Influence of Er:YAG laser surface treatment on flexural and bond strengths to glass-infiltrated zirconia-reinforced ceramic.

To evaluate the effect of Er:YAG laser conditioning of a glass-infiltrated alumina-based zirconia-reinforced ceramic on its flexural strength and on bonding to a resin cement. Sixteen blocks (5 × 5 × 4 mm) and 50 discs (Ø 12 mm, 1 mm thickness) of In-Ceram Zirconia (ICZ) obtained from CAD-CAM blocks were infiltrated with glass. For the microtensile bond strength (µTBS) test, all blocks were treated with aluminum oxide (AOX) and divided into 4 groups (n = 4): G1 (AOX), no combined surface treatment; G2 (ROC), tribochemical silica-coating; G3 (EY200), Er:YAG laser 200 mJ/15 Hz; and G4 (EY250), Er:YAG laser 250 mJ/10 Hz. The ceramic blocks were silanated and cemented with a resin cement (Panavia F2.0/Kuraray) to composite resin blocks and subjected to the µTBS test. For the flexural strength evaluation, the discs were divided into 5 groups (n = 10) as described above, in addition to a control group (G5 - CTRL, mirror-polished without further treatment). Each surface treatment was submitted to qualitative evaluation under SEM. One-way ANOVA (α = 5%) revealed the highest bond strength value for EY200 with no significant difference from ROC. The groups AOX and EY250 showed similar µTBS values that were statistically lower than those of EY200. For flexural strength, ROC was the only group with significantly lower values when compared with the CTRL. The use of Er:YAG laser at 200 mJ/15 Hz can be considered an innovative and effective alternative for surface conditioning of ICZ since it did not reduce the flexural strength of the ceramic and improved the resin cement bond to this substrate.

Is photobiomodulation (PBM) effective for the treatment of dentin hypersensitivity? A systematic review.

The present study aims to evaluate the current scientific data regarding the effectiveness of photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH) as an alternative method for pain control. A systematic review was conducted to assess the effectiveness of PBM as treatment for DH. A complete literature search was performed up to October 2016. Searches were conducted using Boolean operators and MeSH terms. References of all selected full-text articles and related reviews were scanned. A total of 280 articles were identified (241 articles were excluded by the title and abstract). Of the 39 articles selected for analysis, 36 were excluded because they presented one or more exclusion criteria. Therefore, three articles were qualified for inclusion in this systematic review. PBM may not lead to adverse effects provided that adequately controlled parameters are followed when treating DH. More consistent studies should be conducted in order to adequately observe the advantageous therapeutic effect of PBM.

Evaluation of different treatment protocols for dentin hypersensitivity: an 18-month randomized clinical trial.

This randomized and longitudinal in vivo study aimed to assess different protocols for the treatment of dentin hypersensitivity with low-power laser (with different doses), high-power laser, and a desensitizing agent, for a period of 12 and 18 months. The lesions from 32 patients (117 lesions), who were submitted to the inclusion and exclusion criteria, were divided into nine groups (n = 13): G1: Gluma Desensitizer (Heraeus Kulzer), G2: low-power laser with low dose (three points of irradiation in vestibular portion and an apical point 30 mW, 10 J/cm2, 9 s per point with the wavelength of 810 nm, with three sessions with an interval of 72 h), G3: low-power laser with high dose (one point in the cervical area, and one apical point 100 mW, 40 J/cm2, 11 s per point with the wavelength of 810 nm in three sessions with an interval of 72 h), G4: low-power laser with low dose + Gluma Desensitizer, G5: low-power laser with high dose + Gluma Desensitizer, G6: Nd:YAG laser (Power Laser™ ST6, Research® in contact 1.0 W, 10 Hz and 100 mJ, ≈85 J/cm2, with the wavelength of 1064 nm), G7: Nd:YAG laser + Gluma Desensitizer, G8: low-power laser with low dose + Nd:YAG laser, and G9: low-power laser with high dose + Nd:YAG laser. The level of sensitivity of each volunteer was assessed by visual analog scale of pain (VAS) with the aid of air from the triple syringe and exploration probe, 12 and 18 months after treatment. All analyses were performed separately for air and probe stimulus. The level of significance was considered for values of p < 0.05. After statistical analysis, all treatments were shown to be effective in reducing dentinal hypersensitivity, and the results were considered not statistically different from those at 12 months. Therefore, until the 18-month evaluation, it could be said that no statistical differences were observed in the sensitivity levels for all treatments.

