Polifluoruro de amonio como alternativa de acondicionamiento para laminados ultradelgados de disilicato de litio. Reporte de caso / Ammonium polyfluoride as an alternative for the surface conditioning of ultrathin lithium disilicate veneers. A case report

RESUMEN: Los laminados vitrocerámicos ultradelgados constituyen una alternativa conservadora para la resolución de alteraciones estéticas. Sin embargo, su acondicionamiento con ácido fluorhídrico suele no estar exento de complicaciones, por lo que el uso de un sistema autograbante en base a polifluoruro de amonio (Monobond Etch&Prime, MEP) permite disminuir el riesgo de sobregrabado, simplificando la técnica. El presente reporte presenta el seguimiento a dieciocho meses de un caso clínico resuelto mediante laminados vitrocerámicos acondicionados únicamente con MEP. Caso. Paciente joven con alteraciones estéticas en el sector anterosuperior. Se realizaron preparaciones conservadoras para la confección de laminados ultradelgados en disilicato de litio (e.maxPress). Las vitrocerámicas fueron acondicionadas sólo con MEP y se cementaron con Variolink Esthetic LC. Al año y medio las restauraciones se observaron indemnes, manteniendo un buen ajuste marginal y ausencia de tinciones. Conclusiones. MEP aparece como una alternativa prometedora para reemplazar al ácido fluorhídrico en la cementación de laminados vitrocerámicos.

ABSTRACT: Ultrathin glass-ceramic veneers are a conservative approach for the restorative treatment of aesthetic disorders in the anterior region. However, surface conditioning with hydrofluoric acid of the thin structures can be usually a challenging step. Therefore, the use of a self-etching ceramic primer containing ammonium polyfluoride (Monobond Etch&Prime, MEP) offers a simplified technique with a reduced risk of overetching. Here we present an 18-month follow-up of ultrathin glass-ceramic veneers conditioned with MEP only. Case. Young female patient with an aesthetic disorder in the front region. The four upper incisors were conservatively prepared for ultrathin lithium disilicate (e.maxPress) veneers. Pre-treatment of the glass-ceramics consisted only of MEP application, followed by adhesive cementation with Variolink Esthetic LC. At the 1.5-year recall, the restorations appeared undamaged, with no marginal gap or staining. Conclusions. MEP constitutes a promising alternative to hydrofluoric acid for the adhesive cementation of glass-ceramic veneers.

Resin-dentin bond stability of etch-and-rinse adhesive systems with different concentrations of MMP inhibitor GM1489

Abstract Enzymatic degradation of the hybrid layer can be accelerated by the activation of dentin metalloproteinases (MMP) during the bonding procedure. MMP inhibitors may be used to contain this process. Objective To evaluate the degree of conversion (DC%), dentin bond strength (µTBS) (immediate and after 1 year of storage in water), and nanoleakage of an experimental (EXP) and a commercial (SB) adhesive system, containing different concentrations of the MMP inhibitor GM1489: 0, 1 µM, 5 µM and 10 µM. Methodology DC% was evaluated by FT-IR spectroscopy. Dentin bond strength was evaluated by µTBS test. Half of beams were submitted to the µTBS test after 24 h and the other half, after storage for 1 year. From each tooth and storage time, 2 beams were reserved for nanoleakage testing. Data were analyzed using ANOVA and Tukey's test to compare means (α=0.05). Results All adhesive systems maintained the µTBS after 1 year of storage. Groups with higher concentrations of inhibitor (5 µM and 10 µM) showed higher µTBS values than groups without inhibitor or with 1 µM. The nanoleakage values of all groups showed no increase after 1 year of storage and values were similar for SB and EXP groups, in both storage periods. The inhibitor did not affect the DC% of the EXP groups, but the SB5 and SB10 groups showed higher DC% values than those of SB0 and SB1. Conclusions The incorporation of GM1489 in the adhesive systems had no detrimental effect on DC%. The concentrations of 5 µM GM1489 for SB and 5 µM or 10 µM for EXP provided higher μTBS than groups without GM1489, in the evaluation after 1 year of storage; whereas the concentration of inhibitor did not affect adhesive systems nanoleakage.

A Comparative Study of Laser Irradiation Versus Sandblasting in Improving the Bond Strength of Titanium Abutments.

