Er:YAG Laser and Hemolasertherapy: Bone and Gingiva Gain-Case Report.

Background: Modern dentistry has increasingly valued conservative and biologically less invasive clinical practices, seeking to preserve the patients' tissues and natural dental elements. Most extractions in the dental clinic are preceded by periodontal disease that presents bone and gingival tissue loss, compromising the aesthetics as well as the support of dental elements. Objectives: The clinical approach in these cases often involves bone exertion followed by the successful installation of osseointegrated implants. Material and Methods: In this study, a case of extensive periodontal involvement and mobility of dental elements was carried out in a minimally invasive way, using the Er:YAG laser for periodontal decontamination and the hemolasertherapy technique to regenerate adjacent tissues, totaling nine weeks of treatment. Results: Clinical and radiographical improvement of tissue health and complete preservation of dental elements were observed. Conclusion: The patient underwent a follow-up appointment 2 years after the start of treatment when it was still possible to verify the stability of the clinical condition and the tissue gains obtained.

Twelve-Month Follow-Up of Different Dentinal Hypersensitivity Treatments by Photobiomodulation Therapy, Nd:YAG and Nd:YAP Lasers.

In this retrospective study, data for three different laser-assisted approaches for the management of dentinal hypersensitivity (DH) was collected (n = 920 teeth). In total, 387 teeth were treated with photobiomodulation (PBM) therapy with 660 nm red light laser (PBM group), 327 were treated with the Nd:YAG laser (1064 nm) and 206 were treated with the Nd:YAP laser (1340 nm). To assess the effectiveness of each treatment, a visual analogue scale (VAS) was used, where zero represented no pain at all and ten represented the greatest pain. VAS was used before (T0), immediately after (T1), one week after (T2), four weeks after (T3), six months after (T4) and one year after treatment (T5). Means and standard deviations of VAS at different follow-up times were calculated. Values were compared within and between groups. Statistical significance was considered to be achieved when p-value was less than 0.05. Confidence level was proposed to be 99% with a P value lower than 0.001. Within groups, a statistically significant reduction was obtained when the mean value of VAS at T0 was compared with T5. At T5, the PBM group had the highest reduction of VAS (with mean value of 0), while the Nd:YAG and Nd:YAP groups had scores of 1.065 ± 0.674 and 4.665 ± 0.674, respectively. Conclusion: this retrospective study showed that PBM therapy and irradiation with Nd:YAG and Nd:YAP lasers are effective in managing DH pain. However, PBM therapy was the only procedure that showed complete pain relief at six and twelve months after treatment.

Blinded, parallel and randomized clinical evaluation of in-office dental bleaching with violet LED (405-410nm).

This clinical study evaluated the effect of bleaching performed with violet LED light (405-410 nm), either combined with hydrogen peroxide (HP) gel, or not, on color change, dental sensitivity, participants' satisfaction and impact on their quality of life. A hundred participants were divided into one of the groups (n = 25): G1 - 35% HP (4 sessions, 1x/week); G2 - violet LED (4 sessions, 1x/week); G3 - violet LED (4 sessions, 2x/week); G4 - hybrid technique (violet LED + 35% HP; 4 sessions, 1x/week). Color evaluation was performed with colorimetric tests (objective and subjective), before, 14 days and 3 months after completion. Additionally, satisfaction with treatment, impact on quality of life (OHIP-14) and dental sensitivity were recorded. The data were submitted to statistical analysis, considering a significance level of 5%, with the exception of the data from the questionnaire on satisfaction (descriptive analysis). Two-way ANOVA and Tukey tests showed that there was no difference between color variation resulting from techniques used in G1 and G4; those used in G2 and G3 did not differ and were less effective for bleaching than those of the other groups, in both subjective and objective evaluations. Regarding tooth sensitivity, subjects in G2 and G3 experienced no sensitivity, ​​while those in G4 showed lower sensitivity values than those in G1. With respect to quality of life, only subjects in G1 and G2 showed a significant positive impact. Among the evaluated techniques, the hybrid type seemed to be a good alternative, showing effective bleaching with less tooth sensitivity.

Effects of heating by steam autoclaving and Er:YAG laser etching on dentin components.

