Effect of low-level laser therapy (λ780 nm) on the mechanically damaged dentin-pulp complex in a model of extrusive luxation in rat incisors.

In order to regenerate the dental pulp, many strategies have been developed as phototherapy. In the pulp repair, we do not know if gallium-aluminum-arsenide (GaAlAs) laser preserves the primary odontoblasts or stimulates the formation of more dentin matrix when dental pulp is damaged. The aim of the present study was to examine the effect of laser phototherapy (λ780 nm) on vascularization, inflammation, density of the primary odontoblast layer, and formation of reactionary and reparative dentin in the dental pulp by provoking extrusion of the rat incisor. The upper incisors were extruded 3 mm and then repositioned into their original sockets followed by a laser irradiation of the palatal mucosa (λ = 780 nm; p = 70 mW; CW; 4.2 J/cm2; 60 s) every 48 h. Non-traumatized and/or non-irradiated incisors were used as the controls. At 8 and 30 days after surgery, incisors were processed for histological and histomorphometric analysis. Morphological analysis revealed no differences in vascularization between groups, but showed discrete inflammation in some non-irradiated and injured specimens, which correlated with a more irregular reparative dentin. The density of primary odontoblasts in the groups treated with lasers was higher when compared to non-irradiated groups, but no statistically significant difference between groups (p > 0.05). The thickness of the tertiary dentin was increased in both traumatized groups with no statistically significant difference between non-irradiated and irradiated groups (p > 0.05).The present findings revealed that the GaAlAs laser induced small changes on dentin-pulp complex, with more regular dentin matrix in the irradiated dental pulps.

Analysis of Human Tooth Pulp Chamber Temperature After 670 nm Laser Irradiation: In Vitro Study.

OBJECTIVE: One of the limiting factors of employing laser radiation on dental therapies is the potential of causing thermal injuries to pulp tissues. The purpose of this study was to evaluate intra-chamber temperature increase on extracted human teeth exposed to 670 nm wavelength InGaAlP laser diode radiation. MATERIALS AND METHODS: In vitro intra-chamber temperature measurements of 12 standardized human teeth (incisors, canines, premolars, and molars; n = 3) were taken both before and after laser radiation. A type-K thermocouple fast-response thermocouple wire with a 0.5 mm diameter probe was inserted into the tooth pulp chamber (ICEL-Manaus-brand). The laser device Lasotronic-brand InGaAlP laser diode was used to irradiate tooth enamel, perpendicularly to the external surface for 30 sec, with power of levels of 340, 272, 204, 136, and 68 mW. The measurements were taken at three time points: 0, 30 sec, and 3 min after the laser irradiation. Measurements were repeated 24 h after removal and reinsertion of the probe in the pulp chamber. The temperature gradient (ΔT in °C) was calculated (ΔT = final temperature-initial temperature) for each group. Data of ΔT were statistically analyzed by two-way analysis of variance (ANOVA) at the 95% confidence level and compared by Tukey post hoc test (α = 0.05). RESULTS: ANOVA showed statistically significant differences to the interaction of factors (p < 0.05). The highest ΔT values obtained were observed to incisors with 340 mW, 272 mW; 204 mW of power (respectively 4.7°C, 4.2°C, and 3.1°C); and canines presented the lowest ΔT (0.8°C-0.3°C) with no influence of power output. CONCLUSIONS: Since the thermal increase was observed in this study, especially in incisors, attention should be paid to avoid pulpal damage.

Bond Strength of Abraded and Non-Abraded Bleached Enamel to Resin After Er,Cr:YSGG Laser Irradiation.

