Dentin Topographic Features following Chemomechanical Caries Removal in Primary Teeth.

AIM: Study the topographic features of dentin after caries removal with a chemomechanical agent (Papacarie) compared with the conventional drilling method. STUDY DESIGN: The sample included 7 exfoliated and extracted primary teeth with carious dentin lesions, not reaching the pulp. Each tooth was sectioned longitudinally through the center of the carious lesions into two halves. The teeth were then divided into two groups according to the method of caries removal. Following caries removal, dentin topography and the cut section were examined using the scanning electron microscope. RESULTS: Papacarie produced an irregular, porous, rough and globular dentin appearance. The dentin surfaces were generally free of smear layer, visible bacteria and the dentinal tubules were opened. The dentin cut surfaces showed patent dentinal tubules with open orifices. The drilling method created a smooth and amorphous surface with a continuous smear layer occluding the dentinal tubules. Numerous bacteria were also observed. The cut dentin surfaces showed patent dentinal tubules with their orifices plugged with smear layer. CONCLUSIONS: Papacarie produced a rough and porous surface with partial or complete removal of the smear layer and opened dentinal tubules, while the drill produced a smooth surface with uniform smear layer occluding the dentinal tubules.

Enamel surface evaluation after bracket debonding and different resin removal methods.

OBJECTIVE: To assess enamel surface under scanning electron microscopy (SEM) after resin removal and enamel polishing procedures following brackets debonding, as well as compare the time required for these procedures. METHODS: A total of 180 deciduous bovine incisors were used. The enamel surface of each tooth was prepared and brackets were bonded with light cured Transbond XT composite resin. Brackets were removed in a testing machine. The samples were randomized and equally distributed into nine groups according to the resin removal and polishing technique: Group 1, 30-blade tungsten carbide bur in high speed; Group 2, 30-blade tungsten carbide bur in high speed followed by a sequence of 4 Sof-lex polishing discs (3M); Group 3, 30-blade tungsten carbide bur in high speed followed by Enhance tips (Dentsply). All groups were subdivided into (a) unpolished; (b) polished with aluminum oxide paste; and (c) polished with water slurry of fine pumice. Subsequently, the enamel surface was assessed and statistical analysis was carried out. RESULTS: There were statistically significant differences in enamel roughness and removal time among all groups. Groups 3a, 3b and 3c appeared to be the most efficient methods of removing resin with low damages to enamel. Groups 2a, 2b and 2c were the most time consuming procedures, and Group 2a caused more damages to enamel. CONCLUSION: The suggested protocol for resin removal is the 30-blade tungsten carbide bur in high speed followed by Enhance tips and polishing with aluminum oxide paste. This procedure seems to produce less damages and is less time consuming.

Enamel surface evaluation after bracket debonding and different resin removal methods

OBJECTIVE: To assess enamel surface under scanning electron microscopy (SEM) after resin removal and enamel polishing procedures following brackets debonding, as well as compare the time required for these procedures. METHODS: A total of 180 deciduous bovine incisors were used. The enamel surface of each tooth was prepared and brackets were bonded with light cured Transbond XT composite resin. Brackets were removed in a testing machine. The samples were randomized and equally distributed into nine groups according to the resin removal and polishing technique: Group 1, 30-blade tungsten carbide bur in high speed; Group 2, 30-blade tungsten carbide bur in high speed followed by a sequence of 4 Sof-lex polishing discs (3M); Group 3, 30-blade tungsten carbide bur in high speed followed by Enhance tips (Dentsply). All groups were subdivided into (a) unpolished; (b) polished with aluminum oxide paste; and (c) polished with water slurry of fine pumice. Subsequently, the enamel surface was assessed and statistical analysis was carried out. RESULTS: There were statistically significant differences in enamel roughness and removal time among all groups. Groups 3a, 3b and 3c appeared to be the most efficient methods of removing resin with low damages to enamel. Groups 2a, 2b and 2c were the most time consuming procedures, and Group 2a caused more damages to enamel. CONCLUSION: The suggested protocol for resin removal is the 30-blade tungsten carbide bur in high speed followed by Enhance tips and polishing with aluminum oxide paste. This procedure seems to produce less damages and is less time consuming. .