A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis.

This randomized placebo-blind study aimed to evaluate the effect of laser phototherapy (LPT) on pain caused by symptomatic irreversible pulpitis (SIP). Sixty patients diagnosed with SIP were randomly assigned to treatment groups (n = 15): G1 (control), G2 (laser placebo-sham irradiation), G3 (laser irradiation at 780 nm, 40 mW, 4 J/cm2), and G4 (laser irradiation at 780 nm, 40 mW, 40 J/cm2). Spontaneous pain was recorded using a VAS score before (T0), immediately after (T1), and 15 min after treatment (T2). Local anesthetics failure during emergency endodontic treatment was also assessed. There was no pain difference in T1 and T2 between the experimental laser groups (G3 and G4) and the placebo group (G2). The 4-J/cm2 (G3) irradiation resulted in significant increase in the local anesthetics failure in lower jar teeth. This effect could be suggested as consequence of the LPT improvement in local circulation and vasodilatation that would result in the increase of local anesthetic agent absorption. The application of 780-nm diode laser irradiation, at 4 and 40 J/cm2, showed no effect in reducing the pain in SIP in comparison to the placebo group. The fluence of 4 J/cm2 showed a negative effect in local anesthetics, resulting in significant increase of complimentary local anesthesia during emergency endodontic treatment. This work provides evidence of the consequence of LPT application on teeth with symptomatic irreversible pulpitis. LPT should be avoided in teeth with pain due to irreversible pulpitis.

Effects of Er:YAG and Er,Cr:YSGG laser irradiation on the adhesion to eroded dentin.

Limited information is available regarding the adhesion to eroded dentin. This study aims to evaluate the effect of different surface treatments on eroded dentin morphology and on microtensile bond strength (µTBS) of adhesive systems to this substrate. Ninety-six extracted third molars were randomly divided into eight groups (n = 12) according to the type of surface treatment and the adhesive system: G1 = Control + Clearfil SE Bond [SE], G2 = Diamond bur [DB] + SE, G3 = Er:YAG laser (60 mJ, 2 Hz, 0.12 W, 19.3 J/ cm(2)) + SE, G4 = Er,Cr:YSGG laser (50 mJ, 30 Hz, 1.5 W, 4.5 J/ cm(2)) + SE, G5 = Control + Single Bond [SB], G6 = DB + SB, G7 = Er:YAG + SB, G8 = Er,Cr:YSGG + SB. The erosive cycling was performed by immersion in 0.05 M citric acid (pH 2.3, 10 min, 6x/day) and in supersaturated solution (pH 7.0, 1 h, between acid attacks), during 5 days. Blocks of composite were bonded to the samples according to the manufacturers' instructions. After 24 h-storage in distilled/deionized water (37 °C), stick-shaped samples were obtained and submitted to µTBS test. Each surface treatment was analyzed under scanning electron microscopy (n = 4) and the bond strength values (megapascal) were analyzed by two-way ANOVA and Tukey tests (α = 0.05). All surface treatments lead to changes on eroded dentin. G4 showed the highest bond strength mean (28.3 ± 9.2 MPa), which was statistically significant higher than all the other groups (p < 0.05). The surface treatment with Er,Cr:YSGG laser irradiation (4.5 J/cm(2)/50 mJ/30 Hz/140 µs) prior to bonding with a self-etching adhesive system significantly increases adhesion to eroded dentin, as compared to conventional treatment.

Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation.

Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost-effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval -5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8°C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs.

Microtensile bond strength analysis of adhesive systems to Er:YAG and Er,Cr:YSGG laser-treated dentin.

The aim of this in vitro study was to evaluate the effect of different surface treatments (control, diamond bur, erbium-doped yttrium aluminum garnet (Er:YAG) laser, and erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser) on sound dentin surface morphology and on microtensile bond strength (µTBS). Sixteen dentin fragments were randomly divided into four groups (n = 4), and different surface treatments were analyzed by scanning electron microscopy. Ninety-six third molars were randomly divided into eight groups (n = 12) according to type of surface treatment and adhesive system: G1 = Control + Clearfil SE Bond (SE); G2 = Control + Single Bond (SB); G3 = diamond bur (DB) + SE; G4 = DB + SB, G5 = Er:YAG laser (2.94 µm, 60 mJ, 2 Hz, 0.12 W, 19.3 J/cm(2)) + SE; G6 = Er:YAG + SB, G7 = Er,Cr:YSGG laser (2.78 µm, 50 mJ, 30 Hz, 1.5 W, 4.5 J/cm(2)) + SE; and G8 = Er,Cr:YSGG + SB. Composite blocks were bonded to the samples, and after 24-h storage in distilled/deionized water (37 °C), stick-shaped samples were obtained and submitted to µTBS test. Bond strength values (in megapascal) were analyzed by two-way ANOVA and Tukey tests (α = 0.05). G1 (54.69 ± 7.8 MPa) showed the highest mean, which was statistically significantly higher than all the other groups (p < 0.05). For all treatments, SE showed higher bond strength than SB, except only for Er,Cr:YSGG treatment, in which the systems did not differ statistically from each other. Based on the irradiation parameters considered in this study, it can be concluded that Er:YAG and Er,Cr:YSGG irradiation presented lower values than the control group; however, their association with self-etching adhesive does not have a significantly negative effect on sound dentin (µTBS values of >20 MPa).

Association of different primers and resin cements for adhesive bonding to zirconia ceramics.

PURPOSE: To evaluate the shear bond strength (SBS) to zirconia ceramics using different associations of primers and resin cements. MATERIALS AND METHODS: Two blocks of LAVA zirconia (3Y-TZP) were randomly submitted to an application of three different commercially available primers: Alloy Primer (AP), Z-Prime Plus (ZP), and Signum Zirconia Bond (SZB). Nonprimed specimens were considered controls. After treatment, the 80 specimens (5 mm × 5 mm × 2 mm) were randomly cemented with one of the resin cements: Panavia F, Multilink, seT, and NX3. For cementation, cylinders of resin cement were built on the ceramic surfaces using the SDI SBS apparatus. The specimens were submitted to the SBS test. Fractured surfaces were observed under stereomicroscopy to determine the failure mode, and mean bond strength values were analyzed using the Kruskal-Wallis and Mann-Whitney tests (α = 0.05). RESULTS: Signum Zirconia Bond had the highest SBS compared to all other primers and the control group, regardless of the resin cement used. The highest values were obtained when associating Panavia F with Signum Zirconia Bond. Alloy Primer increased bonding values when associated with seT cement only. When no primer was used, no statistical difference was observed among resin cements. All specimens fractured due to adhesive failure. CONCLUSION: Signum Zirconia Bond is capable of increasing bonding values of resin cements to zirconia ceramics. Its association with Panavia F shows enhanced results when considering short-term adhesion to zirconia.

Analysis of the interfacial micromorphology and bond strength of adhesive systems to Er:YAG laser-irradiated dentin.