Objective: The purpose of this study was to evaluate the effects of Er,Cr:YSGG laser irradiation with different energy powers versus sandblasting for enhancing the tensile bond strength (TBS) between titanium implant abutments (IAs) and resin cements. Background data: Clinical decementation of prosthetic restorations often occurs, particularly on short IAs. Increasing the bonding area on the IA surface can enhance the function and longevity of the superstructure. Materials and methods: Fifty dental IAs were used in solid form and randomly assigned to five groups (n = 10 each) for the following different pretreatments: control group was left untreated, a laser operating at 2.78 µm wavelength with different energy powers (1, 2, and 3 W) was used for three laser groups, and 50 µm alumina particles were applied to the abutment surface for the sandblasting group. Fifty metal substructures that had an occlusal metal O-ring were cast and cemented to all abutments using dual-cure resin cement. Test specimens were then subjected to thermal cycling. TBS tests were performed with a universal testing machine. The specimens' surface topography and roughness were evaluated with scanning electron microscope, and energy dispersive spectroscopy (EDS) was used to measure the elemental profiles of each specimen. Data were analyzed using a one-way analysis of variance/Kruskal-Wallis test at a significance level of p < 0.05. Results: Surface treatments affected the surface roughness and TBS of the IA. The sandblasting group showed the highest bond strength values (510.77 ± 60.86 N) and followed by the 2 W group (279.07 ± 37.9 N). In EDS analysis, no elemental components other than titanium and oxygen were observed, except for in the sandblasting group. Conclusions: Sandblasting and 2 W laser treatment increased the surface roughness of the IA, which could contribute to the increased interfacial bond strength between the IA and resin cement.

Effect of Combined Surface Treatments on Surface Roughness and Resin Bond Strength to Y-TZP Ceramic and Nickel-Chromium Metal Alloy.

Objective: This study compared the effects of different surface treatments on the surface roughness (Ra), and shear bond strength (SBS) of resin cement to yttria-stabilized tetragonal zirconia (Y-TZP) ceramic and nickel-chromium (Ni-Cr) base metal alloy, respectively. Materials and methods: Thirty disk-shaped specimens (3 mm height and 10 mm diameter) of each material (Y-TZP and Ni-Cr) were prepared. Both zirconia and metal specimens were randomly assigned to three equal groups, according to the surface treatments (n = 10): sandblasting, sandblasting + Er:YAG laser, and sandblasting + Nd:YAG laser. Resin cement cylinders (4 mm diameter and 3 mm thickness) were placed on each specimen. The SBS tests were performed at a 1 mm per minute crosshead speed through a knife-edge rod after 5000 thermal cycles. The Ra (µm) of the specimens was measured using a profilometer and evaluated topographically by atomic force microscopy and scanning electron microscopy. Analysis of variance, followed by Tukey's honestly significant difference, in addition to the Kruskal-Wallis test, followed by the Mann-Whitney U test, were used for statistical analysis (α = 0.05). Results: Combined sandblasting and laser treatment of the metal groups led to statistically higher Ra values than sandblasting alone (p < 0.05). For Y-TZP, there were no significant differences between the Ra values of the subgroups (p > 0.05). The SBS of the sandblasted metal group was significantly higher than the other two laser-irradiated groups, whereas the SBS of sandblasted zirconia was only significantly higher than the Nd:YAG laser-irradiated group (p < 0.05). Conclusions: Combined laser and sandblasting surface treatments resulted in rougher surfaces than sandblasting alone, especially for the metal specimens. Sandblasting, alone, improved the SBS of resin cement in both metal and zirconia, compared with the laser and sandblasting treatments, combined.

Shear Bond Strength Between Zirconia and Veneer Ceramic: Effect of Thermocycling and Laser Treatment.