OBJETIVO: avaliar a superfície do esmalte, por meio de microscopia eletrônica de varredura, após descolagem de braquetes e o polimento do esmalte, com diferentes técnicas de remoção de resina, bem como comparar o tempo necessário para a realização do procedimento. MÉTODOS: foram utilizados 180 dentes bovinos decíduos. A superfície do esmalte dos dentes foi preparada e realizada a colagem dos braquetes com resina Transbond XT. Os braquetes foram removidos em máquina de ensaio mecânico. Foram formados, aleatoriamente, nove grupos, de acordo com o tipo de remoção da resina e de polimento, sendo: Grupo 1, broca de tungstênio de 30 lâminas em alta rotação; Grupo 2, broca de tungstênio de 30 lâminas em alta rotação e sequência de quatro discos Soflex (3M); Grupo 3, broca de tungstênio de 30 lâminas em alta rotação e pontas de acabamento Enhance (Dentsply). Todos os grupos foram subdividido em (a) sem polimento, (b) polimento com pasta de óxido de alumínio e (c) polimento com pedra-pomes. As superfícies foram avaliadas e foi realizada análise estatística. RESULTADOS: houve diferença estatística entre os grupos em relação à rugosidade de superfície e ao tempo de remoção. Os grupos 3a, 3b e 3c demonstraram ser os métodos mais eficientes de remoção da resina, promovendo pouco dano à superfície do esmalte. Os grupos 2a, 2b e 2c consumiram maior tempo de procedimento, e o grupo 2a causou maior dano ao esmalte. CONCLUSÃO: sugere-se como protocolo de remoção o uso de broca de tungstênio de 30 lâminas para remoção do maior volume da resina, pontas de acabamento Enhance e polimento com a pasta de óxido de alumínio, por produzirem menor dano. .

Influence of long-term water storage and thermocycling on shear bond strength of glass-ionomer cement to Er:YAG laser-prepared dentin.

PURPOSE: To evaluate the influence of long-term water storage and thermocycling on the shear bond strength of a glass-ionomer cement to Er:YAG-irradiated and bur-prepared dentin. MATERIALS AND METHODS: Fifteen bovine incisors were selected and the roots removed. Crowns were sectioned into four pieces, resulting in 60 samples that were individually embedded in polyester resin (n = 15) and ground to plane the enamel and expose the dentin. The bonding site was delimited and samples were randomly assigned according to the method of cavity preparation: Er:YAG laser (250 mJ/4 Hz) or high-speed handpiece (diamond bur #2096). Samples were fixed to a metallic device, where glass-ionomer cement (GIC) cylinders were prepared. Subsequently, they were subdivided according to the duration of water storage (WS) and number of thermocycles (TCs) - 24 h WS/no TCs and 6 months WS/12,000 TCs - and subjected to a shear bond strength test (500 N at 0.5 mm/min). RESULTS: The duration of water storage and number of thermocycles tested had no statistically significant effect on the shear bond strength to laser-irradiated dentin (p > 0.05). For bur-prepared substrate, the long-term degradation process promoted a decrease in shear bond strength values (p < 0.05). CONCLUSION: Long-term water storage and thermocycling did not affect shear bond strength of glass-ionomer cement bonded to Er:YAG laser-prepared dentin.

Influence of two different bracket base cleaning procedures on shear bond strength reliability.

PURPOSE: To search if the shear bond strengths of brackets would change after two different base-cleaning procedures such as sandblasting or carbide bur cleaning, and to determine if a previously bonded tooth surface had any effect on bond strength. MATERIALS AND METHODS: A total of 120 new brackets were first bonded to 120 extracted premolars and then debonded and bond strength was recorded. The debonded brackets were divided into two groups and recycled either by sandblasting or tungsten-carbide bur cleaning. Sixty recycled brackets were divided into two subgroups: In each group; 30 recycled brackets were bonded to unused 30 extracted premolars. The remaining brackets were bonded to 30 previously used premolars. The brackets were debonded again and their bond strengths were remeasured. RESULTS: Bond strength of rebonded brackets after sandblasting was not significantly different from that of new brackets while the bond strength of rebonded brackets after carbide bur cleaning group significantly decreased. The previously bonded tooth surface did not affect the bond strength significantly. CLINICAL SIGNIFICANCE: This study showed that rebonding the brackets after sandblasting supplies sufficient bond strength. Previously bonded tooth surface did not cause a decreasing effect on bond strength. However, when carbide bur cleaning procedure is chosen, the clinician should proceed cautiously.