OBJECTIVE: The objective of the study was to evaluate the microtensile bond strength (µTBS) of a composite resin to abraded or non-abraded bleached enamel after Er,Cr:YSGG laser irradiation and to observe the fracture patterns of the tested interfaces. MATERIALS AND METHODS: Two hundred twenty-eight bovine incisors were sectioned, resulting in 228 enamel blocks (7 × 4 × 4 mm3) that were divided into 12 groups (n = 19) according to the factors "adhesion" after bleaching (immediate adhesion; after 14 days; and a control group with adhesion on unbleached teeth); enamel "abrasion" (with or without abrasion simulating cavity preparation); and "laser" (with or without Er,Cr:YSGG laser irradiation). Bleached enamel groups were treated with 20% carbamide peroxide, 8 h/day for 21 days. Abrasion was performed with silicon carbide sandpaper. Specimens were restored with adhesive system and a composite resin (Adper Single Bond 2 and Z250; 3M ESPE). After 7 days, specimens were prepared by cutting into 1 mm beans to µTBS test performed in a universal testing machine. Fracture mode analysis was performed by using a stereoscopic loupe. The µTBS data were statistically analyzed by three-way analysis of variance with 95% confidence level and compared by running a Tukey post hoc test (α = 0.05). RESULTS: There was no statistically significant difference between triple interaction and double interactions among factors. There was no significant difference between the factors "adhesion," "abrasion," and "laser." Laser irradiation produced significantly lower bond strength values in irradiated groups compared with the non-irradiated ones. All groups had a high percentage of adhesive failures. CONCLUSIONS: Abrasion provided no benefit to bond strength of composite resins to bleached enamel. Er,Cr:YSGG (20 Hz, 0.5 W, 3.97 J/cm2) treatment reduced the bond strength of composite resins to enamel.

Temperature Development on the External Root Surface During Laser-Assisted Endodontic Treatment Applying a Microchopped Mode of a 980 nm Diode Laser.

OBJECTIVE: The aim of this article was to investigate the temperature increase of the external root surface during laser-assisted endodontic treatment using a diode laser (980 nm) in a microchopped mode. METHODS: Ten freshly extracted, human maxillary incisors with mature apices were collected, prepared to size F4 at working length (ProTaper; Dentsply Maillefer, Ballaigues, Switzerland), mounted to a holder, and irradiated (using spiral movements in coronal direction) with a diode laser (GENTLEray 980 Classic Plus; KaVo, Biberach, Germany) with a 200 µm fiber in four different treatment groups: Group 1 (control group) was irradiated in six cycles of 5-sec irradiation/20-sec pause with 2.5 W in the pulse mode. Groups 2 to 4 were irradiated at six cycles of 5-sec irradiation/20-sec pause in the microchopped mode (Group 2-1.6 W; Group 3-2.0 W; Group 4-2.5 W). The applied mode was 25 ms on/25 ms off. Within the on period, the laser delivered an intermittent sequence of energy complexes and the maximum output was equal to the nominated output of the device (12 W). Canals were kept moist by sterile saline irrigation in between irradiations, and temperature changes were continuously measured using a thermal imaging camera. Recordings were analyzed by a mixed model (analysis of variance [ANOVA] for repeated measurements). RESULTS: The highest mean of temperature rise, 1.94°C ± 1.07°C, was measured in Group 4, followed by Group 3 (1.74°C ± 1.22°C) and Group 2 (1.58°C ± 1.18°C). The lowest increase occurred in Group 1 (1.06°C ± 1.20°C). There was a significant difference (p = 0.041) between the groups. Significant differences were found between Groups 1 and 4 (p = 0.007) and 1 and 2 (p = 0.035). In addition, a marginally significant difference between Groups 1 and 2 (p = 0.052) was noted. There was no significant difference between Groups 2, 3, and 4. Despite the low mean values reported, the highest temperature increase (+5.7°C) was measured in one of the specimens of treatment Group 2 at the middle third. CONCLUSIONS: Under the conditions used and within the limitations of the study, the microchopped diode laser irradiation is a safe possible treatment option in laser-assisted endodontic treatment, concerning the temperature elevation on the external root surface.

Intrapulpal Temperature Increase During Er:YAG Laser-Aided Debonding of Ceramic Brackets.

