Lasers in Apicoectomy: A Brief Review.

Since the invention of laser, various applications for lasers in endodontics have been proposed, such as disinfection of the root canal system, canal shaping, pulp diagnosis, and apico-ectomy. One of the major applications of laser in endodontics is apicoectomy. The aim of this article is to review the benefits and drawbacks of laser applications in apicoectomy, including effect on apical seal, effect on dentin permeability, effect on postsurgery pain, effect on crack formation, effect on root-end morphology, effect on treatment outcome, and connective tissue response to laser-treated dentin.

Investigations of radicular dentin permeability and ultrastructural changes after irradiation with Er,Cr:YSGG laser and dual wavelength (2780 and 940 nm) laser.

The aim of this study was to assess the effectiveness of dual wavelength (2780 nm Er,Cr:YSGG, 940 nm diode) laser in elimination of smear layer comparing it with Er,Cr:YSGG laser in terms of radicular dentin permeability and ultrastructural changes of root canal walls. Fifty-one sound single-rooted extracted teeth were instrumented up to size F4 and divided into three groups: group Co, non-irradiated samples; group A, irradiated with Er,Cr:YSGG laser; group B, irradiated with the dual wavelength laser. Afterward, the roots were made externally impermeable, filled with 2% methylene blue dye, divided horizontally into three segments reflecting the cervical, middle, and apical thirds then examined under microscope. Using analytical software, the root section area and dye penetration area were measured, and then, the percentage of net dye penetration area was calculated. Additionally, scanning electron microscope investigations were accomplished. Analysis of variance (ANOVA) showed significant differences between all groups over the three root thirds. Dye permeation in dual wavelength laser group was significantly higher over the whole root length: cervical, middle, and apical compared to Er,Cr:YSGG laser group and non-irradiated samples (p < 0.001). Scanning electron micrographs of dual wavelength irradiated samples showed a distinctive removal of smear layer with preservation of the annular structure of dentinal tubules. Er,Cr:YSGG laser root canal irradiation produced uneven removal of smear layer, in efficient cleanliness especially in the apical third. There was no sign of melting and carbonization. Within the studied parameters, root canal irradiation with dual wavelength laser increased dentin permeability.

The effects of CO2 laser with or without nanohydroxyapatite paste in the occlusion of dentinal tubules.

The aim of this study was to evaluate a new treatment modality for the occlusion of dentinal tubules (DTs) via the combination of 10.6 µm carbon dioxide (CO2) laser and nanoparticle hydroxyapatite paste (n-HAp). Forty-six sound human molars were used in the current experiment. Ten of the molars were used to assess the temperature elevation during lasing. Thirty were evaluated for dentinal permeability test, subdivided into 3 groups: the control group (C), laser only (L-), and laser plus n-HAp (L+). Six samples, two per group, were used for surface and cross section morphology, evaluated through scanning electron microscope (SEM). The temperature measurement results showed that the maximum temperature increase was 3.2 °C. Morphologically groups (L-) and (L+) presented narrower DTs, and almost a complete occlusion of the dentinal tubules for group (L+) was found. The Kruskal-Wallis nonparametric test for permeability test data showed statistical differences between the groups (P < 0.05). For intergroup comparison all groups were statistically different from each other, with group (L+) showing significant less dye penetration than the control group. We concluded that CO2 laser in moderate power density combined with n-HAp seems to be a good treatment modality for reducing the permeability of dentin.

Determination of the effect of Nd:YAG laser irradiation through dentinal tubules on several oral pathogens.