Influence of CVD diamond tips and Er:YAG laser irradiation on bonding of different adhesive systems to dentin.

AIM: The aim of this study was to compare the microtensile bond strength of three adhesive systems, using different methods of dentin preparation. MATERIALS AND METHODS: A hundred and eight bovine teeth were used. The dentin from buccal face was exposed and prepared with three different methods, divided in 3 groups: Group 1 (DT)- diamond tip on a high-speed handpiece; Group 2 (CVD)-CVD tip on a ultrasonic handpiece; Group 3 (LA)-Er: YAG laser. The teeth were divided into 3 subgroups, according adhesive systems used: Subgroup 1-Adper Single Bond Plus/3M ESPE (SB) total-etch adhesive; Subgroup 2-Adper Scotchbond SE/3M ESPE (AS) selfetching adhesive; Subgroup 3-Clearfil SE Bond/Kuraray (CS) selfetching adhesive. Blocks of composite (Filtek Z250-3M ESPE) 4 mm high were built up and specimens were stored in deionized water for 24 hours at 37°C. Serial mesiodistal and buccolingual cuts were made and stick-like specimens were obtained, with transversal section of 1.0 mm(2). The samples were submitted to microtensile test at 1 mm/min and load of 10 kg in a universal testing machine. Data (MPa) were subjected to ANOVA and Tukey's tests (p < 0.05). RESULTS AND CONCLUSION: Surface treatment with Diamond or CVD tips associated with Clearfil SE Bond adhesive produced significantly lower bond strength values compared to other groups. Surface treatment with Er: YAG laser associated with Single Bond Plus or Clearfil SE Bond adhesives and surface treatment with CVD tip associated with Adper Scotchbond SE adhesive produced significantly lower bond strength values compared to surface treatment with diamond or CVD tips associated with Single Bond Plus or Adper Scotchbond SE adhesives. CLINICAL SIGNIFICANCE: Interactions between laser and the CVD tip technologies and the different adhesive systems can produce a satisfactory bonding strength result, so that these associations may be beneficial and enhance the clinical outcomes.

Subcutaneous emphysema and pneumomediastinum complicating a dental procedure.

Cervicofacial emphysema and pneumomediastinum are rarely observed complications of dental interventions. The complications are associated with the use of a high-speed air-turbine dental drill. It is a potentially life-threatening condition, but the majority of cases are self-limiting and benign. We describe a patient with remarkable subcutaneous emphysema, pneumomediastinum, and partial pneumothorax after right second mandibular molar extraction. Dentists and physicians more often attribute the rapid onset of dyspnea in patients after a dental procedure to an allergic reaction to the anesthesia used during the procedure. Dentists and physicians should be aware that soft tissue emphysema can cause acute swelling of the cervicofacial region after dental procedures, which may mimic an allergic reaction.

One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study.

INTRODUCTION: This study analyzed the in vivo microbiological status of the root canal systems of mesial roots of mandibular molars with primary apical periodontitis after 1- or 2-visit endodontic treatment. METHODS: Mesial root canals were instrumented by using either a combination of K3 and LightSpeed instruments (mesiobuccal canals) or the ProTaper system (mesiolingual canals), with 5% NaOCl irrigation. Patency files were used. Smear layer was removed, and a final rinse with 5 mL of 2% chlorhexidine was performed. In the 2-visit group (7 roots, 14 canals), canals were medicated with calcium hydroxide for 1 week and then obturated by using the continuous wave of compaction technique. In the 1-visit group (6 roots, 12 canals), canals were immediately obturated after chemomechanical procedures. Teeth were extracted 1 week after root canal instrumentation and processed for histobacteriologic analysis. RESULTS: In the 1-visit group, no case was completely free of bacteria; residual bacteria occurred in the main root canal (5 of 6 cases), isthmus (5 of 6), apical ramifications (4 of 6), and dentinal tubules (5 of 6). In the 2-visit group, 2 cases were rendered bacteria-free; residual bacteria were found in the main canal only in 2 cases (none of them with persistent dentinal tubule infection), in the isthmus (4 of 7 cases), and in ramifications (2 of 7). The 2 instrumentation techniques performed similarly. When filling material was observed in ramifications, it was usually intermixed with necrotic tissue, debris, and bacteria. CONCLUSIONS: The 2-visit protocol by using an interappointment medication with calcium hydroxide resulted in improved microbiological status of the root canal system when compared with the 1-visit protocol. Residual bacteria were more frequent and abundant in ramifications, isthmuses, and dentinal tubules when root canals were treated without an interappointment medication. Apical ramifications and isthmuses were never completely filled. The use of an antibacterial interappointment agent is necessary to maximize bacterial reduction before filling.