Objective: The purpose of this study is to investigate the effect of various presintering and sintered surface treatments and thermocycling on the bond strength between zirconia and veneer ceramics. Background data: Bond stability between zirconia and veneer ceramic is a major concern, and only limited evidence about its longevity is currently available. Moreover, no study has yet evaluated the influence of thermocycling on the bond strength of veneer ceramic to zirconia after Er,Cr:YSGG laser irradiation at different pulse durations and sandblasting. Materials and methods: In this study, 220 nonsintered zirconia specimens were prepared with CAD/CAM and randomly divided into 2 groups; half of the specimens in each group were stored in water for 1 week, and the other half were thermocycled (5000 cycles) between baths of 5°C and 55°C. Specimens were then divided into five subgroups based on the following surface treatments: control (untreated surface), sandblasting (120 µm Al2O3), and Er,Cr: YSGG laser irradiations (3 W-8 Hz, 3 W-15 Hz, and 3 W-20 Hz, MGG 6 laser tip, for 20 sec, distance of 10 mm, water/airflow of 55% and 65%). Morphological assessment was done using atomic force microscopy and scanning electron microscopy, and phase transformation was assessed by X-ray diffractometry. All specimens were then veneered with veneering ceramic, and bond strength test using a universal testing device at a 1 mm/min crosshead speed. Data were evaluated by Kruskal-Wallis variance analysis and the Mann-Whitney U test. Results: There was no significant difference in the bonding strength values among the (p > 0.05). Thermocycling reduced the bond strength, but it was not significant (p > 0.05), except for the presintering 20 Hz group (p < 0.02). Conclusions: Application of thermocycling to sintered zirconia specimens may be detrimental to the shear bond strength of zirconia ceramics. Treating the zirconia surface after sintering is not recommended, due to the decrease in bond strength.

Effect of Surface Treatment with CO2 Laser on Bond Strength in Composite Resin Restorations.

Objective: Evaluate the bond strength of repairs made on composite resin following the treatment of the surface of the flaw with different bonding agents and/or CO2 laser. Background: The influence of CO2 laser and its interaction with other bonding agents on the surface of the flaw is not yet known. In this study, CO2 laser was chosen to treat the surface of the flaw due to its capacity to promote irregularities on the surface that enhance mechanical micro-retention. Methods: A block was created with Vitra APS nanohybrid composite resin (color: A3; FGM, Joinville, Brazil) measuring 5 mm in width, length, and depth (volume: 125 mm3). The surface of the flaw was treated before the repair with an adhesive, silane bonding agent, and/or CO2 laser. Six specimens were created in composite resin for each group (total: n = 36): G1: resin+resin; G2: adhesive+resin; G3: laser+adhesive; G4: laser+silane+adhesive; G5: silane+adhesive; G6: laser+silane. After the repair, the surfaces of the fracture of all specimens, which were submitted to the microtraction test, were analyzed under an optical microscope. Bond strength values obtained according to the type of surface treatment were tabulated and submitted to the Kruskal-Wallis test. Dunn's test was used to compare means. Results: G3 and G4 had significantly higher bond strength values compared to all other groups tested. Adhesive fractures predominated in all groups. However, G3 and G4 had a higher percentage of cohesive fractures compared to the other groups. Conclusions: The application of CO2 laser as a surface treatment led to greater bond strength of composite resin repairs in comparison with the groups that only received treatment with a burr and silanization. The groups submitted to CO2 laser also had a significantly lower number of adhesive failures when submitted to the microtraction test.

Surface Processing: An Elegant Way to Enhance the Femtosecond Laser Ablation Rate and Ablation Efficiency on Human Teeth.

BACKGROUND AND OBJECTIVES: The employability of the non-invasive femtosecond laser ablation technique for dental treatment has been severely limited by its low ablation rate despite the advantage of minimal tissue damage. The study explores a means of improving the femtosecond laser ablation rate and efficiency by physiochemical surface modification. MATERIALS AND METHODS: Surface modification of dental hard tissues has been carried out by food graded orthophosphoric acid and Carie care gel pretreatment. The laser ablation characteristics were studied by using a Ti:Sapphire laser (10 kHz, 10 mm/s, 100 fs, 800 nm) to ascertain the influence of pretreatment. Surface morphology and chemical composition were obtained by using an optical profiler, SEM and EDAX. RESULTS: The ablation threshold fluence decreased by almost one-third whereas the ablation rate and ablation efficiency nearly tripled upon pretreatment. The microstructural and compositional analysis clearly reveals that surface modification and demineralization reduce the threshold fluence and increase the ablation rate by effective utilization of the laser beam energy. The pretreatment effect is more pronounced in orthophosphoric acid as compared with Carie care gel. CONCLUSIONS: Physiochemical surface modification can be an efficient method to improve the laser ablation rate and ablation efficiency. Compositional analysis can be an elegant tool for pre-surgery determination of laser ablation characteristics. CLINICAL SIGNIFICANCES: Pretreatment surface modification can be an effective way to overcome the limitation of the femtosecond laser for tooth preparation in the clinical setting by strongly enhancing the ablation rate. An enhanced ablation rate along with de nova prediction of ablation characteristics will enable the clinician to perform dental surgery in real time with minimal tissue damage. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Influence of Er;Cr:YSGG Laser on Shear Bond Strength and Color Stability of Lithium Disilicate Ceramics: An In Vitro Study.