The simultaneous need for infection-control protocols in sample preparations and for safe laser irradiation parameters prompted this study about the effects of heat produced by both sample sterilization and laser etching on dentin components. The dentin was exposed on 30 bovine incisors, and then divided into two main groups: autoclaved (group A) or thymol treatment (group B). The surface of the dentin was schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control-CG) or irradiated with Er:YAG laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ). Elemental distribution maps were done by energy-dispersive X-ray fluorescence (µ-EDXRF) on each treatment area. The dentin surface in depth was exposed and line-scan maps were performed. The B_CG treatment produced the best distribution of calcium (Ca) and phosphorus (P) content throughout the dentin surface. Er:YAG laser etching produced irregular patterns of elemental distribution in the dentin. Laser energies of 120 and 180 mJ produced the highest maximum calcium values. The Er:YAG laser energy of 180 mJ produced a localized increase in Ca and P content on the superficial layer of the dentin (∼ 0-0.10 mm). The autoclaving treatment of samples in experiments is not recommended since it produced damaging effects on dentin components. Er:YAG laser irradiation produced a heterogeneous Ca and P distribution throughout the dentin surface with areas of increased Ca concentration, and this may affect clinically the permeability, solubility, or adhesive characteristics of dental hard tissues with restorative procedures.

Influence of the parameters of the Er:YAG laser on the apical sealing of apicectomized teeth.

Failures in the sealing of the tooth apex have been considered to be responsible for most of the failures of apical surgeries. The Er:YAG laser has been proposed as an alternative for the use of rotator instruments in surgical endodontics due to its precision, lack of vibration, less post-operative discomfort, bacterial reduction, and less stress for patients and professionals. Following approval by the ethics committee, 12 extracted human canines without previous endodontic treatment with anatomically normal roots and free from apical lesions were washed in running tap water and disinfected. The teeth were sectioned axially at the crown-root junction and submitted to routine endodontic treatment. The apical limit was set at 1 mm before the apical foramen. The root canals were routinely filled with Gutta-Percha points and Sealer 26 and were randomly distributed into two groups (n = 6). In group I, apicectomy was performed with the Er:YAG laser (KAVO KEY Laser II®, Germany, λ = 2.940 nm, pulsed mode, 2051 tip, with air spray cooling, 250 mJ/15 Hz). Apical cut was performed of perpendicular mode 3 mm from the apical foramen. In group II, the same procedures and the same sequence as above was used, varying only the parameters of the Er:YAG laser (400 mJ/6 Hz). Sealing of the cervical end the apex was carried out with acrylic resin; the roots were covered by a layer of epoxy glue and two layers of nail polish. The specimens were divided into groups and fixed, by the cervical third, on wax. Impermeabilization of the residual root apical third was performed following the same procedures used in the cervical third but the residual apex was left free from the impermeabilization. After that, the roots were immersed in a 2% methylene blue solution and placed in a bacteriological oven for 48 h and then washed in running tap water for 2 h. The samples were sagittally split into two parts. The segments were visually observed and the one showing the greatest level of dye leakage was selected and kept in an individual container and coded accordingly. Apical staining was measured using a stereoscopic magnifying glass, a compass, and a caliper. The measurement was performed by three endodontists, previously calibrated, and unaware of the sample coding. The results showed that group I showed the greatest level of dye leakage. There was a significantly difference between the groups (p = 0.001). It is concluded that the apicectomies carried out with 400 mJ/6 Hz showed the smallest infiltration value.

Shear bond strength of two adhesive systems bonded to Er:YAG laser-prepared dentin.

Dentinal surfaces prepared with an Er:YAG laser have distinctly different characteristics compared to those prepared with conventional instruments. The objective of this study was to evaluate the shear bond strength of a total-etch adhesive system and a self-etch adhesive system to dentin, prepared conventionally or with an Er:YAG laser. Specimens that were prepared with a diamond bur and treated with the total-etch adhesive showed the highest mean bond strength, followed by specimens prepared with the laser and treated with the total-etch adhesive, specimens prepared with a diamond bur and treated with the self-etch adhesive, and specimens prepared with the laser and treated with the self-etch adhesive, but there were no differences among the groups (P > 0.05). These data indicate that the tested adhesive systems promote similar shear bond strengths, whether the dentin is prepared with a diamond bur or an Er:YAG laser, and that an Er:YAG laser is a suitable cavity preparation method that promotes an adequate surface for a posterior adhesive procedure.