Conditioning effects of cavities prepared with an Er,Cr:YSGG laser and an air-turbine.

The purpose of this study was to examine, morphologically and histochemically, five types of conditioning effects on cavities prepared with an Er,Cr:YSGG laser and an air-turbine. Cavities were prepared using a Waterlase(®) MD turbo handpiece (W) and an air-turbine (AT) on human extracted molars. The cavity conditionings used were non-conditioned (G1), K-etchant Gel (G2), K-etchant Gel + AD Gel (G3), Clearfil SE Bond primer (G4) and Clearfil S(3) Bond (G5). On naked eye observations, enamel of G1, G2 and G3 in the W cavities and etched enamel of G2 and G3 in the AT cavities were observed as rough and dull in appearance. G4 and G5 in W and AT cavities were observed as shiny surfaces. On SEM observations, no smeared layer was observed in W cavities, while a smeared layer and bur-scratches were observed in AT cavities. In W cavities, rough surfaces were observed on enamel. That is, cracks and minute rough surfaces were observed. In contrast, equally etched scale-shaped enamel rods were observed in AT cavities. Widely opened dentinal tubules and protruding peritubular matrices of dentin were observed in W cavities. A few remaining smeared plugs could be observed at the AT cavities. On LM observations, 13-16 µm layers of the dentin in G1, G2, G4 and G5 of W cavities were stained red in color by the Azan staining method, while redness was not observed in G3. No groups were stained red in AT cavities. It was considered that layers stained red in color were thermal degeneration layers of dentin induced by W. Namely 30 s etching of 40% phosphoric acid gel followed by 90 s treatment of 10% NaClO gel should be recommended for use when combined with an Er,Cr:YSGG laser for cavity preparation.

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.

A pilot study of bioaerosol reduction using an air cleaning system during dental procedures.

BACKGROUND: Bioaerosols are defined as airborne particles of liquid or volatile compounds that contain living organisms or have been released from living organisms. The creation of bioaerosols is a recognized consequence of certain types of dental treatment and represents a potential mechanism for the spread of infection. OBJECTIVES: The aims of the present study were to assess the bioaerosols generated by certain dental procedures and to evaluate the efficiency of a commercially available Air Cleaning System (ACS) designed to reduce bioaerosol levels. METHODS: Bioaerosol sampling was undertaken in the absence of clinical activity (baseline) and also during treatment procedures (cavity preparation using an air rotor, history and oral examination, ultrasonic scaling and tooth extraction under local anaesthesia). For each treatment, bioaerosols were measured for two patient episodes (with and without ACS operation) and between five and nine bioaerosol samples were collected. For baseline measurements, 15 bioaerosol samples were obtained. For bioaerosol sampling, environmental air was drawn on to blood agar plates using a bioaerosol sampling pump placed in a standard position 20 cm from the dental chair. Plates were incubated aerobically at 37°C for 48 hours and resulting growth quantified as colony forming units (cfu/m³). Distinct colony types were identified using standard methods. Results were analysed statistically using SPSS 12 and Wilcoxon signed rank tests. RESULTS: The ACS resulted in a significant reduction (p = 0.001) in the mean bioaerosols (cfu/m³) of all three clinics compared with baseline measurements. The mean level of bioaerosols recorded during the procedures, with or without the ACS activated respectively, was 23.9 cfu/m³ and 105.1 cfu/m³ (p = 0.02) for cavity preparation, 23.9 cfu/m³ and 62.2 cfu/m³ (p = 0.04) for history and oral examination; 41.9 cfu/m³ and 70.9 cfu/m³ (p = 0.01) for ultrasonic scaling and 9.1 cfu/m³ and 66.1 cfu/m³ (p = 0.01) for extraction. The predominant microorganisms isolated were Staphylococcus species and Micrococcus species. CONCLUSION: These findings indicate potentially hazardous bioaerosols created during dental procedures can be significantly reduced using an air cleaning system.