UNLABELLED: This study evaluated the effects of different parameters of dentin irradiation with erbium -doped yttrium aluminum garnet (Er:YAG) laser on bond strength to dentin and analyzed the ultramorphological characteristics of resin-laser-irradiated dentin interfaces using a transmission electron microscope (TEM). Dentin surfaces were abraded with SiC paper (600 grit) or Er:YAG laser-irradiated (120/4, 140/6, 180/4, or 200/6 mJ/Hz). Three adhesive systems were tested: Single Bond Plus (3M ESPE), Clearfil Protect Bond (Kuraray Med.), and Clearfil Tri-S Bond (Kuraray Med.). Treatments were performed over flat dentin surfaces of human third molars. Specimens were stored in distilled water for 1 week or 6 months and prepared for a microtensile bond strength test and interfacial ultrastructure for analysis. Microtensile bond strength data (n = 5) were analyzed with three-way analysis of variance. Irradiation with Er:YAG laser did not reduce the bond strength values for self-etching adhesives even after 6 months of water storage. The hybrid layer formation was observed only when the adhesives were applied to non-irradiated dentin (control group). Nanoleakage occurred in all resin-dentin interfaces using Single Bond Plus for both periods. Nanoleakage pattern and bond strength of self-etching adhesives to dentin were less affected by Er:YAG laser irradiation and by the 6-month storage in water than was those of the etch-and-rinse adhesive. TEM analysis revealed no hybridization when dentin was laser-irradiated. CLINICAL SIGNIFICANCE: Minimally invasive caries removal has been proposed. Nevertheless, bonding mechanisms to lased dentin are not entirely described. Knowing the interaction between the treated dentin and bonding agents and its behavior over time is of utmost importance for new technologies. Regarding that, two-bottle self-etching adhesive system provided a more consistent evidence of its better behavior when bonding to lased substrate.

Micromorphology of resin-dentin interfaces using one-bottle etch&rinse and self-etching adhesive systems on laser-treated dentin surfaces: a confocal laser scanning microscope analysis.

BACKGROUND AND OBJECTIVES: This study evaluated the hybrid layer (HL) morphology created by three adhesive systems (AS) on dentin surfaces treated with Er:YAG laser using two irradiation parameters. STUDY DESIGN: Occlusal flat dentin surfaces of 36 human third molars were assigned into nine groups (n = 4) according to the following ASs: one bottle etch&rinse Single Bond Plus (3M ESPE), two-step Clearfil Protect Bond (Kuraray), and all-in-one S(3) Bond (Kuraray) self-etching, which were labeled with rhodamine B or fluorescein isothiocyanate-dextran and were applied to dentin surfaces that were irradiated with Er:YAG laser at either 120 (38.7 J/cm(2)) or 200 mJ/pulse (64.5 J/cm(2)), or were applied to untreated dentin surfaces (control group). The ASs were light-activated following MI and the bonded surfaces were restored with resin composite Z250 (3M ESPE). After 24 hours of storage in vegetable oil, the restored teeth were vertically, serially sectioned into 1-mm thick slabs, which had the adhesive interfaces analyzed with confocal laser microscope (CLSM-LSM 510 Meta). CLSM images were recorded in the fluorescent mode from three different regions along each bonded interface. RESULTS: Non-uniform HL was created on laser-irradiated dentin surfaces regardless of laser irradiation protocol for all AS, while regular and uniform HL was observed in the control groups. "Stretch mark"-like red lines were found within the HL as a result of resin infiltration into dentin microfissures, which were predominantly observed in 200 mJ/pulse groups regardless of AS. Poor resin infiltration into peritubular dentin was observed in most regions of adhesive interfaces created by all ASs on laser-irradiated dentin, resulting in thin resin tags with neither funnel-shaped morphology nor lateral resin projections. CONCLUSION: Laser irradiation of dentin surfaces at 120 or 200 mJ/pulse resulted in morphological changes in HL and resin tags for all ASs evaluated in the study.

The influence of erbium:yttrium-aluminum-garnet laser ablation with variable pulse width on morphology and microleakage of composite restorations.