Objective: The aim of this study was to assess the effect of Er;Cr:YSGG laser parameters (power and frequency) on the bond strength and color stability of lithium disilicate (LD) ceramics. Materials and methods: One hundred ten specimens of LD ceramic were fabricated following heat pressed technique. Fifty disks were randomly distributed into five groups according to types of surface treatment [hydrofluoric (HF) acid, L1S L2S, L1D, and L2D]. For all laser-treated groups, bond preparation settings were used with a gold hand piece using a MZ10 tip (Er;Cr:YSGG, water lase I plus; Biolase). After surface treatment, adhesive bond was applied, and after photopolymerization, a composite buildup was performed. To evaluate shear bond strength, a controlled force was applied until failure using a universal testing machine. Color stability was assessed for six groups (HF, L1S L2S, L1D, L2D, and control) of LD ceramic (shade A1, LT translucency) through the CIE L*a*b* system. Three specimens from each of the six groups were selected randomly for assessment of surface topography using scanning electron microscopy. Means and standard deviations were compared using analysis of variance and Tukey's post hoc test (p < 0.05). Results: The maximum and minimum mean bond strength were shown by the L2D group 19.95 ± 1.014 and L1S group specimens 14.68 ± 0.863, respectively. Highest mean ΔE was found in L2S group 8.17 ± 2.10 and the lowest mean ΔE was found in control group (no treatment) 0.11 ± 0.05. Conclusions: LD specimens lased (Er;Cr:YSGG) with 3.75 W power and 15 Hz frequency for 4 min showed bond strength comparable with HF acid samples, and color changes within acceptable range (ΔE 1.17). Laser treatment (Er;Cr:YSGG) at 3.75 W power and 15 Hz frequency for 4 min of LD ceramics appears to be clinically efficient, showing acceptable bond strength and color stability.

Effect of Different Surface Treatments and Roughness on the Repair Bond Strength of Aged Nanohybrid Composite.

Objective and background: Different surface treatments have been tested in composite repair studies. However, there is still no consensus on the most effective repair protocol. The aim of this study is to measure the roughness values of eight different surface treatments for the repair procedure, to examine the effect of each surface treatment and three different composites on the repair bond strength with and without silane, and to evaluate whether there is a correlation between bond strength and roughness. Methods: The blocks were prepared with Filtek Z550 (3M ESPE) for the roughness measurements and divided into eight groups according to surface treatments. The roughness values of the surface treatments were measured by a 3D scanning contact profilometer (Nanomap LS). For the shear test, further samples were prepared, aged, and divided into three subgroups for the repair procedure with Filtek Z550 (3M ESPE), Vertise Flow (Kerr, USA), and G-aenial Flo (GC, Japan) after the surface treatments. Then, the shear test was performed. The Kruskal-Wallis and Spearman's Correlation tests were used for statistical evaluation of the data. Results: Significant differences were found between surface treatments and composite resins in terms of bond strength (p < 0.05). There is no correlation between the roughness and bond strength values. Conclusions: In bond strength, surface topography is more important than the numerical value of roughness. In the repair of composite restorations, methods that are already in clinical practice and more practical can be used instead of methods that require additional costs and devices.