Microleakage in conservative cavities varying the preparation method and surface treatment.

OBJECTIVE: To assess microleakage in conservative class V cavities prepared with aluminum-oxide air abrasion or turbine and restored with self-etching or etch-and-rinse adhesive systems. MATERIALS AND METHODS: Forty premolars were randomly assigned to 4 groups (I and II: air abrasion; III and IV: turbine) and class V cavities were prepared on the buccal surfaces. Conditioning approaches were: groups I/III - 37% phosphoric acid; groups II/IV - self-priming etchant (Tyrian-SPE). Cavities were restored with One Step Plus/Filtek Z250. After finishing, specimens were thermocycled, immersed in 50% silver nitrate, and serially sectioned. Microleakage at the occlusal and cervical interfaces was measured in mm and calculated by a software. Data were subjected to ANOVA and Tukey's test (α=0.05). RESULTS: Marginal seal provided by air abrasion was similar to high-speed handpiece, except for group I. There was SIGNIFICANT difference between enamel and dentin/cementum margins for to group I and II: air abrasion. The etch-and-rinse adhesive system promoted a better marginal seal. At enamel and dentin/cementum margins, the highest microleakage values were found in cavities treated with the self-etching adhesive system. At dentin/cementum margins, high-speed handpiece preparations associated with etch-and-rinse system provided the least dye penetration. CONCLUSION: Marginal seal of cavities prepared with aluminum-oxide air abrasion was different from that of conventionally prepared cavities, and the etch-and-rinse system promoted higher marginal seal at both enamel and dentin margins.

Microleakage in conservative cavities varying the preparation method and surface treatment

OBJECTIVE: To assess microleakage in conservative class V cavities prepared with aluminum-oxide air abrasion or turbine and restored with self-etching or etch-and-rinse adhesive systems. Materials and Methods: Forty premolars were randomly assigned to 4 groups (I and II: air abrasion; III and IV: turbine) and class V cavities were prepared on the buccal surfaces. Conditioning approaches were: groups I/III - 37 percent phosphoric acid; groups II/IV - self-priming etchant (Tyrian-SPE). Cavities were restored with One Step Plus/Filtek Z250. After finishing, specimens were thermocycled, immersed in 50 percent silver nitrate, and serially sectioned. Microleakage at the occlusal and cervical interfaces was measured in mm and calculated by a software. Data were subjected to ANOVA and Tukey's test (α=0.05). RESULTS: Marginal seal provided by air abrasion was similar to high-speed handpiece, except for group I. There was SIGNIFICANT difference between enamel and dentin/cementum margins for to group I and II: air abrasion. The etch-and-rinse adhesive system promoted a better marginal seal. At enamel and dentin/cementum margins, the highest microleakage values were found in cavities treated with the self-etching adhesive system. At dentin/cementum margins, high-speed handpiece preparations associated with etch-and-rinse system provided the least dye penetration. CONCLUSION: Marginal seal of cavities prepared with aluminum-oxide air abrasion was different from that of conventionally prepared cavities, and the etch-and-rinse system promoted higher marginal seal at both enamel and dentin margins.

Comparison of cutting efficiencies between electric and air-turbine dental handpieces.