OBJECTIVE: The purpose of this study was to evaluate the temperature changes in the pulp chamber while using a newly introduced application of Er:YAG laser to debond ceramic brackets in a study model with a pulpal circulation with and without thermocycled samples. BACKGROUND DATA: An esthetic alternative to stainless steel brackets, ceramic brackets have been proposed. However, because of their low fracture resistance and high bond strengths, ceramic brackets can cause a problem when they are being removed using conventional techniques. MATERIALS AND METHODS: Experimental Groups A and B were established for samples with or without thermocycling. The same 20 maxillary central incisor and 20 premolar teeth were used in both groups. Pulpal blood microcirculation was simulated using an apparatus described in a previous study. Monocrystalline brackets were bonded by using Transbond XT. In Group A, brackets were debonded using the Er:YAG laser (600 mJ, 2 Hz, long pulse, and no air or water spray) after being stored in distilled water for 24 h. In Group B, brackets were debonded using the same laser system as that used in Group A after being stored in distilled water for 24 h and then thermocycled for a total of 5000 cycles between 5°C and 55°C. The laser irradiation duration and intrapulpal temperature changes were measured. RESULTS: In Group B, the intrapulpal temperature increase of the central incisors was significantly higher than that of the premolar teeth. In the central incisor and premolar teeth groups, there were no statistically significant difference between Groups A and B (p > 0.05). A positive correlation was found between laser irradiation duration and temperature increase (p < 0.01). CONCLUSIONS: The use of Er:YAG laser is an effective method for debonding the monocrystalline ceramic brackets. This method can be used safely under the consideration of intrapulpal temperature changes.

Effects of near-infrared LED therapy on experimental tooth replantation in rats.

BACKGROUND/AIM: Dental avulsion damages periodontal tissues and may induce dentoalveolar ankylosis and root resorption after replantation. The aim of this work was to evaluate the effects of light-emitting diode (LED) therapy after tooth replantation. MATERIAL AND METHODS: The upper right incisors of 36 male Wistar rats were extracted and replanted after 15 min. The control group (Co, n = 18) was submitted to replantation and the LED group (n = 18) was submitted to replantation and LED therapy (940 nm, 4 J cm-2 ) for three consecutive days (0, 24, and 48 h). Six animals from each group were euthanized at 7, 14, and 21 days for histological analysis. The upper left incisors were used as a negative control. Data were compared using the Fisher exact test, considering P < 0.05. RESULTS: After 7 days, the Co (73.3%) and LED (72.2%) groups presented areas of periodontal ligament necrosis. However, periodontal ligament necrosis was more frequent in the LED group at 14 (70%, P < 0.05) and 21 days (43.2%, P < 0.05) in relation to the Co group (33 and 21.6%). Inflammatory cell infiltration was more frequent in the Co group at 7 days (100%) than the LED group (24.4%, P < 0.05), but increased in the LED group after 21 days (83.3%, P < 0.05). Bone necrosis was more frequent in the LED group after 14 (79%, P < 0.05) and 21 days (60%, P < 0.005) than in the Co group (45% and 20%). Bone repair was evident in the Co group at 14 days. All of the replanted teeth had pulp necrosis. CONCLUSION: The results suggest that the application of LED therapy up to 48 h after tooth replantation may delay periodontal ligament repair.

Effect of low-level laser irradiation on the rate and short-term stability of rotational tooth movement in dogs.

INTRODUCTION: Low-level laser therapy (LLLT) has many biostimulative effects such as acceleration of mesiodistal orthodontic tooth movement. However, its effects on the extent and short-term stability of rotational tooth movement have not been researched. The purpose of this study was to investigate the effect of low-level laser irradiation during rotational tooth movement on the rate of movement and the amount of relapse in dogs. METHODS: In this interventional study, fixed orthodontic appliances were used to rotate both mandibular lateral incisors in 8 dogs. Sixteen teeth were divided into 2 groups: the experimental group with LLLT during orthodontic force application, and a control group with orthodontic couple force application only. In the first group, the gallium-aluminum-arsenide diode laser (810 nm, 200 mw, 10 seconds, 2 J/session, 32 J/cm(2)/point) was emitted on 2 points at the buccal side of the roots on days 0, 1, 2, 3, 4, 7, 14, 21, and 28 during 4 weeks of movement, and the amount of relapse was then observed for 3 months. The extent of rotational movement was measured on dental casts, and the statistical analysis was carried out with t tests. RESULTS: There was no significant difference between the LLLT group and the control group on the amount of rotational tooth movement (P = 0.66). The mean percentages of relapse after 1 week, 1 month, and 3 months were 33.02%, 53.44%, and 60.64% in the LLLT group and 54.22%, 68.74%, and 73.92% in the control group, respectively. This demonstrates significant differences between these groups at all studied times (P ≤0.05). This difference was greatest in the first week and then decreased until the end of the third month. The greatest percentage of relapse in both groups was registered in the first week after tooth movement. CONCLUSIONS: The total energy dose of the laser used in this study could not accelerate rotational tooth movement, but it did effectively reduce the relapse tendency in teeth rotated by orthodontic movements.