The effects of Nd:YAG laser irradiations at different power settings on several oral pathogens were evaluated. A total of 252 dentin samples were divided into seven groups consisting of 36 dentin specimens each. In each group, 9 of the 36 specimens were used as controls, thereby including a control in every group. The remaining 27 specimens were divided into three subgroups consisting of nine specimens according to different Nd:YAG laser settings (1.5, 1.8, and 2 W). Each group was inoculated on the nonpulpal side with one of the following microorganisms: Candida glabrata, Candida tropicalis, Candida krusei, Candida sake, Candida lusitaniae, Candida kefyr, and Rhodotorula mucilaginosa. The following irradiation procedure was used: the specimens were irradiated on the bacteria-free side (the side consisting of the pulpal wall) using contact mode under the constant scanning movement of the optical fiber at an angle of 10°. One lasing cycle consisted of four irradiation cycles of 10 s each, with 15-s intervals in between each irradiation cycle. The remainder of the controls and the lased specimens of each group were prepared for the microbiological investigation. After incubation for 24 h at 37 °C, the colonies were counted, and the total number of surviving microorganisms was statistically assessed. Microorganisms irradiated with Nd:YAG laser at power settings 2 W, 15 pps did not survive. Although there was a significant reduction of microorganisms at 1.5 and 1.8 W, when comparing Nd:YAG laser irradiation with the control group, sterilization did not occur.

Correlation between light transmission and permeability of human dentin.

The influence of dentin permeability on transdentinal LED light propagation should be evaluated since this kind of phototherapy may further be clinically used to stimulate the metabolism of pulp cells, improving the healing of damaged pulps. This study evaluated the influence of the dentin permeability on the transdentinal LED light (630 nm) transmission. Forty-five 0.5-mm-thick dentin disks were prepared from the coronal dentin of extracted sound human molars. An initial measurement of transdentinal LED light transmission was carried out by illuminating the discs in the occlusal-to-pulpal direction onto a light power sensor to determine light attenuation. The discs were treated with EDTA for smear layer removal, subjected to analysis of hydraulic conductance, and a new measurement of transdentinal LED light transmission was taken. Spearman's correlation coefficient was used for analysis of data and showed a weak correlation between dentin permeability and light attenuation (coefficient = 0.19). This result indicates that higher or lower dentin permeability does not reflect the transdentinal propagation of LED light. Significantly greater transdentinal propagation of light was observed after treatment of dentin surface with EDTA (Wilcoxon test, p < 0.05). According to the experimental conditions of this in vitro study, it may be concluded that dentin permeability does not interfere in the transdentinal LED light transmission, and that smear layer removal facilitates this propagation.

In vitro effects of Er,Cr:YSGG laser on dentine hypersensitivity. Dentine permeability and scanning electron microscopy analysis.

The aim of the present study was to determine clinical parameters for the use of Er,Cr:YSGG laser in the treatment of dentine hypersensitivity. Two antagonist areas were determined as control and experimental areas for irradiation in 90 premolar roots. Each surface was conditioned with 24% EDTA (sub-group 1) and 35% phosphoric acid (sub-group 2) and irradiated with the following settings: 1) Er:YAG, 60 mJ, 2 Hz, defocused; groups 2 to 9: irradiation with Er,Cr:YSGG laser, 20 Hz, Z6 tip, 0% of air and water: 2) Er,Cr:YSGG 0.25 W; 3) 0.5 W; 4) 0.75 W; 5) 1.0 W; 6) 1.25 W, 7) 1.50 W, 8) 2 W; 9) 2 W. After irradiation, samples were immersed in methylene blue solution and included in epoxy resin to obtain longitudinal cuts. The images were digitalized and analyzed by computer software. Although the samples irradiated with Er:YAG laser showed less microleakage, sub-group 1 showed differences between the groups, differing statistically from groups 3, 6, and 9. The results of sub-group 2 showed that the mean values of Er:YAG samples showed a negative trend, however, no differences were detected between the groups. For scanning electron microscopy analysis, dentine squares were obtained and prepared to evaluate the superficial morphology. Partial closure of dentinal tubules was observed after irradiation with Er:YAG and Er,Cr:YSGG laser in the 0.25 and 0.50 W protocols. As the energy densities rose, open dentinal tubules, carbonization and cracks were observed. It can be concluded that none of the parameters were capable of eliminating microleakage, however, clinical studies with Er:YAG and Er,Cr:YSGG lasers should be conducted with the lowest protocols in order to determine the most satisfactory setting for dentine hypersensitivity.

