONS: Irrespective of the radiopacifying agents used, EndoBinder presented similar behavior to MTA.