Clinical evaluation of the effectiveness of different bleaching therapies in vital teeth.

The aims of this in vivo study were to compare the effectiveness and color stability of at-home and in-office bleaching techniques and to evaluate whether the use of light sources can alter bleaching results. According to preestablished criteria, 40 patients were selected and randomly divided into four groups according to bleaching treatment: (1) at-home bleaching with 10% carbamide peroxide, (2) in-office bleaching with 35% hydrogen peroxide (HP) without a light source, (3) in-office bleaching with 35% HP with quartz-tungsten-halogen light, and (4) in-office bleaching with 35% HP with a light-emitting diode/laser. Tooth shade was evaluated using the VITA Classical Shade Guide before bleaching as well as after the first and third weeks of bleaching. Tooth shade was evaluated again using the same guide 1 and 6 months after the completion of treatment. The shade guide was arranged to yield scores that were used for statistical comparison. Statistical analysis using the Kruskal-Wallis test showed no significant differences among the groups for any time point (P > .01). There was no color rebound in any of the groups. The bleaching techniques tested were equally effective. Light sources are unnecessary to bleach teeth.

Histomorphometric analysis of inflammatory response and necrosis in re-implanted central incisor of rats treated with low-level laser therapy.

Low-level laser therapy is a tool employed in the management of post-operative inflammation process and in the enhancement of reparative process. The aim of the study was to perform histological evaluation of dental and periodontal ligament of rats central upper-left incisor teeth re-implanted and irradiated with low-level laser (InGaAl, 685 nm, 50 J/cm(2)) 15, 30, and 60 days after re-implantation. Seventy-two male rats had the central upper left incisor removed and kept for 15 min on dry gauze before replantation. Laser was irradiated over the root surface and empty alveolus prior replantation and over surrounding mucosa after the re-implantation. After histological procedures, all slices were analyzed regarding external resorption area and histological aspects. We observed an increase of root resorption (p < 0.05) in the control group compared to the laser group at 15, 30, and 60 days. These results showed that the laser groups developed less root resorption areas than the control group in all experimental periods. Additionally, histological analysis revealed less inflammatory cells and necrotic areas in laser groups.

Metrical and histological investigation of the effects of low-level laser therapy on orthodontic tooth movement.

The aim of this study was to evaluate the effects of 820-nm diode laser on osteoclastic and osteoblastic cell proliferation-activity and RANKL/OPG release during orthodontic tooth movement. Thirty-eight albino Wistar rats were used for this experiment. Maxillary incisors of the subjects were moved orthodontically by a helical spring with force of 20 g. An 820-nm Ga-Al-As diode laser with an output power of 100 mW and a fiber probe with spot size of 2 mm in diameter were used for laser treatment and irradiations were performed on 5 points at the distal side of the tooth root on the first, second, and 3rd days of the experiment. Total laser energy of 54 J (100 mW, 3.18 W/cm(2), 1717.2 J/cm(2)) was applied to group II and a total of 15 J (100 mW, 3.18 W/cm(2), 477 J/cm(2)) to group III. The experiment lasted for 8 days. The number of osteoclasts, osteoblasts, inflammatory cells and capillaries, and new bone formation were evaluated histologically. Besides immunohistochemical staining of PCNA, RANKL and OPG were also performed. No statistical difference was found for the amount of tooth movement in between the control and study groups (p > 0.05). The number of osteoclasts, osteoblasts, inflammatory cells, capillary vascularization, and new bone formation were found to be increased significantly in group II (p < 0.05). Immunohistochemical staining findings showed that RANKL immunoreactivity was stronger in group II than in the other groups. As to OPG immunoreactivity, no difference was found between the groups. Immunohistochemical parameters were higher in group III than in group I, while both were lower than group II. On the basis of these findings, low-level laser irradiation accelerates the bone remodeling process by stimulating osteoblastic and osteoclastic cell proliferation and function during orthodontic tooth movement.