Nd:YAG laser irradiation of etched/unetched dentin through an uncured two-step etch-and-rinse adhesive and its effect on microtensile bond strength.

PURPOSE: To evaluate whether Nd:YAG laser irradiation of etched and unetched dentin through an uncured adhesive affected the microtensile bond strength (µTBS). MATERIALS AND METHODS: Flat dentin surfaces were created in 19 extracted human third molars. Adper Single Bond (SB) adhesive was applied over etched (groups 1 to 3) or unetched dentin (groups 4 to 6). The dentin was then irradiated with a Nd:YAG laser through the uncured adhesive, using 0.75 or 1 W power settings, except for the control groups (groups 1 and 4). The adhesive was light cured and composite crowns were built up. After 24 h, the teeth were sectioned into beams, with cross-sectional areas of 0.49 mm2, and were stressed under tension. Data were statistically analyzed using two-way ANOVA and Tukey's test (α = 5%). Dentin surfaces of fractured specimens and the interfaces of untested beams were observed under scanning electron microscopy (SEM). RESULTS: Acid etching, laser irradiation, and their interaction significantly affected bonding (p < 0.05). Laser irradiation did not improve bonding of etched dentin to resin (p > 0.05). However, higher µTBS means were found on unetched lased dentin (groups 5 and 6), but only in comparison to group 4, where neither lasing nor etching was performed. Groups 4 to 6 showed the lowest µTBS means among all groups tested (p < 0.05). Laser irradiation did not change the characteristics of the hybrid layers created, while solidification globules were observed on lased dentin surfaces under SEM. CONCLUSION: Laser irradiation of dentin through the uncured adhesive did not significantly improve the µTBS in comparison to the suggested manufacturer's technique.

Comparison of dentin root canal permeability and morphology after irradiation with Nd:YAG, Er:YAG, and diode lasers.

The aim of this study was to compare the effects of Nd:YAG, Er:YAG, and diode lasers on the morphology and permeability of root canal walls. The three laser wavelengths mentioned interact differently with dentin and therefore it is possible that the permeability changes caused will determine different indications during endodontic treatment. Twenty-eight human single-rooted teeth were instrumented up to ISO 40 and divided into four groups: group C, control (GC), non-laser irradiated; group N (GN), irradiated with Nd:YAG laser; group E (GE), with Er:YAG laser and group D (GD) with diode laser. After that, the roots were filled with a 2% methylene blue dye, divided into two halves and then photographed. The images were analyzed using Image J software and the percentage of dye penetration in the cervical, middle, and apical root thirds were calculated. Additional scanning electron microscopy (SEM) analyses were also performed. The analysis of variance (ANOVA) showed significant permeability differences between all groups in the middle and cervical thirds (p < 0.05). The Tukey test showed that in the cervical third, GN presented means of dye penetration statistically significantly lower than all of the other groups. In the middle third, GE and GD showed statistically higher dye penetration means than GC and GN. SEM analysis showed melted surfaces for GN, clean wall surfaces with open dentinal tubules for GE, and mostly obliterated dentinal tubules for GD. Er:YAG (2,094 nm) laser and diode laser (808 nm) root canal irradiation increase dentinal permeability and Nd:YAG (1,064 nm) laser decreases dentin permeability, within the studied parameters.

Acid resistance of dentin after erbium:yttrium-aluminum-garnet laser irradiation.

The purpose of this study was to evaluate the acid resistance of erbium:yttrium-aluminum-garnet (Er:YAG) lased sub-surface dentin using a scanning electron microscope (SEM). Dentin disks were exposed to a single pulse of Er:YAG laser irradiation at 80 mJ/pulse under water spray, with the contact sapphire tip vertical to the dentin surfaces (n = 15). Five specimens from the laser-ablated dentin surfaces were observed. Ten specimens were crosscut, exposing the center of the lased point. For five of the specimens, the sub-surface of the lased dentin, with or without 10% phosphoric acid treatment, was evaluated. We used the remaining five specimens to analyze the degree of acid treatment on crosscut surface by observing the re-crosscut surfaces at the lased point. The irradiated dentin surfaces were irregular, scaly or flaky. Three sub-layers were observed in the sub-surface: a superficial, less decalcified layer; an intermediate most decalcified layer; and a deep, normal shade layer. Er:YAG laser irradiation affected the acid resistance of sub-surface dentin.