STATEMENT OF PROBLEM: Dentistry is gravitating toward the increased use of electric handpieces. The dental professional should have sufficient evidence to validate the switch from an air-turbine handpiece to an electric handpiece. However, there is little research quantifying the cutting efficiency of electric and air-turbine handpieces. Studies that do quantify cutting efficiency typically do so with only a single material. PURPOSE: The purpose of this study was to compare the cutting efficiency of an electric handpiece and an air-turbine handpiece, using various materials commonly used in dentistry. MATERIAL AND METHODS: Seven materials: Macor (machinable glass ceramic), silver amalgam, aluminum oxide, zirconium oxide, high noble metal alloy, noble metal alloy, and base metal alloy, were each cut with a bur 220 times; 110 times with an electric handpiece, and 110 times with an air-turbine handpiece. The weight difference of the material was calculated by subtracting the weight of the material after a cut from the weight of the material before the cut. The cutting efficiency was calculated by dividing the weight difference by the duration of the cut (g/s). Data were analyzed by a 2-way analysis of variance followed by Tukey's Honestly Significant Difference (HSD) test (alpha=.05). RESULTS: The electric handpiece cut more efficiently than the air-turbine handpiece (F=3098.9, P<.001). In particular, the high noble metal alloy, silver amalgam, and Macor were cut more efficiently with the electric handpiece (0.0383 +/-0.0002 g/s, 0.0260 +/-0.0002 g/s, and 0.0122 +/-0.0002 g/s, respectively) than with the air-turbine handpiece (0.0125 +/-0.0002 g/s, 0.0142 +/-0.0002 g/s, and 0.008 +/-0.0002 g/s, respectively). CONCLUSIONS: The electric handpiece is more efficient at cutting various materials used in dentistry, especially machinable glass ceramic, silver amalgam, and high noble alloy, than the air-turbine handpiece.

Heat transfer to the implant-bone interface during preparation of a zirconia/alumina abutment.

PURPOSE: Excessive heat at the implant-bone interface may compromise osseointegration. This study examined the heat generated at the implant surface during preparation of a zirconia/alumina abutment in vitro. MATERIALS AND METHODS: Sixty zirconia/alumina abutments were randomized into 12 experimental groups. The abutments were connected to implants and embedded in an acrylic resin block in a 37 degrees C water bath. The abutments were reduced by 1 mm in height over a period of 1 minute with a high-speed handpiece and then polished for 30 seconds with a low-speed handpiece, both with and without an air/water coolant. Temperatures were recorded via thermocouples at the cervical, middle, and apical part of the implant surfaces. The Mann-Whitney rank-sum test was used to assess the statistical significance of the difference in temperature between the abutment/implant complexes altered with and without coolant. RESULTS: The 1-mm reduction with the high-speed handpiece without coolant resulted in a maximum temperature of 41.22 degrees C at the cervical portion of the implant. Three of four temperatures above 40 degrees C were observed at the cervical part of the implant following use of the high-speed handpiece without coolant. The temperature difference between "with coolant" and "without coolant" during both low-speed polishing and high-speed reduction was statistically significant at the cervical portion of the implant (P = .009). In contrast, the temperature difference between "with coolant" and "without coolant" during both low-speed polishing and high-speed reduction was not statistically significant at the middle and apical parts of the implant (P > .05). CONCLUSIONS: Preparation of a zirconia/alumina abutment caused an increase in temperature within the implant, but this temperature increase did not reach the critical levels described in the implant literature.

Effect of different laser devices on the composition and microhardness of dentin.

This study determined the compositional changes and microhardness of the cavity floor prepared by Er,Cr:YSGG and Er:YAG lasers and compared the results with the conventional method of bur preparation. Fifteen non-carious human molars were used in this study. On the buccal and lingual surfaces of each tooth, two cavities (mesio-distal 3 mm, inciso-gingival 3 mm, depth 2 mm) were prepared with two different laser devices (Er,Cr:YSGG laser; Waterlase MD and Er:YAG laser; KaVo Key Laser 3) and a high-speed turbine. The teeth were embedded into polyester resin and cross-sectioned. The microhardness measurements from the floor of each half cavity were recorded with the Vickers surface hardness tester. The remaining halves of the cavities were subjected to SEM-EDS atomic analysis. The results were statistically evaluated by one-way ANOVA and Kruskal Wallis tests (p = 0.05). No significant differences were observed among the microhardness values, quantities of Ca (Ca weight %), P (P weight %) and Ca/P ratio of the lased and conventionally prepared cavities (p > 0.05). The cavity preparation techniques and differences in laser devices did not significantly alter the composition and microhardness of dentin tissue. Both laser devices used in this study were observed to lead to minimal thermal damage in the dentin tissue and minimal thermally-induced changes in dentinal compositions.