Apical microleakage and SEM analysis of dentin surface after 980 nm diode laser irradiation.

This study evaluated the effect of 980-nm diode laser on apical microleakage and intraradicular dentin morphology. Roots of 110 mandibular incisors were used in the study: 92 for microleakage test and 18 for scanning electron microscopy (SEM). Roots were randomly assigned to 3 groups according to the irrigating solution (water, NaOCl and NaOCl/EDTA) and were divided into 3 subgroups according to the laser irradiation protocol (without irradiation, irradiated at 1.5 W and irradiated at 3.0 W). Two specimens of each subgroup were prepared for SEM. The remaining roots were filled with AH Plus and gutta-percha. Apical leakage was assessed by ink penetration and data were analyzed statistically by ANOVA and Tukey-Krammer test (α=0.05). SEM analysis showed intensification of changes with increase of laser power as well as variations according to the irrigating solution. Modified smear layer was observed in specimens treated with water and irradiated with laser. Roots irrigated with NaOCl/EDTA had lower levels of infiltration (0.17 ± 0.18 mm) differing significantly (p<0.05) from those of roots irrigated with water (0.34 ± 0.30 mm), but similar (p>0.05) to those irrigated with NaOCl (0.28 ± 0.29 mm). Non-irradiated roots had lower levels of infiltration (0.10 ± 0.14 mm), differing (p<0.05) from those irradiated at 1.5 W (0.32 ± 0.22 mm) and 3.0 W (0.37 ± 0.32 mm). The 980 nm diode laser modified dentin morphology and increased apical microleakage.

Case report: laser-assisted rebonding of a central incisor tooth due to a severe trauma - 4 years of follow-up.

BACKGROUND: The success of reattaching fractured tooth crowns fragments, as a result of trauma, has improved as a result of the introduction of lasers in dental care. This case report documents a 4 year follow-up of a re-bonded tooth fragment on a maxilary first permanent incisor. CASE REPORT: An 8-year-old girl presented with a fractured maxillary might first permanent incisor (II) as a result of a severe trauma. The child's parents had preserved the tooth fragment in a glass of milk immediately after the injury. TREATMENT: An Er,Cr:YSGG Laser with a wavelength of 2,780 nm was used with 20Hz, 5 W (250 mJ), 90 % air, 80% water for etching of the enamel and 20 Hz, 3W (150 mJ), 65% air, 55% water for dentine etching with a G6 (600 micron, sapphire, 6mm long) tip. For conditioning the enamel and dentine no additional acid etching was used. Only a 2 step self-etched adhesive system Clearfil Protect® (Kuraray Medical, Japan) was applied. Then a flowable composite resin, Grandi Flow® (Voco, Cuxhaven, Germany) was applied in order to bind the broken fragment onto the tooth. FOLLOW-UP: The re-bonded tooth fragment has been retained in place and symptom free, as assessed by clinical examination, intraoral photographs and radiographs for a period of 4 years. CONCLUSION: Laser-assisted re-bonding of a tooth fragment was found to be successful.

Effectiveness of Er,Cr:YSGG laser on dentine hypersensitivity: a controlled clinical trial.

AIM: Attempts have been made to treat dentine hypersensitivity (DH) with lasers. However, there is limited knowledge on the effects of erbium, chromium-doped:yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser on DH. The aim of this study was to evaluate the efficacy of Er,Cr:YSGG laser on reduction in DH. METHODS: Forty-two patients (146 teeth) were included. Teeth were assigned to an experimental group and irradiated with the Er,Cr:YSGG laser. In the control group same clinical instrument was used without laser emission. DH was assessed for both groups utilizing the visual analog scale. Plaque index (PI) scores were recorded immediately following treatment, at 1 week, 1 and 3 months. RESULTS: The results showed that Er,Cr:YSGG laser irradiation had a significantly higher desensitizing effect compared with the placebo immediately after treatment (p<0.05). Intra-group comparisons revealed no statistically significant differences within the placebo group (p>0.05). For the test group, the differences between baseline and all time points following treatment were statistically significant (p<0.05). No significant differences were observed in PI between the test and control groups at any follow-up examination (p>0.05). CONCLUSION: Within the limits of this study, it appears that Er,Cr:YSGG laser is effective in the treatment of DH compared with the placebo treatment.