In Vitro Evaluation of the Effectiveness of Dental Bleaching with Carbamide Peroxide and Violet Light.

Objective: The aim of the current study was to use the CIELab system to evaluate the performance of the whitening treatment involving violet light-emitting diode (LED) combined with a home 10% and 22% carbamide peroxide dental bleaching technique on dental enamel. Methods: Fifty blocks of bovine dental enamel were divided into five groups: control group (control), receiving only LED irradiation; Whitening 10%, receiving 10% carbamide peroxide treatment; Whitening 10%+VL, receiving 10% carbamide peroxide treatment combined with LED irradiation; Whitening 22%, receiving 22% carbamide peroxide treatment; and Whitening 22%+VL, receiving 22% carbamide peroxide treatment combined with violet LED irradiation. Color tests were performed before the protocols, after 1 week and after 2 weeks of treatment by using a spectrophotometer and the CIELab parameters: L*, (a*) and (b*). The Whitening 10%, Whitening 10%+VL, Whitening 22% and Whitening 22%+VL groups were submitted to 10% and 22% carbamide peroxide 8 h per day for 14 days, whereas the Control was only stored in artificial saliva. For irradiation in the Control, Whitening 10%+VL, and Whitening 22%+VL groups, we used violet LED at a wavelength of 405-410 nm activated for 60 permanent seconds and 30 sec of pause once per week. As all data exhibited normal distribution, the comparisons were performed by using two-way repeated-measures analysis of variance. A post hoc t-test was employed, followed by the Ryan-Holm stepdown Bonferroni procedure. Results: After 1 week, the Whitening 22%+VL group differed significantly from all other groups in relation to hue, while no difference was found between the remaining groups (p < 0.05). Analyzing lightness, the Whitening 22%+VL and Whiteness10%+VL groups differed from the other groups (p > 0.05). In the 2nd week, the Whitening 22%+VL groups differed significantly from all other groups (p < 0.05) in hue, chroma, and lightness. The comparative analysis of bleaching times within the same group revealed significant differences in the Whitening 22%+VL group between baseline and week 1, baseline and week 2, as well as weeks 1 and 2 in terms of hue (p > 0.05). In the Whitening 22%+VL group, significant differences (p < 0.05) were found between baseline and week 2 as well as between weeks 1 and 2 in chroma (p > 0.05). In the Whitening 22%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, baseline and week 2, as well as between weeks 1 and 2 in lightness. In the Whitening 10%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, between baseline and week 2, as well as between weeks 1 and 2 in lightness. Conclusions: Tooth whitening treatment involving 10% and 22% carbamide peroxide combined with violet light promoted changes in the three axes of color (ΔH, ΔC, and ΔL) of the specimens evaluated. The use of the gel bleach alone was more efficient when the higher concentration was used. When violet light was combined with the gel, the lower concentration was more efficient.

Clinical evaluation of in-office tooth whitening with violet LED (405 nm): A double-blind randomized controlled clinical trial.