An in vitro investigation of the effectiveness of bioactive glass air-abrasion in the 'selective' removal of orthodontic resin adhesive.

The process of clinically debonding orthodontic brackets causes histomorphological damage to enamel that needs to be quantified and minimized. This study compared three methods for removing residual resin adhesive following bracket debonding. The surface finish following removal of residual adhesive using a slow-speed eight-bladed tungsten carbide bur (group 1), alumina air-abrasion (group 2), and bioactive-glass air-abrasion (group 3) and following polishing, was examined using scanning electron microscopy imaging of resin replicas. Contact profilometry was used to image surfaces before and after debonding for quantifiable volumetric analysis of enamel damage. Surface scarring was seen on scanning electron micrographs from group 1, a sharp pitted surface was identified in group 2, while group 3 exhibited similar, but subjectively smoother, pits. The surface finish following polishing was similar for groups 2 and 3 but did not completely remove the scarring evident from group 1. Quantifiable enamel lost was as follows: group 1, 0.285 mm(3); group 2, 0.386 mm(3); and group 3, 0.135 mm(3); statistical differences were observed between groups 2 and 3. From these results, bioactive-glass air-abrasion more consistently caused less physical damage to enamel and achieved a clinically smooth surface finish following polishing and is therefore to be recommended for clinical use.

Microleakage of glass ionomer restoration in cavities prepared by Er,Cr:YSGG laser irradiation in primary teeth.

PURPOSE: The purpose of this study was to evaluate microleakage of cavity preparation in primary teeth made with an Er, Cr:YSGG laser (L) or high-speed drill (HD) and conventional (CGIC) and resin-modified glass ionomer cement (RMGIC). METHODS: One hundred primary teeth were divided into 10 groups (N=10): (a) groups 1 and 2 represented cavities prepared by a no. 1012 diamond bur with HD; (b) groups 3 through 10 represented cavities prepared with an Er, Cr:YSGG laser (with a repetition rate of 20 Hz power settings varying for enamel=2.5 W and 3 W and dentine=1.0 W and 1.5 W). After cavity preparation, samples were restored with CGIC (Ketac Molar Easy Mix) and RMGIC (Vitremer), impermeabilized, thermal cycled, stained, washed, and sectioned. The degree of dye penetration was scored by 3 standardized examiners using a light stereoscope at X30 magnification. RESULTS: The Kruskal-Wallis test detected no statistical differences between the cavity preparation methods (P<.049). Neither of the GICs tested were able to avoid microleakage, and the RMGIC showed the lowest statistical degree of microleakage compared with CGIC for both types of cavity preparation. CONCLUSIONS: The Er,Cr:YSGG laser provided an equivalent method of cavity preparation compared to the high-speed drill. The resin-modified glass ionomer cement showed the lowest degree of microleakage. This restorative material should be considered when choosing the cavity preparation method.

Difference in physiological responses to sound stimulation in subjects with and without fear of dental treatments.

The effects of sound generated by an ultrasonic dental scaler and a dental turbine on heart rate, systolic and diastolic blood pressure, and hemodynamic changes in the frontal cortex were measured and compared with those of pure tone stimulation in 17 young volunteers. Near-infrared spectroscopy and the Finapres technique were used to measure hemodynamic and cardiovascular responses, respectively. The dental sound changed the various physiological parameters. To determine if this change was related to participants' previous experiences with dental treatment, participants were divided into two groups: those who had a previous unpleasant experience with dental treatment and those who had not. Participants with previous unpleasant dental experiences showed a significant decrease in cerebral blood flow. Participants who had not had an unpleasant dental experience did not show significant changes in cerebral blood flow. Thus, although sounds associated with dental treatment may reduce cerebral blood flow, this effect may depend on the dental experiences of the patient. It is recommended that dentists treat patients gently and with empathy to promote a friendly image of dentistry.