Effects of Nd:YAG laser irradiation on the hybrid layer of different adhesive systems.

PURPOSE: The aim of this in vitro study was to evaluate the microtensile bond strength (microTBS) and hybrid layer morphology of different adhesive systems, either followed by treatment with Nd:YAG laser irradiation or not. Previous studies have shown the effects of Nd:YAG laser irradiation on the dentin surface at restoration margins, but there are few reports about the significance of the irradiation on the hybrid layer. MATERIALS AND METHODS: The flattened coronal and root dentin samples of 24 bovine teeth were randomly divided into 8 groups, according to the adhesive system used -- Scotchbond Multi Purpose (SBMP) or Clearfil SE Bond (CSEB) -- and were either irradiated with Nd:YAG or not, with different parameters: 0.8 W/10 Hz, 0.8 W/20 Hz, 1.2 W/10 Hz, 1.2 W/20 Hz. The left sides of specimens were the control groups, and right sides were irradiated. A composite crown was built over bonded surfaces and stored in water (24 h at 37 degrees C). Specimens were sectioned vertically into slabs that were subjected to microTBS testing and observed by SEM. RESULTS: Control groups (27.81 +/- 1.38) showed statistically higher values than lased groups (21.37 +/- 0.99), and CSEB control group values (31.26 +/- 15.71) were statistically higher than those of SBMP (24.3 +/- 10.66). There were no significant differences between CSEB (20.34 +/- 10.01) and SBMP (22.43 +/- 9.82) lased groups. Among parameters tested, 0.8 W/10 Hz showed the highest value (25.54 +/- 11.74). Nd:YAG laser irradiation caused dentin to melt under the adhesive layer of both adhesive systems tested. CONCLUSION: With the parameters used in this study, Nd:YAG laser irradiation of the hybrid layer promoted morphological changes in dentin and negatively influenced the bond strength of both adhesive systems.

The effect of CO2 Laser on the permeability of dentinal tubules: a preliminary in vitro study.

OBJECTIVES: The purpose of this in vitro study was to determine whether there is a change in dentin permeability following 9.6-microm CO(2) laser irradiation and high-speed drilling. MATERIALS AND METHODS: Twenty permanent, intact, non-carious molars were selected. The crowns were separated from the roots at the cemento-enamel junction. The teeth were randomly divided into two groups, control and experimental, each containing 10 teeth. After class I preparation using a high-speed drill, 9.6-microm CO(2) laser irradiation was applied to dentinal areas only on the experimental group. The samples were soaked in 0.5% methylene blue for 48 h; three independent examiners using scanning electron microscopy evaluated dye penetration through the specimens. RESULTS: The results of the three examiners were similar. There was a significant difference in dye penetration into dentin after laser irradiation versus controls (p < 0.05). CONCLUSIONS: The 9.6-microm CO(2) laser appears to be a promising tool in the clinical setting. However, further investigation is needed to ensure maximum effectiveness.

Suitable conditions for sealing of open dentinal tubules using a pulsed Nd:YAG laser.