Nickel and Chromium Ion Levels in Hair and Gingival Crevicular Fluid with the Corrosion of Brackets in Orthodontic Patients: A Longitudinal Study

Objective: To assess the levels of nickel and chromium ions in hair and Gingival Crevicular Fluid (GCF) of orthodontic patients and to evaluate the corrosion of orthodontic bracket surfaces. Material and Methods: Nickel and chromium ion concentrations were measured in hair and GCF of 15 patients (9 females and 6 males, aged 16-28 years old) who had fixed orthodontic treatment using atomic absorption spectroscopy. The samples were taken before treatment (baseline), 4, 8, and 16 months later during treatment. Along with ionic sampling, microscopic sampling was done. One of each patient brackets was removed to get 15 brackets per group. Five brackets were taken randomly from each group to be examined under scanning electron microscope (SEM). Data obtained were analyzed using paired t-tests. Results: After 16 months, compared with the baseline, average hair nickel level changed from 0.125 µg/g to 0.956 µg/g with statistically significant difference (p=0.00); average chromium level changed from 0.090 µg/g to 0.295 µg/g but no significant difference (p>0.05); average GCF nickel level changed from 3.335 µg/g to 10.410 µg/g; average chromium level changed from 1.859 µg/g to 9.818 µg/g. Both of these increases were significant (p=0.000). SEM examinations showed that the corrosion on brackets was seen in the fourth month, and more severely visible after 8 and 16 months of uses. Conclusion: After 16 months of treatment, compared with the baseline, the hair nickel level was increased by 7.7 times; while for chromium was by 3.3 times. Gingival crevicular fluid nickel level was increased by 3.1 times and chromium level was by 5.3 times. The longer time of treatment, the more ions released and the more corrosion of brackets will be.

Evaluation of Intra Root Canal Er,Cr:YSGG Laser Irradiation on Prosthetic Post Adherence.

PURPOSE: In clinical prosthetics procedures, including endodontics and post fixation, the presence of a smear layer can reduce the post bond strength. An Er,Cr:YSGG laser, which emits at 2780 nm, can promote a smear-layer-free surface due to the ablation process. Considering these aspects, the purpose of this work was to evaluate the influence of Er,Cr:YSGG laser irradiation using either a radial or an axial fiber tip on the bond strength of three resin cements to the fiber-reinforced composite posts. MATERIALS AND METHODS: Ninety recently extracted single rooted human teeth had their root canal instrumented and were randomly distributed into nine experimental groups, in which three resin cements (total-etching Variolink II, self-etching Panavia F, and self-adhesive RelyX Unicem Aplicap) and three root canal treatments (no treatment, laser irradiation using the radial fiber tip, laser irradiation using the axial fiber tip) were used. Specimens were then sectioned into three sections (cervical, middle, and apical thirds) with two slices on each section. A push-out test was performed on each slice, and the values were recorded as MPa. The push-out data were analyzed by a Ryan-Joiner normality test followed by a two-way ANOVA test and Tukey pairwise comparison. The statistical analysis was performed on each third section separately, with a 5% significance level. RESULTS: Laser irradiation with axial fiber tip significantly increased the post bond strength of RelyX Unicem Aplicap on middle third of specimens (p < 0.001) when compared to other root canal treatments (unlased or irradiated with radial tip). Considering the Panavia resin cement, laser irradiation with either axial or radial tips promoted a significant increase on the post bond strength of middle third when compared to unlased specimens (p < 0.001); however, laser irradiation did not influence the post bond strength of Variolink resin cement. CONCLUSIONS: The use of the Er,Cr:YSGG laser for clinical prosthetics procedures enhances the post bond strength of Panavia and RelyX Unicem Aplicap resin cements, mainly at middle third of roots, and does not interfere with the bond strength of Variolink resin cement. For the RelyX Unicem Aplicap system, the use of axial tip is most advantageous and can be recommended for future clinical application.

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial

Abstract Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

Shear Bond Strength of Different CAD/CAM Ceramics: Acid vs Er:YAG Laser Etching.