The effect of different preparation and etching procedures on the microleakage of direct composite veneer restorations.

OBJECTIVES: The aim of this in vitro study was to compare the microleakage of direct composite veneer restorations prepared by a conventional dental bur or Er,Cr:YSGG (erbium, chromium doped yttrium scandium gallium garnet) laser and etched with different procedures. METHODS: Fifty maxillary incisor teeth prepared for direct veneers with gingival margins in dentin and incisal margins in enamel were randomly divided into five groups (n = 10): group 1 (control), prepared with diamond bur and etched with phosphoric acid; group 2, prepared with diamond bur and etched with Er,Cr:YSGG laser (Waterlase MD/Biolase); group 3, prepared with laser and not etched; group 4, prepared with laser and etched with phosphoric acid; and group 5, prepared and etched with laser. After the application of the etch and rinse adhesive system (Prime & Bond NT/Dentsply), teeth were restored with the nano ceramic restorative material (Ceram X Duo/Dentsply), subjected to thermocycling and immersed in 0.5% basic fuchsin dye for 24 h. The teeth were sectioned longitudinally and dye penetration was evaluated by a binocular stereomicroscope equipped with a measuring device. Data were analyzed by Kruskal-Wallis and Wilcoxon signed ranks tests. The level of significance was set at p = 0.05. RESULTS: Significant differences were observed in enamel of the five groups (p < 0.05). Minimal microleakage was observed in groups 1 and 3. The highest microleakage was evaluated in group 5 (p < 0.05). No significant differences were found among the five groups in dentin (p > 0.05). No differences were recorded between the microleakage values in enamel and dentin within each group and this was valid for all groups (p > 0.05). CONCLUSIONS: The results confirmed that enamel and dentin surfaces prepared with Er,Cr:YSGG laser for direct composite veneer restorations may provide comparable sealing.

Apical microleakage and SEM analysis of dentin surface after 980 nm diode laser irradiation

This study evaluated the effect of 980-nm diode laser on apical microleakage and intraradicular dentin morphology. Roots of 110 mandibular incisors were used in the study: 92 for microleakage test and 18 for scanning electron microscopy (SEM). Roots were randomly assigned to 3 groups according to the irrigating solution (water, NaOCl and NaOCl/EDTA) and were divided into 3 subgroups according to the laser irradiation protocol (without irradiation, irradiated at 1.5 W and irradiated at 3.0 W). Two specimens of each subgroup were prepared for SEM. The remaining roots were filled with AH Plus and gutta-percha. Apical leakage was assessed by ink penetration and data were analyzed statistically by ANOVA and Tukey-Krammer test (α=0.05). SEM analysis showed intensification of changes with increase of laser power as well as variations according to the irrigating solution. Modified smear layer was observed in specimens treated with water and irradiated with laser. Roots irrigated with NaOCl/EDTA had lower levels of infiltration (0.17 ± 0.18 mm) differing significantly (p<0.05) from those of roots irrigated with water (0.34 ± 0.30 mm), but similar (p>0.05) to those irrigated with NaOCl (0.28 ± 0.29 mm). Non-irradiated roots had lower levels of infiltration (0.10 ± 0.14 mm), differing (p<0.05) from those irradiated at 1.5 W (0.32 ± 0.22 mm) and 3.0 W (0.37 ± 0.32 mm). The 980 nm diode laser modified dentin morphology and increased apical microleakage.