UNLABELLED: BACKGROUND DATA AND OBJECTIVES: Nd:YAG laser radiation has been applied in treatment of dentine hypersensitivity; dentine melt created after irradiation on a tooth surface can occlude open dentinal tubules. Different conditions (energy of pulses, number of successive irradiations, and type of dye agent) have been reported in the literature. In our study, different conditions are compared and the most suitable ones are suggested. METHODS: One hundred nine dentine samples prepared from extracted human third molars in the form of 2- or 3-mm thick discs and facets from an outer convex surface of a root were irradiated by pulses with duration 0.3 ms and beam diameter 0.3 or 0.6 mm. The laser repetition rate was 15 Hz. Energies per pulse have been changed from 20 mJ to 250 mJ (the corresponding energy densities rho are 22 and 275 J/cm(2) for the beam diameter of 0.3 mm). Dyes including tartrazine, carmine indigo, erythrosin, and methylene blue have been used to cover dentine surfaces and to increase absorption of laser radiation. Irradiated dentine surfaces have been investigated using scanning electron microscopy. RESULTS: Sealing of open dentinal tubules can be accomplished even without dyes, provided that a sufficiently intense laser radiation level is used. To avoid damage to the dentine's surface the use of dyes is necessary. Erythrosin has been found to be the best agent, and closing of dentinal tubules occurred after four doses of irradiation with 30-mJ pulses with a beam diameter of 0.6 mm (energy density rho = 8.25 J/cm(2), total energy density rho(T) = 33 J/cm(2)). The upper limit has been reached using four doses of irradiation by 90-mJ pulses with a beam diameter of 0.3 mm (rho = 99 J/cm(2), rho(T) = 396 J/cm(2)). CONCLUSIONS: Occluding dentinal tubules can safely and effectively be accomplished using pulsed Nd:YAG laser radiation provided that the dentine surface is covered with erythrosin solution.

Longitudinal Effect of Surface Treatments Modified by NaOCl-Induced Deproteinization and Nd:YAG Laser on Dentin Permeability.

OBJECTIVE: The purpose of this study was to evaluate dentin permeability after dentin hypersensitivity treatments: fluoride, adhesive system, and collagen deproteinization with and without Nd:YAG laser exposure, and after erosive and abrasive challenges. MATERIALS AND METHODS: Dentin permeability was assessed by measuring dentinal fluid flow using a permeability device. Eighty bovine dentin specimens (6 mm diameter/1 mm thickness) had permeability measured in the presence of the smear layer and after removal of the smear layer by ethylenediaminetetraacetic acid (EDTA). They were then divided into eight groups according to treatment (n = 10): Group C, control; Group L, Nd:YAG laser; Group F, fluoride; Group FL, fluoride plus Nd:YAG laser; Group A, adhesive; Group AL, adhesive plus Nd:YAG laser; Group D, 10% NaOCl plus adhesive; and group DL, NaOCl plus adhesive plus Nd:YAG laser. Nd:YAG laser was irradiated at 60 mJ/pulse/10 Hz/47.7 J/cm2/1 W and applied freehanded without contact for 60 sec. Permeability was measured 24 h after the treatments. The specimens were exposed to erosive and abrasive challenges for 5 days. Erosive challenge was done by immersion in Coca-Cola, four times a day/90 sec each. After the first and last erosive challenge of the day, the abrasive challenge was conducted by brushing the specimens (24,000 cycles/3.8 cm range/200 g weight), and permeability was measured again. Results were analyzed statistically using two factor ANOVA and Tukey tests (α = 0.05). RESULTS: With the exception of groups FL and A, all treatments reduced permeability. A significant reduction in permeability was seen when the treatments were combined with laser exposure. The association of adhesive and Nd:YAG laser led to the lowest rate of permeability after 24 h. NaOCl-induced deproteinization associated with Nd:YAG laser showed the lowest permeability rate after erosive/abrasive challenges. CONCLUSIONS: Dentin hypersensitivity treatments reduced dentin permeability when associated with Nd:YAG laser, even after erosive/abrasive challenges.

Combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine.