BACKGROUND: Although there is little evidence showing the effectiveness of violet LED on in-office tooth whitening, there are some studies which have reported satisfactory results. This double-blind randomized controlled clinical trial aimed to evaluate the effect of a violet light emission diode (LED) (405 nm) system, used in-office, on tooth whitening, sensitivity, use of medication after whitening and quality of life. METHODS: Eight patients were randomized into 4 groups (n = 20): G1 - violet LED, G2 - 35% carbamide peroxide (CP) and violet LED, G3 only CP 35% and G4 35% hydrogen peroxide (HP). The color was measured using a spectrophotometer at the following times: baseline, 15 and 180days. The colorimetric changes were analyzed using measurements from the CieLab System ΔE (ΔL, Δa and Δb) and the WID (Whiteness Index for Dentistry) for the 4 groups. Tooth sensitivity was recorded via a visual analog scale (VAS). Additionally, the Psychosocial Impact of Dental. Aesthetics Questionnaire (PIDAQ) was used to evaluate quality of life. RESULTS: For the analysis of ΔL, G4 and G2 presented more brightness than G1 and G3 (p<0.05), implying that G2 is at least as good as G4 (p>0.05). For measure of Δa, G4 presented better results, standing out from the other groups. (p<0.05). For Δb, both G4 and G2 showed a greater tendency for blue color than groups G1 and G3 (p <0.05). When analyzing ∆E at the 180-day follow up, G4 produced the highest ∆E, while G3 showed the lowest ∆E. The other 2 whitening groups produced intermediate ∆E values. For ∆W, G1 and G3 significantly differed from G2 and G3. When analyzing the 180-day follow up, G2 produced the highest ∆W, while G3 showed the lowest ∆W. The other two whitening treatments produced intermediate ∆W values. As for sensitivity, only G4 patients showed dental sensitivity within 24 h of the bleaching, with pain ceasing after 48 h. For G4, 33% of the patients needed to take analgesics within the first 24 h after the first 3 whitening sessions. For PIDAQ, there was no overall decrease in score over time for any of the groups and there was no difference between them (p>0.05). CONCLUSION: Our results showed that violet LED was not able to whiten teeth at the same intensity, when used alone, as it was when associated with 35% CP, contrary to our initial hypothesis. However, given that pain was not consistently reported in G2, one could suggest that treatment with LED + 35% CP is quite similar to that of 35% HP when used for tooth whitening, but with better pain outcomes. All treatments suggested an improvement in quality of life.Clinical Trial Registry: This trial is registered at ClinicalTrials.gov; the registration number is NCT03192852 https://clinicaltrials.gov/ct2/show/NCT03192852.

Clinical Evaluation of In-Office Dental Bleaching Using a Violet Light-Emitted Diode.

Objective: To clinically evaluate the effect of the violet light-emitted diode (LED) light (405-410 nm) associated to in-office dental bleaching with 35% carbamide peroxide, on tooth color change and sensitivity. Participant's satisfaction after treatment was also evaluated. Materials and methods: A total of 50 participants were selected and randomized into a treatment group (n = 25): G1-two bleaching sessions of 30 min each, with 7-day interval (D0 and D7); G2-two bleaching sessions (same protocol as G1) associated with violet LED light, 30 min each session. The color evaluation was performed before and after 7 days of the second session (D0 and D14); the medium third of buccal surface of canine and central incisor teeth were evaluated under VITA Shade Guide and spectrophotometry (subjective and objective). Tooth sensitivity was evaluated immediately after the treatment and after 48 h of each bleaching session (D0, D2, D7, and D9), and a self-perception questionnaire was applied on D14. Results: Data were subjected to nonparametric Mann-Whitney test and both canine and central incisor teeth presented color change. Group G2 showed significantly more change than G1. Fisher's exact test showed no statistically significant dental sensitivity differences between groups. Both groups reported a high level of satisfaction but chi-square test showed statistically higher satisfied patients with dental bleaching in G2 than G1. Conclusions: The violet LED light (405-410 nm) could improve dental bleaching effectiveness, without sensitivity increase.

Effects of Er:YAG laser irradiation and manipulation treatments on dentin components, part 2: energy-dispersive X-ray fluorescence spectrometry study.

The effects of laser etching, decontamination, and storage treatments on dentin components were studied by energy-dispersive X-ray fluorescence spectrometry (EDXRF). Thirty bovine incisors were prepared to expose the dentin surface and then divided into two main groups based upon the decontamination process and storage procedure: autoclaved (group A, n=15) or stored in aqueous thymol solution (group B, n=15). The surfaces of the dentin slices were schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control subgroup) or irradiated with erbium-doped yttrium-aluminum-garnet (Er:YAG) laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ). Samples were analyzed by micro-EDXRF, yielding three spectra for each area (before and after treatment). Surface mappings covering an area of 80x60 points with steps of 20 mum were also performed on selected specimens. The amount of Ca and P in group A specimens decreased significantly (P<0.05) after the acid etching and the CaP ratio increased (P<0.001). Er:YAG laser-etching using lower laser energies did not produce significant changes in dentin components. The mapping data support the hypothesis that acid etching on dentin produced a more chemically homogeneous surface and thus a more favorable surface for the diffusion of adhesive monomers.