Este estudo avaliou o efeito do laser de diodo 980 nm na microinfiltração apical e na morfologia intrarradicular da dentina. Raízes de 110 incisivos inferiores foram utilizadas no estudo: 92 para o teste de microinfiltração e 18 para microscopia eletrônica de varredura (MEV). As raízes foram divididas em 3 grupos de acordo com a solução irrigante (água, NaOCl e NaOCl/EDTA) e subdivididas em 3 de acordo com a irradiação laser (sem irradiação, irradiados com 1,5 W e irradiados com 3,0 W). Duas amostras de cada subgrupo foram preparadas para MEV. As raízes restantes foram preenchidas com AH Plus e guta percha. A infiltração apical foi avaliada nas raízes por meio da penetração do corante e os dados foram analisados por ANOVA e teste de Tukey-Krammer (α=0,05). Os resultados da MEV mostraram intensificação das mudanças quando se aumentou a potência do laser e variações de acordo com a solução irrigadora. Camada de smear modificada foi observada em espécimes tratados com água e irradiados com laser. Raízes irrigadas com NaOCl/EDTA tiveram níveis menores de infiltração (0,17 ± 0,18 mm) estatisticamente diferente (p<0,05) das raízes irrigadas com água (0,34 ± 0,30 mm), mas semelhante (p>0,05) aos irrigados com NaOCl (0,28 ± 0,29 mm). As raízes não irradiadas tiveram níveis menores de infiltração (0,10 ± 0,14 mm), diferente (p<0,05) de 1,5 W (0,32 ± 0,22 mm) e 3.0 W (0,37 ± 0,32 mm). O laser de diodo 980 nm alterou a morfologia da dentina e aumentou a infiltração marginal apical.

Low-level laser therapy effects in traumatized permanent teeth with extrusive luxation in an orthodontic patient.

The aim of this case report was to present and evaluate the effect of low-level laser therapy on traumatized permanent teeth with extrusive luxation in an orthodontic patient. The treatment and follow-up evaluation of two orally luxated maxillary permanent central incisors in a 19-year-old man is described. Detailed anamnesis was taken, and extraoral, intraoral, radiographic examinations and electrical and thermal pulpal tests were performed to determine the type of the luxation and the further treatment protocol. Teeth were splinted with composite resin, and antibiotic therapy was prescribed. Low-level laser therapy was applied for 25 sessions. No root canal treatment was applied to the teeth. Continuation of the orthodontic treatment was restarted after 6 months. No sign of clinical or radiographic pathology was detected after 2 years from the end of the treatment. Teeth were identified healthy and sound without any root canal intervention. Treatments with low-level laser applications may be evaluated as noninvasive alternative treatment options in comparison with endodontic treatment for teeth with extrusive luxation more than 2 mm, especially for those who have orthodontic treatment needs.

Morphological assessment of dentine and cementum following apicectomy with Zekrya burs and Er:YAG laser associated with direct and indirect Nd:YAG laser irradiation.

OBJECTIVES: This study aimed to assess the apical surface morphology of maxillary central incisors resected 3.0 mm from the tooth apex using Zekrya burs or Er:YAG laser, with or without subsequent direct Nd:YAG laser irradiation (apical and buccal surfaces) and indirect irradiation (palatal surface). STUDY DESIGN: Forty maxillary central incisors were instrumented and obturated. The roots were divided into 4 groups according to the root resection method (Zekrya bur or Er:YAG laser - 1.8 W, 450 mJ, 4 Hz, 113 J/cm(2)) and further surface treatment (none or Nd:YAG laser - 2.0 W, 100 mJ, 20 Hz, 124 J/cm(2)). The teeth were prepared for SEM analysis. Scores ranging from 1 to 4 were attributed to cut quality and morphological changes. The data were analyzed by the Kruskal-Wallis test and by Dunn's test. RESULTS: SEM images showed irregular surfaces on the apical portions resected with Zekrya burs, with smear layer and grooves in the resected dentine and slight gutta-percha displacement and plasticization. On the other hand, apicectomies carried out with Er:YAG laser showed morphological changes compatible with ablated dentine, with rough surfaces and craters. In spite of the presence of plasticized gutta-percha, with the presence of bubbles, an irregular adaptation of the filling material to the root walls was also observed. Direct Nd:YAG laser irradiation of the apical and buccal surfaces of the resected roots resulted in areas of resolidification and fusion in the dentine and cementum, with a vitrified aspect; indirect Nd:YAG laser irradiation of the palatal surfaces yielded a lower number of changes in the cementum, with irregular resolidification areas. CONCLUSIONS: There were no differences in terms of cut quality between the use of burs and Er:YAG laser or between the 2 surfaces (apical and buccal) treated with Nd:YAG laser with direct irradiation. However, morphological changes were significantly less frequent on surfaces submitted to indirect irradiation (palatal) when compared with those directly irradiated.