The objective of this study was to evaluate the influence of various pulse widths with different energy parameters of erbium:yttrium-aluminum-garnet (Er:YAG) laser (2.94 mum) on the morphology and microleakage of cavities restored with composite resin. Identically sized class V cavities were prepared on the buccal surfaces of 54 bovine teeth by high-speed drill (n = 6, control, group 1) and prepared by Er:YAG laser (Fidelis 320A, Fotona, Slovenia) with irradiation parameters of 350 mJ/ 4 Hz or 400 mJ/2 Hz and pulse width: group 2, very short pulse (VSP); group 3, short pulse (SP); group 4, long pulse (LP); group 5, very long pulse (VLP). All cavities were filled with composite resin (Z-250-3 M), stored at 37 degrees C in distilled water, polished after 24 h, and thermally stressed (700 cycles/5-55 degrees C). The teeth were impermeabilized, immersed in 50% silver nitrate solution for 8 h, sectioned longitudinally, and exposed to Photoflood light for 10 min to reveal the stain. The leakage was evaluated under stereomicroscope by three different examiners, in a double-blind fashion, and scored (0-3). The results were analyzed by Kruskal-Wallis test (P > 0.05) and showed that there was no significant differences between the groups tested. Under scanning electron microscopy (SEM) the morphology of the cavities prepared by laser showed irregular enamel margins and dentin internal walls, and a more conservative pattern than that of conventional cavities. The different power settings and pulse widths of Er:YAG laser in cavity preparation had no influence on microleakage of composite resin restorations.

Influence of etching with erbium, chromium:yttrium-scandium-gallium-garnet laser on microleakage of class V restoration.

The aim of this in vitro study was to evaluate some parameters of dental etching when irradiated with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. One-hundred sound human third molars were selected and randomly distributed into ten groups (n = 10). The class V cavities of group 1 (control) were prepared with a bur and etched with 37% phosphoric acid, while groups G2 to G10, were prepared with laser (5 W, 88.46 J/cm(2), 90/70% air/water) and etched with the following powers: G3 and G4, 0.25 W; G5 and G6, 0.5 W; G7 and G8, 0.75 W; G9 and G10, 1 W. Group G2 received no laser etching. Prior to restoration, G2, G4, G6, G8 and G10 received acid etching. After restoration, all samples were submitted to a microleakage test. According to statistical analysis (Kruskal-Wallis and Dunn's tests), G10 presented the lowest microleakage values (P<0.05). The other groups showed no differences between them. Etching with Er,Cr:YSGG laser (1 W) followed by phosphoric acid was effective in reducing the microleakage of class V restorations.

Calcitonin, sodium alendronate and high intensity laser in the treatment of traumatized teeth: a preliminary study.

The aim of this study was to evaluate the influence of erbium:yttrium-aluminum-garnet (Er:YAG) laser compared with traditional treatment on dentin permeability to calcitonin and sodium alendronate. Forty bovine roots were sectioned and divided into eight groups. Groups 1 and 2 (G1/G2) were immersed in saline solution; G1T/G2T were immersed in ethylene diamine tetra-acetic acid plus sodium lauryl ether sulfate (EDTA-T) and sodium hypochlorite (NaOCl); G1I/G2I were irradiated with Er:YAG laser (2.94 microm, 6 Hz, 40.4 J/cm(2)); G1TI/G2TI were immersed in EDTA-T, NaOCl and subjected to Er:YAG irradiation. After 4 h the radioactivity of the saline solution was measured. Statistical analysis revealed a significant difference (P < 0.05) when the groups treated with EDTA-T and NaOCl followed by Er:YAG laser irradiation were compared with the groups treated with EDTA-T only and with the groups that received no treatment. Er:YAG laser associated with traditional procedures significantly increased the diffusion of calcitonin and sodium alendronate through dentin. All groups showed calcitonin and sodium alendronate diffusion.

Adhesives bonded to erbium:yttrium-aluminum-garnet laser-irradiated dentin: transmission electron microscopy, scanning electron microscopy and tensile bond strength analyses.