Effects of Er:YAG laser irradiation and manipulation treatments on dentin components, part 1: Fourier transform-Raman study.

The effects of laser etching, decontamination, and storage treatments on dentin components were studied using Fourier transform (FT)-Raman spectroscopy. Thirty bovine incisors were prepared to expose the dentin surface and then divided in two main groups based upon the decontamination process and storage procedure: autoclaved (group A, n=15) or stored in thymol aqueous solution (group B, n=15). The surfaces of the dentin slices were schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control subgroup) or irradiated with erbium-doped yttrium-aluminum-garnet (Er:YAG) laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ, and total energy of 12 J). Samples were analyzed by FT-Raman spectroscopy; we collected three spectra for each area (before and after treatment). The integrated areas of five Raman peaks were calculated to yield average spectra. The areas of the peaks associated with phosphate content (P<0.001), type I collagen, and organic C-H bonds (P<0.05) were reduced significantly in group A (control). Analyses of samples irradiated with reduced laser energies did not show significant changes in the dentin components. These results suggest that thymol storage treatment is advised for in vitro study; furthermore, 12 J of Er:YAG laser energy does not affect dentin components.

Microleakage of "Bulk-Fill" Composite Resin for Class II Restorations Pretreated With CO2 Laser in Deciduous Molars: An In Vitro Study.

Introduction: Microleakage has been reported to cause dentin hypersensitivity because of the passage of bacteria and their products through the restoration-tooth interface and is one of the main reasons for replacement of restorations. CO2 laser can be used for treatment of dentin hypersensitivity. Thus, this study aimed to evaluate in vitro the microleakage in composite restorations following surface pretreatment with acid etching and CO2 laser. Methods: Twelve human caries-free primary molars were selected. Class II cavities were prepared on occlusal mesial and occlusal distal surfaces. Specimens were randomly divided into four groups (n=6): Group 1 (G1) - 37% phosphoric acid gel etching + Beautiful-Bulk Restorative - Giomer (Shofu Inc); Group 2 (G2) - 37% phosphoric acid gel etching + SDR Bulk-Fill Flow (Dentsply); Group 3 (G3) - CO2 laser irradiation + Beautiful-Bulk Restorative - Giomer (Shofu Inc); Group 4 (G4) - CO2 laser irradiation + SDR Bulk-Fill Flow (Dentsply). Surfaces were restored with bonding agent (Natural Bond DE, DFL). Specimens were cut longitudinally and immersed in 0.5% methylene blue solution for 4 hours. Microleakage scores were assessed under a magnifying glass at x3,5 and qualitatively analyzed by scanning electron microscope (SEM). Data were analyzed using nonparametric Wilcoxon test (P < 0.05). Results: Scores prevailed between 0 and 2, however, no statistically significant difference was found among the groups (P = 0.05). Conclusion: It could be concluded that all composite resins bulk fill did not show significant difference among them regarding microleakage using either CO2 laser or 37% phosphoric acid etching.

Hemolasertherapy: A Novel Procedure for Gingival Papilla Regeneration-Case Report.

BACKGROUND: Interdental papilla is of major importance to patients' orofacial aesthetics, especially regarding anterior teeth as part of the smile's harmony. Loss of gingival tissue, which constitutes interdental papilla, forms what in odontology is called black spaces. This loss, besides affecting the smile's aesthetics, also provokes phonetic and functional damage. OBJECTIVE: The objective of the authors is to present the result of three clinical cases treated with an innovative technique called hemolasertherapy, which stimulates growth of gingival papilla and thus permanently fills in the black spaces. METHODS: The photobiomodulation therapy (PBMT) used a 660 nm diode laser (Laser Duo, MMO-São Carlos, SP, Brazil), punctual, contact mode in two steps: before the bleeding (first PBMT) and immediately after bleeding (second PBMT). Parameters used were power output: 100 mW, CW; diameter tip: 5 mm; spot area: 0.19 cm2; irradiation exposure time per point: 20 sec; 14 points per daily session; total of 2 sessions, with a 1-week interval; E: 2 J per point; E: per daily session, 28 J; irradiance per point: 0.52 W/cm2; fluence per point: 10.4 J/cm2. Total in two daily sessions: total energy: 56 J; total fluence: 294.75 J/cm, 560 sec total time. An in vitro preliminary study was simultaneously carried out to demonstrate what could happen at cellular level in hemotherapy clinical cases associated with PBMT laser application. RESULTS: This initial study demonstrated that the blood clot originated from the bleeding provoked in the gingival area is rich in mesenchymal stem cells. PBMT enables preservation, viability, and further differentiation, stimulating the return of gingival stem cells, which would support their survival and differentiation in the blood clot, thus favoring interdental papilla regeneration. CONCLUSIONS: Follow-up was done for a time span of 4-5 years and considered excellent with regard to papilla preservation.