Damage to incisors after nonmyeloablative total body irradiation may complicate NOD/SCID models of hemopoietic stem cell transplantation.

Immunocompromised murine xenotransplantation models have become an important tool to study stem cell biology. One of the most common recipient strains used is the NOD/SCID mouse, which offers sufficient longevity to quantify moderate levels of engraftment. During pilot experiments, we noted incisor abnormalities 5 to 6 wk after nonmyeloablative doses of irradiation. Here we report a detailed examination of this phenomenon and propose possible explanations and management strategies. A total of 15 NOD/SCID mice received 3 Gy total body irradiation (TBI) and were monitored over 9 wk. A control group of 15 mice were treated in exactly the same way as the study mice except that they did not receive irradiation. A total of 9 TBI mice developed incisor abnormalities between days 40 and 50 after irradiation, resulting in rapid weight loss. No mice in the control group developed incisor abnormalities, however 3 were euthanized prematurely due to the development of thymic lymphoma. Upon development of incisor abnormalities and weight loss, 2 mice in the TBI group had their teeth trimmed and received soft food. Both mice made a rapid recovery and survived for the remainder of the study. The development of incisor abnormalities occurred in 2 substrains, and alterations in antibiotic use and supplementation of the vitamin content of feeds did not prevent the abnormalities. Investigators working with this model should be aware of this complication and modify protocols appropriately.

In-office vital tooth bleaching--what do lights add?

Aqueous hydrogen peroxide (H2O2) has been used clinically at 30% to 35% levels to lighten teeth for many years, but the process has required multiple visits. Heat and light have been used empirically in attempts to catalyze H2O2 decomposition and speed tooth lightening. The contribution of bleaching lights (LumaArch, Optilux 500, and Zoom!) to act as catalysts for lightening teeth was studied in 83 pairs of contralateral anterior maxillary and mandibular teeth on 15 human subjects. Split-arch design using centrals, laterals, and canines on one side treated with bleach plus light, were compared with contralateral teeth using bleach alone. Three researchers trained in the use of the Vitapan 3D-Master Shade Guide took shades with independently agreement within 0.5 value-chroma sum 89% of the time throughout the study Laboratory tests determined bleach gel chemistry, bleach light output, and effects on the bleaches of light alone and heat alone. Results showed that the three test lights did not lighten teeth more than their bleach gels alone. All teeth lightened to nearly the same degree (1.7 color increments), but LumaArch required 60% less time and Zoom! used 1/3 lower H2O2 concentration. Laboratory tests indicated that the proprietary chemicals mixed into each bleach gel just before use acted as catalysts and were probably responsible for more rapid lightening produced by LumaArch gel, and need for less H2O2 in Zoom! gel. Neither the heat produced by the accessory lights, nor the light output itself were responsible for catalytic activity with any of the three systems tested. Collectively, the data demonstrate positive effects from chemical catalysts added to bleaching gels. No output from any of the lights resulted in heat or light that catalyzed the gels.

Irradiation effects in the electron microprobe quantitation of mineralized tissues.

The accuracy of absolute quantitation within thick, mineralized tissue specimens is influenced by count rate variations of characteristic X-rays during electron microprobe analysis. The variations occur for electron doses approximately greater than 10(-10) C/micrometer2 and are primarily dependent upon the light element fraction within the irradiated volume. Specimen preparation procedures affect both count rate dynamics and interpretatin of microanalytical results. X-ray intensity data acquird at initial electron exposure and utilized in standard matrix correction schemes will project valid elemental concentrations for known calcium compounds over wide ranges of specimen density. Measurement error could approach +/- 2-3% for the major elemental constituents in mineralized tissues, but only with appropriate control or interpretation of electron irradiation phenomena.