The aim of this in vitro study was to investigate the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation on dentinal collagen by transmission electron microscopy and to analyze the resin-dentin interface by scanning electron microscopy. A tensile bond strength test was also applied. Specimens from 69 sound human third molars were randomly divided into three groups: control (no laser), and two irradiated groups, laser 250 (250 mJ/2 Hz) and laser 400 (400 mJ/4 Hz). Then, specimens were restored with two adhesive systems, an etch-and-rinse or a self-etch system. Although ultrastructural examination showed a modified surface in the irradiated dentin, there was no statistical difference in bond strength values between the laser groups and controls (P < 0.05). In conclusion, the use of Er:YAG laser for ablating human dentin did not alter the main adhesion parameters when compared with those obtained by conventional methods, thus reinforcing its use in restorative dentistry.

Laser phototherapy in the treatment of periodontal disease. A review.

Many studies in the literature address the effect of low-power lasers in the management of pathologies related to periodontal tissues. Due to the lack of standardized information and the absence of a consensus, this review presents the current status of laser phototherapy (LPT) in periodontics and discusses its benefits and limits in the treatment of periodontal disease. The literature was searched for reviews and original research articles relating to LPT and periodontal disease. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. The literature search retrieved references on wound and bone healing, analgesia, hypersensitivity, inflammatory process and antimicrobial photodynamic therapy. Each topic is individually addressed in this review. The current literature suggests that LPT is effective in modulating different periodontal disease aspects in vitro, in animals, and in simple clinical models. Further development of this therapy is now dependent on new clinical trials with more complex study designs.

Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium-aluminum-garnet laser irradiation. A scanning electron microscopy study.

The purpose of this study was to evaluate the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser (2.94 mum) irradiation on the removal of root surface smear layer of extracted human teeth and to compare its efficacy with that of citric acid, ethylenediamine tetra-acetic acid (EDTA), or a gel containing a mixture of tetracycline hydrochloride (HCl) and citric acid, using scanning electron microscopy (SEM). Thirty human dentin specimens were randomly divided into six groups: G1 (control group), irrigated with 10 ml of physiologic saline solution; G2, conditioned with 24% citric acid gel; G3, conditioned with 24% EDTA gel; G4, conditioned with a 50% citric acid and tetracycline gel; G5, irradiated with Er:YAG laser (47 mJ/10 Hz/5.8 J/cm(2)/pulse); G6, irradiated with Er:YAG laser (83 mJ/10 Hz/10.3 J/cm(2)/pulse). Electron micrographs were obtained and analyzed according to a rating system. Statistical analysis was conducted with Kruskal-Wallis and Mann-Whitney tests (P < 0.05). G1 was statistically different from all the other groups; no statistically significant differences were observed between the Er:YAG laser groups and those undergoing the other treatment modalities. When the two Er:YAG laser groups were compared, the fluency of G6 was statistically more effective in smear layer removal than the one used in G5 (Mann-Whitney test, P < 0.01). Root surfaces irradiated by Er:YAG laser had more irregular contours than those treated by chemical agents. It can be concluded that all treatment modalities were effective in smear layer removal. The results of our study suggest that the Er:YAG laser can be safely used to condition diseased root surfaces effectively. Furthermore, the effect of Er:YAG laser irradiation on root surfaces should be evaluated in vivo so that its potential to enhance the healing of periodontal tissues can be assessed.

Bioactive glass and high-intensity lasers as a promising treatment for dentin hypersensitivity: An in vitro study.