Evaluation of in-office tooth whitening treatment with violet LED: protocol for a randomised controlled clinical trial.

INTRODUCTION: In-office tooth whitening treatment using violet light emited diode (LED) (405 nm) is a novel bleaching method that causes less sensitivity while offering the same effectiveness as the gold standard (35% hydrogen peroxide, H2O2). This study describes a protocol for the first randomised controlled clinical trial to compare the effects of the two methods. METHODS AND ANALYSIS: Eighty patients will be divided into four groups: G1 violet LED; G2 violet LED +35% carbamide peroxide; G3 35% H2O2 and G4 violet LED +gingivoplasty. Colour will be measured at baseline, immediately after the first session and at the 15 and 180 days follow-up using the Vita Classical and the digital Easyshade V spectrophotometer (Vita, Zahnfabrik, Germany). Sensitivity after whitening will be measured using the Visual Analogue Scale at baseline and at each session in all groups and in all follow-ups. The tissue removed during gingivoplasty (G4) will be submitted to immunohistochemical analysis for the determination of inflammatory changes caused by violet LED. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) will be evaluated before, as well as at established time point controls. The results will be expressed as mean and SD values. After determining the normality of the data, a one-way repeated-measures analysis of variance will be used for the comparison of data with normal distribution and the Kruskal-Wallis test will be used for data with non-normal distribution. A p<0.05 will be considered indicative of statistical significance. After determining the normality of the data, the Kruskal-Wallis test will be used for non-parametric data. Multivariate analysis of variance (MANOVA) and the Wilcoxon test will be used for comparing data from the PIDAQ. ETHICS AND DISSEMINATION: This protocol has been approved by the Human Research Ethics Committee of UniversidadeNove de Julho (certificate: 2.034.518). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03192852; Pre-results.

Effects of treatment for manipulation of teeth and Er:YAG laser irradiation on dentin: a Raman spectroscopy analysis.

OBJECTIVE: The main purpose of this study was to evaluate the utility of Raman spectroscopy analysis as a research tool to study the effects of Er:YAG laser etching on dentin mineral and organic components. A secondary aim was to study the effects of the decontamination process and the storage procedure on dentin components. BACKGROUND DATA: There are no spectroscopy reports relating the effects of Er:YAG laser irradiation as an alternative to acid etching and the manipulation process on the dentin structure. METHODS: Twelve non-carious human third molars were divided in two main groups: stored in thymol solution (group A, n = 6) or autoclaved (group B, n = 6). The specimens were either etched with 37% phosphoric acid (control subgroup) or irradiated with Er:YAG laser. Irradiated samples were divided into the following subgroups: I, II, and III (80 mJ, 3 Hz, 30 sec; 120 mJ, 3 Hz, 30 sec; and 180 mJ, 3 Hz, 30 sec, respectively). Samples were analyzed by Raman spectroscopy. RESULTS: The mineral and organic dentin contents were more affected in autoclaved teeth than in the specimens stored in thymol. Peak area reduction in group A specimens treated with phosphoric acid and pulse energy of 80 mJ were the most conservative surface treatments regarding changes in the peak area of organic and inorganic dentin components. CONCLUSION: The autoclaving process and pulse energies of 120 and 180 mJ produced greater reduction of organic and inorganic contents in dentin, associated with greater reduction in the areas of 968, 1077, 1460, and 1670 cm(1) Raman peaks.