OBJECTIVE: To evaluate whether Er:YAG laser etching could be an alternative surface treatment to hydrofluoric (HF) acid etching. BACKGROUND: Surface treatment is important to bonding properties and utility times of computer aided design/computer aided manufacture (CAD/CAM) dental ceramics. The traditional method of HF acid etching is harmful to humans if not handled properly. MATERIALS AND METHODS: Four different CAD/CAM ceramics (Vita Mark II, IPS Empress CAD, IPS e.max CAD, and Vita Enamic) were cut into 72 blocks and divided into 6 groups according to different surface treatments (n = 12): Group A: no treatment; Group B: HF acid; and Group C to F: different Er:YAG laser power settings (300, 400, 500, and 600 mJ). Ten blocks of each group were measured for shear bond strength (SBS) and the failure modes were evaluated; the rest blocks were observed by scanning electronic microscopy (SEM). RESULTS: HF acid etching resulted in the highest SBS for Vita Mark II, IPS Empress CAD, and Vita Enamic; however, the difference was not statistically significant (p > 0.05) compared to the second highest group of laser with 600 mJ in IPS Empress CAD. For IPS e.max CAD, the highest SBS was obtained from laser group with 400 mJ. The SBS results were consistent with failure modes and surface characterizations in SEM images. CONCLUSIONS: Our results showed that Er:YAG laser had little impact on Vita Mark II and Vita Enamic; but proper power settings could be an alternative surface treatment to HF acid etching (600 mJ for IPS Empress CAD and 400 mJ for IPS e.max CAD).

Shear Bond Strength of Orthodontic Brackets Luted with RMGIC After Er:YAG Laser Etching with Two Pulse Modes Using a Digitally Controlled "X-Runner" Handpiece.

OBJECTIVE: To compare the shear bond strength (SBS) values of orthodontic brackets luted using a resin-modified glass ionomer cement (RMGIC) on enamel surfaces etched using either an Er:YAG laser in two different working modes, or a conventional etching protocol, including phosphoric acid. MATERIALS AND METHODS: Sixty healthy human premolars were randomly allocated to three experimental groups (n = 20) and etched with: Group 1: Er:YAG laser in super-short pulse (SSP) mode (100 mJ, 20 Hz, 2 W); Group 2: Er:YAG laser in quantum square pulse mode (120 mJ, 10 Hz, 1.2 W) using a digitally controlled handpiece ("X-Runner"); Group 3 (control): 5.25% sodium hypochlorite pretreatment, then 37% phosphoric acid for 15 sec. Stainless steel brackets were bonded using light-curing RMGIC for orthodontic bonding. After term cycling (1800 cycles), SBS testing was performed using a universal testing machine. After debonding, both enamel and bracket surfaces were examined to determine the amount of RMGIC still present on the surfaces. RESULTS: Group 3 surfaces gave the lowest mean SBS (10.6104 ± 2.66196 MPa), whereas Group 1 provided the highest 1 (13.1795 ± 3.37904 MPa), which was significantly different from the control (Group 3, p = 0.0226). Group 2 provided intermediate values (11.8486 ± 0.59832 MPa) nonsignificantly different from the control or from SSP (p = 0.4215 and p = 0.3082, respectively). CONCLUSIONS: Er:YAG laser treatment in SSP mode of enamel surfaces for orthodontic bonding provided higher SBS and a shear behavior of the luting material similar to the conventional acid-etching procedures, making it a viable alternative to acid etching.

Optical Evaluation of Enamel Microleakage with One-Step Self-Etch Adhesives.

OBJECTIVE: In this in vitro study, cross-polarization optical coherence tomography (CP-OCT) was used to evaluate microleakage in dental composite restorations bonded to enamel with two types of one-step self-etching (SE) adhesives. BACKGROUND DATA: One-step SE adhesives were proposed to simplify bonding of composite restorations. However, bonding of these simplified adhesive to dental enamel is still questionable. OCT is a promising diagnostic tool that allows micron-scale imaging of biological tissues and structures. METHODS: Class-V cavities (4-mm diameter × 1-mm depth) were prepared on the labial surfaces of extracted human anterior teeth with margins and floor located in enamel. The cavities were then divided into two groups (n = 5) and restored with either Tetric N-Bond Universal (Ivoclar Vivadent, Liechtenstein) or Palfique Bond (Tokuyama Dental Corporation, Japan), followed by Estelite Flow Quick flowable composite (Tokuyama Dental Corporation). After storage in 100% humidity for 24 h, specimens were immersed in ammoniacal silver nitrate solution for another 24 h. Later, they were rinsed and immersed in photo-developing solution under fluorescent light for 8 h. CP-OCT at 1310 nm center wavelength was used to scan seven two-dimensional cross-sectional images from each specimen. Each cross-sectional image was analyzed using ImageJ software to quantify interfacial microleakage at the cavity floor. RESULTS: Student's t-test showed significant difference between the tested adhesives (p < 0.05). Palfique Bond adhesive presented inferior interfacial adaptation as it obtained higher values of floor microleakage compared to Tetric N-Bond Universal adhesive group. CONCLUSIONS: CP-OCT enabled nondestructive quantitative assessment of microleakage in enamel dental restorations.