OBJECTIVE: This study evaluated the combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine. DESIGN: Sixty slabs of bovine root dentine (2×2×2mm) were eroded with citric acid 0.3% (pH 3.2) during 2h and then kept in artificial saliva during 24h. Specimens were randomly assigned in 6 groups (n=10), to receive the following treatments: fluoride varnish; fluoride varnish+Er:YAG laser; fluoride varnish+Nd:YAG laser; non-fluoride varnish; non-fluoride varnish+Er:YAG laser; non-fluoride varnish+Nd:YAG laser. The Er:YAG (100mJ, 3Hz) and Nd:YAG (70mJ, 15Hz) were applied for 10s. Specimens were subjected to further erosive challenges with citric acid 0.3% 4×/day, during 1min, for 5 days, remaining in artificial saliva between cycles. Dentin permeability was then assessed. Two-way ANOVA demonstrated no significant interaction between laser and varnish (p=0.858). RESULTS: No effect was also detected for the main factor varnish (p=0.768), while permeability of eroded root dentin was significantly lower when such substrate was laser-irradiated, no matter the laser source (p<0.001). CONCLUSIONS: This study concluded that Er:YAG and Nd:YAG lasers can be employed to control the permeability of eroded root dentin, regardless of fluoride varnish application.

Effects of different desensitizing treatments on root dentin permeability.

The objective of this study was to evaluate the effects of diode laser and a desensitizing dentifrice on dentin permeability. Fifty-two root dentin fragments were obtained (5 × 5mm) and treated with 24% EDTA gel. The samples were divided into 4 groups (n = 13): G1, control (no treatment); G2, diode laser (λ = 908 nm, 1.5 W, continuous mode, 20s); G3, application of abrasive dentifrice for 1 minute (Elmex Sensitive Professional (International Gaba); and G4, application of abrasive dentifrice for 1 minute followed by irradiation with diode laser. Ten samples per group were immersed in 2% methylene blue solution for 4h. The specimens were washed, longitudinally sectioned, observed under optical microscopy, photographed and assessed based on the degree of dye leakage. The remaining samples were observed under scanning electron microscopy (SEM). The leakage data were subjected to ANOVA test, followed by Tukey's t-test (α = 5%). Groups 2, 3 and 4 showed less dye penetration than the control group (p < 0.05), but were similar among each other. SEM images showed that dentinal tubules were open in G1, and fused and occluded in G2. Group 3 showed dentinal tubules that were occluded by the metal ions from the toothpaste. G4 presented similar characteristics to G3, and the presence of fused dentin. The diode laser and the dentifrice were effective in reducing dentinal permeability, and the combination of the two treatments did not show better results than either one used alone.

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.

Effects of Er:YAG and Nd:YAG lasers on dentin permeability in root surfaces: a preliminary in vitro study.

OBJECTIVE: This in vitro study evaluated the effects of Nd:YAG and Er:YAG lasers on reducing dentin permeability by sealing opened tubules. BACKGROUND DATA: According to hydrodynamic theory, dentine hypersensitivity occurs when dentin is exposed with tubules opened. Consequently, a painful sensation occurs due to an intensification of the dentinal permeability. Treatment, therefore, should be based on a decrease of this permeability, achieved by the obliteration of dentinal tubules. The Nd:YAG laser is known for its capacity to seal dentinal tubules; however, few studies concerning treatment with Er:YAG laser are available. METHODS: The Nd:YAG laser was used, based on two parameters: (A) 1.0 W, 10 Hz, and (B) 1.5 W, 15 Hz. The Er:YAG laser was used at 60 mJ, 2 Hz, four applications of 20 sec each, at 6 mm from the surface. After irradiation, all samples were immersed in 1% Rodamine B dye solution, in order to evaluate the penetration of the dye solution and observe the decrease/increase of dentinal permeability after the laser treatment. RESULTS: The laser conditions used in the present study decreased the permeability as follows: (a) when using the Er:YAG laser at 60 mJ, 2 Hz in 26.05%, and (b) when using the Nd:YAG laser at 1.5 W, 15 Hz in 19.03%--with no statistical difference between them. Additionally, the Nd:YAG laser at 1.0 W, 10 Hz, decreased permeability in 4.59%, with a smaller effect. CONCLUSIONS: According to the results of this in vitro study, the Er:YAG laser at 60 mJ, 2 Hz, and the Nd:YAG laser at 1.5 W, 15 Hz are useful for decreasing dentin permeability.