This in vitro study aimed to analyze the physical and chemical characteristics of the hypersensitive human dentin-like surface after application of a bioactive glass (BG) paste (BG/Ac) irradiated or not with high-power lasers. Dentin specimens were treated with 17% Ethylenediamine tetraacetic acid (EDTA) solution to mimic a hypersensitive dentin and then submitted to neodymium: yttrium-aluminum-garnet (Nd:YAG) laser or CO2 laser irradiation prior and after application of BG/Ac. Characterizations were performed by using X-ray diffraction, Fourier transformed infrared spectroscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy. The results suggested that application of BG/Ac by itself caused some obstructions of dentinal tubules. Nd:YAG laser irradiation reduced the opening of the dentinal tubules with no changes in the collagen structure. CO2 laser irradiation caused dentin melting and resolidification along with cracks and chemical changes in collagen fibers. However, when BG/Ac paste was irradiated with lasers, a sequence of surface reactions between glass and dentin interface led to the formation of an amorphous hydroxyapatite layer, similar to that of an inorganic component of the normal dentin. Moreover, BG/Ac was able to prevent the formation of cracks and degradation of collagen fibers caused by CO2 irradiation. Overall, this study supports that application of BG/Ac paste irradiated by high-power laser could represent an effective and long-lasting therapeutic approach for dentin hypersensitivity.

The use of Er:YAG laser for cavity preparation: an SEM evaluation.

OBJECTIVE: The purpose of this study was to evaluate morphological changes in cavities prepared by the Er:YAG laser (2.94 mum) at different parameters of irradiation and by a diamond bur. EXPERIMENTAL DESIGN: Cavities were prepared on 27 human molars (n = 3): G1, 15 Hz/160 mJ enamel/6 Hz/200 mJ dentin; G2, 15 Hz/180 mJ enamel/6 Hz/200 mJ dentin; G3, 15 Hz/160 mJ enamel/6 Hz/250 mJ dentin; G4, 15 Hz/180 mJ enamel/6 Hz/250 mJ dentin; G5, 15 Hz/180 mJ enamel/10 Hz/180 mJ dentin; G6, 15 Hz/160 mJ enamel/10 Hz/180 mJ dentin; G7, 15 Hz/160 mJ enamel/10 Hz/160 mJ dentin; G8, 15 Hz/180 mJ enamel/10 Hz/160 mJ dentin; G9, diamond bur. For SEM analysis, samples were fixed (2.5% glutaraldheyde, 12 h, 4 degrees C), dehydrated (25-100% ethanol), dried, and sputter-coated with gold. RESULTS: Despite the changes on energy and repetition-rate settings, all laser-treated samples showed no evidence of thermal damage or signs of burning and melting. Er:YAG laser ablated dental hard tissues showed exposed enamel prisms, dentin surface without smear layer, and opened dentinal tubules. CONCLUSION: Different Er:YAG laser parameters were effective for ablation of hard tissues, creating an irregular and microretentive morphological pattern without hard tissue damage.

Analysis of the interfacial micromorphology of adhesive systems in cavities prepared with Er,Cr:YSGG, Er:YAG laser and bur.

The purpose of this in vitro study was to evaluate the interaction pattern of adhesive systems on laser and bur cavities. Cavities were prepared according to the following groups (n=9): (G1) conventional diamond bur (No. 1013); (G2) Er:YAG laser (250 mJ, 4 Hz, 80.6 J/cm2); (G3) Er,Cr:YSGG laser (3.5 W, 20 Hz, 61.7 J/cm2). After cavity preparation, specimens were divided into three subgroups differing the adhesive systems used (n=3): (GA) AdheSE; (GB) Clearfil standard error (SE) Bond; (GC) Single Bond. After insertion of a micro-hybrid composite resin, the specimens were sectioned across the bonded surface dividing the teeth into two halves, which were prepared for SEM analysis. Cavities prepared with laser appeared to be more irregular than the bur cavities. Different patterns of gap formation and resin tags could be observed, showing the differences, advantages, and disadvantages of both types of cavities. Under the settings of the present study, resin tags were more pronounced in lased dentin than bur prepared dentin independently of the bonding systems used. On the other hand gap formation between dentin and resin in laser prepared cavities was observed suggesting collagen alteration.