Shear Bond Strength of Composite and Ceromer Superstructures to Direct Laser Sintered and Ni-Cr-Based Infrastructures Treated with KTP, Nd:YAG, and Er:YAG Lasers: An Experimental Study.

OBJECTIVE: The aim of this study was to examine the shear bond strength (SBS) of ceromer and nanohybrid composite to direct laser sintered (DLS) Cr-Co and Ni-Cr-based metal infrastructures treated with erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser modalities in in vitro settings. METHODS: Experimental specimens had four sets (n = 32) including two DLS infrastructures with ceromer and nanohybrid composite superstructures and two Ni-Cr-based infrastructures with ceromer and nanohybrid composite superstructures. Of each infrastructure set, the specimens randomized into four treatment modalities (n = 8): no treatment (controls) and Er:YAG, Nd:YAG, and KTP lasers. The infrastructures were prepared in the final dimensions of 7 × 3 mm. Ceromer and nanohybrid composite was applied to the infrastructures after their surface treatments according to randomization. The SBS of specimens was measured to test the efficacy of surface treatments. Representative scanning electron microscopy (SEM) images after laser treatments were obtained. RESULTS: Overall, in current experimental settings, Nd:YAG, KTP, and Er:YAG lasers, in order of efficacy, are effective to improve the bonding of ceromer and nanohybrid composite to the DLS and Ni-Cr-based infrastructures (p < 0.05). Nd:YAG laser is more effective in the DLS/ceromer infrastructures (p < 0.05). KTP laser, as second more effective preparation, is more effective in the DLS/ceromer infrastructures (p < 0.05). SEM findings presented moderate accordance with these findings. CONCLUSIONS: The results of this study supported the bonding of ceromer and nanohybrid composite superstructures to the DLS and Ni-Cr-based infrastructures suggesting that laser modalities, in order of success, Nd:YAG, KTP, and Er:YAG, are effective to increase bonding of these structures.

Efficacy of Various Pretreatments on the Bond Strength of Denture Teeth to Denture Base Resins.

OBJECTIVE: This in vitro study evaluated the shear bond strength (SBS) of heat-cured denture base resin (PMMA) to acrylic resin teeth treated with different pretreatments, especially laser irradiation of different powers (1-4 W). MATERIALS AND METHODS: The acrylic resin teeth were separated into seven groups (n = 10) for the following different pretreatments: control group (no surface treatment) (G1), grinding with a tungsten carbide bur (G2), sandblasting (G3), and erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation at 1 W, 2 W, 3 W, 4 W output powers in (G4-7), respectively. Test specimens were produced according to the PMMA manufacturers' instructions and were subjected to a SBS test at a crosshead speed of 1 mm/min until fracture. Debonded surfaces were evaluated by a stereomicroscope for the type of failure. SEM (scanning electron microscope) analyses were done to estimate the surface changes of the acrylic resin teeth. The data were submitted using a one-way ANOVA and post hoc Tukey-Kramer multiple comparison tests (p = 0.05). RESULTS: The highest bond strength was obtained in G3, and similar SBS values were considered in other groups, and no significant differences were found among the surface treatments and the control group (p < 0.05). All groups had a high percentage of adhesive failures. CONCLUSIONS: Laser irradiations promote surface topography alterations. However laser irradiation of the adhesive surface was found ineffective. The SBS of acrylic resin teeth to a PMMA denture base material is independent of the surface pretreatments Er,Cr:YSGG laser irradiation, sandblasting, and grinding with a carbide bur. All the surface treatments provided a similar bond between the acrylic denture base and the teeth.

Does ErbiumiYttrium-Aluminum-Garnet Laser to Enamel improve the Performance of Etch-and-rinse and Universal Adhesives?