The threshold effects of Nd and Ho: YAG laser-induced surface modification on demineralization of dentin surfaces.

Laser irradiation alters the structure of dentin and produces surface layers that give the appearance of being more enamel-like. The laser-modified surface may be more resistant to demineralization; hence, many investigators are proposing continued development of the laser as a possible preventive treatment for caries. The purpose of this study was to explore the morphological changes that occur in dentin when treated at threshold illuminance with two clinically interesting laser wavelengths, and to evaluate the effectiveness of the laser-treated surface at resisting demineralization in an acid-gel solution. The Nd: YAG laser (wavelength 1060 nm) produced significant recrystallization and grain growth of the apatite, without the formation of second phases such as beta-tricalcium phosphate. This recrystallized surface layer showed resistance to demineralization; however, the layer did not provide protection of the underlying dentin from demineralization because of cracks and macroscopic voids that allowed for penetration of the demineralizing gel. The Ho: YAG laser-treated surface (wavelength 2100 nm) did not show significant evidence of recrystallization and grain growth, and only a trace amount of an acid-resistant layer was observed with demineralization. It is speculated that the Ho:YAG laser is coupling with absorbed water, and that the heat transfer from the water to the mineral phase is inefficient. For the purposes of creating a demineralization-resistant layer, threshold illuminance with both Nd: YAG and Ho: YAG was ineffective.

Sterilization of teeth by gamma radiation.

Clinical simulations and restorative materials research and development conducted in vitro require the use of large numbers of extracted teeth. The simultaneous need for infection control procedures and minimal alterations of structure and properties of the tissue prompted this study of gamma irradiation as a method to eliminate microbes associated with extracted teeth and their storage solutions. Evaluations of potential change in structure of dentin were conducted in terms of permeability, Fourier transform infrared spectroscopy (FTIR), and optical properties. The dose required for sterilization by gamma irradiation was established by means of a tooth model inoculated with Bacillus subtilis (10(8) organisms/mL). Sterilization occurred at a dose above 173 krad with use of a Cesium (Cs137) radiation source. Gamma irradiation did not affect permeability of crown segments of dentin. A comparative evaluation of the effects of four sterilization methods on dentin disks was based on FTIR and ultraviolet-visible-near infrared (UV/VIS/NIR) spectra before and after sterilization by (1) gamma irradiation; (2) ethylene oxide; (3) dry heat; and (4) autoclaving. No detectable changes were found with gamma irradiation, but all other methods introduced some detectable change in the spectra. This suggests that common methods of sterilization alter the structure of the dentin, but gamma irradiation shows promise as a method which both is effective and introduces no detectable changes as measured by FTIR, UV/VIS/NIR, or permeability.

Effects of Nd:YAG laser on apical seal of teeth after apicoectomy and retrofill.

The application of Nd:YAG laser to tooth surface can change its surface permeability. The purpose of this study was to investigate the effects of Nd:YAG laser on the permeability of dentin following apicoectomy and retrofill. Sixty single-rooted teeth were randomly assigned to six groups of 10 teeth each. The six groups were arranged in three pairs, experimental and control groups. The canals of teeth in pairs 1 and 2 were cleaned, shaped, obturated, and their apical 2 mm were resected. A class I preparation was prepared and filled with amalgam in each tooth in pair 1. The apical 2 mm of each tooth in pair 3 was removed, and a class I preparation was prepared and filled with amalgam. The apical surface of resected roots in half of the samples in each pair was lased twice by using Nd:YAG laser. The duration of lasing and the number of pulses were recorded for each tooth. After application of nail polish to the unoperated surface of each tooth, the teeth were placed in 0.5% methylene blue dye for 48 h. The amount of dye penetration in sagittal sections of each tooth was measured. The amount of dye penetration was significantly lower in lased roots than in nonlased ones (p < 0.05). Based on our results, it appears that application of Nd:YAG laser reduces the permeability of resected roots.