Combined FT-Raman and SEM studies of the effects of Er:YAG laser irradiation on dentin.

OBJECTIVE: This study evaluated the molecular and morphological changes on dentin elements after Er:YAG laser irradiation. BACKGROUND DATA: Spectroscopy studies reporting the effects of Er:YAG laser irradiation as an alternative to acid etching are needed to better understand the laser's effects. METHODS: The occlusal one-third of the crown of six human third molars was removed. The dentin surface was schematically divided into areas corresponding to four surface treatment groups: control (group C): 37% phosphoric acid etching; group I: Er:YAG laser 80 mJ; group II: Er:YAG laser 120 mJ; and group III: Er:YAG laser 180 mJ. The analysis was performed by scanning electron microscopy (SEM) and Fourier transform Raman spectroscopy (FT-Raman) before and after the treatments. Raman data were submitted to ANOVA and Bonferroni tests. RESULTS: The SEM photomicrographs revealed open dentin tubules in the control group. The molars from groups I, II, and III showed partially open dentin tubules. SEM images showed that the laser-irradiated dentin surface was not favorable to the diffusion of monomers. A significant reduction of the spectra relative intensity was observed in group III specimens. CONCLUSIONS: Er:YAG laser irradiation with 180 mJ could produce chemical changes in proteins, phosphate, and carbonate in dentin.

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.

Molecular analysis of Er:YAG laser irradiation on dentin.

The aim of this study was to evaluate by dispersive Raman spectroscopy the mineral and organic components of human dentin before and after laser irradiation and acid etching. The occlusal enamel of six non-carious human third molars was removed providing 6 dentin discs, which were divided in four quadrants each of them receiving a different surface treatment: etching with a 37% phosphoric acid gel (control); irradiation by Er:YAG laser (KaVo Key Laser II) with 80 mJ, 3 Hz, 30 s (group I); 120 mJ, 3 Hz, 30 s (group II); and 180 mJ, 3 Hz, 30 s (group III). The Raman spectra of normal (untreated) and treated dentin were analyzed and the mineral and the organic component were evaluated. Results were submitted to statistical analysis by ANOVA and Tukey's test at 5% significance level. The minerals and organic content were less affected in the control group and group I (p>0.05). Group II presented more reduction in mineral content (p<0.01) whereas in group III the inorganic (p<0.05) and organic (p<0.01) content were more affected. Dispersive Raman spectroscopy provided valid information of dentin chemical constituents with non-chemical sampling preparation.

Morphological comparative study on ablation of dental hard tissues at cavity preparation by Er:YAG and Er,Cr:YSGG lasers.

OBJECTIVE: The purpose of this study was to evaluate morphologically the dental hard tissue ablation at the class V cavity preparation by two types of laser devices: Er:YAG and Er,Cr:YSGG lasers in vitro. BACKGROUND DATA: There have been no reports on the comparative study of dental tissue ablation at cavity preparation by Er:YAG and Er,Cr:YSGG lasers. METHODS: Twenty-two extracted human mature molar teeth were used in this study and divided into two groups of 11 teeth each. The teeth of the Er:YAG laser-irradiated group were irradiated at the parameters of 250 mJ/pulse and 15 Hz with water spray, and those of the Er,Cr:YSGG laserirradiated group were irradiated at the parameters of 5 Wand 20 Hz with water spray. After cavity preparation, the teeth were dehydrated, coated with platinum, and examined by scanning electron microscopy. RESULTS: Both of the laser devices were capable of ablating dental hard tissues, but similar, irregular, and rugged surface aspects with different depths were observed. Open dentinal tubules at the cavities prepared by Er,Cr:YSGG laser were more clearly visible than those prepared by Er:YAG laser. Smaller width and stripped surfaces were observed on the cavities prepared by Er,Cr:YSGG laser. CONCLUSION: The results suggested that there is little difference between the two types of lasers-Er:YAG and Er,Cr:YSGG lasers-morphologically for class V cavity preparation, because both lasers were capable of preparing class V cavities, and the morphological features of the irradiated surfaces were very similar.