AIM: This study aims to evaluate the effect of erbium: Yttrium-aluminum-garnet (Er:YAG) laser irradiation on the enamel microshear bond strength (µSBS), followed by the utilization of etch-and-rinse and universal adhesive systems. MATERIALS AND METHODS: A total of 32 molars were sectioned in the mesiodistal direction producing 64 samples that were randomized into two groups (n = 32): single bond 2 (SB2) (etch-and-rinse system; 3M), SB universal (SBU) (universal etching system; The SB2 and SBU groups were then divided into two subgroups (n = 16): (i) enamel was irradiated with an Er:YAG laser (λ = 2.94 µm, 60 mJ, 10 Hz), and (ii) enamel served as a control. The samples were restored with TPH3 (Dentsply), stored in artificial saliva for 24 hours, and subjected to a micro-shear test. RESULTS: Kruskal-Wallis (p < 0.05) and Mann-Whitney U tests indicated no significant differences in uSBS between the groups, and the fractures were predominately at the resin-enamel interface. CONCLUSION: The previous irradiation of enamel with Er:YAG laser does not interfere with the performance of simplified two-step etch-and-rinse and universal adhesive systems. CLINICAL SIGNIFICANCE: The increasing use of Er:YAG laser is important to evaluate the influence of this irradiation on the adhesion of restorative materials. Thus, to obtain the longevity of the restorative procedures, it is necessary to know the result of the association of the present adhesive systems to the irradiated substrate.

Double acid etching treatment of dental implants for enhanced biological properties.

BACKGROUND: The topographical features on the surface of dental implants have been considered as a critical parameter for enhancing the osseointegration of implants. In this work, we proposed a surface obtained by a combination of shot blasting and double acid etching. The double acid etching was hypothesized to increase the submicron topography and hence further stimulate the biological properties of the titanium implant. METHODS: The topographical features (surface roughness and real surface area), wettability and surface chemical composition were analyzed. RESULTS: The results showed that the proposed method produced a dual roughness, mainly composed of randomly distributed peaks and valleys with a superimposed nanoroughness, and hence with an increased specific surface area. Despite the fact that the proposed method does not introduce significant chemical changes, this treatment combination slightly increased the amount of titanium available on the surface, reducing potential surface contaminants. Furthermore, the surface showed increased contact angle values demonstrating an enhanced hydrophobicity on the surface. The biological behavior of the implants was then assessed by culturing osteoblast-like cells on the surface, showing enhanced osteoblast adhesion, proliferation and differentiation on the novel surface. CONCLUSIONS: Based on these results, the described surface with dual roughness obtained by double acid etching may be a novel route to obtain key features on the surface to enhance the osseointegration of the implant. Our approach is a simple method to obtain a dual roughness that mimics the bone structure modified by osteoclasts and increases surface area, which enhances osseointegration of dental implants.

Effect of Erbium:yttrium aluminum garnet laser on bond strength of a total-etch adhesive system to caries-affected dentin on gingival wall.

PURPOSE: To assess the effect of the erbium:yttrium aluminum garnet (Er:YAG) laser on bond strength of a total-etch adhesive system to the caries-affected dentin on the gingival wall. MATERIALS AND METHODS: Ten human molars with proximal carious lesions were randomly divided into two groups. In the first group, the carious dentin was removed with a bur, whereas in the second group it was removed with the Er:YAG laser. Carious lesions were excavated with one of these two techniques until laser fluorescence values decreased to 15 in the center of the lesions. The teeth were then restored with a total-etch adhesive system (Adper Single Bond 2) and composite resin (Filtek Z250). Five teeth from each group were sectioned to obtain 1 mm2 stick-shaped microtensile specimens from each tooth. Twenty-five specimens were obtained for each group with using this technique. The data were analyzed in independent-samples t-test (α = 0.05). For each removal technique, one sample was analyzed using scanning electron microscopy. RESULTS: No statistically significant differences were found between the bond strength of the Er:YAG laser and the bur-treated groups (P > 0.05). CONCLUSION: The Er:YAG laser treatment did not negatively affect the bonding performance of the total-etch adhesive system to caries-affected dentin on the gingival wall.