Blue Laser for Polymerization of Bulk Fill Composites: Influence on dentin bond strength and temperature rise during curing and co-curing method.

Blue diode lasers are alternative curing devices for dental composites. The aim of this study was to investigate the influence of blue diode laser polymerization on shear bond strength of bulk fill composites to human dentin and temperature rise during two types of polymerization. Composite cylinders of SDR Plus(SDR) and Ever X Flow(EX) were bonded to dentin slabs using Adhese Universal and curing devices blue diode laser (449 nm, 1.6 W) and Power Cure LED. For each material and curing device there were two polymerization approaches: 1)conventional: separate curing of adhesive; 2)co-curing: simultaneous adhesive and composite curing. Polymerization modes for each material in conventional and co-curing(c) approach were: blue laser 2000 mW/cm2 for 5 s (L5 and L5c); blue laser 1000 mW/cm2 for 10 s (L10 and L10c); Power Cure 2000 mW/cm2 for 5 s (LED5 and LED5c); Power Cure 1000 mW/cm2 for 10 s (LED10 and LED10c). Temeperature was measured using thermal vision camera. For SDR, the highest bond strength was 24.3 MPa in L10c, and the lowest 9.2 MPa in LED5c. EX exhibited the highest bond strength(21.3 MPa) in LED5, and the lowest in L5(7.7 MPa). The highest temperature rise for SDR was in L10 and L5 (7.3 and 7.2 °C), and the lowest in LED5(0.8 °C). For EX, the highest temperature rise was in L5 (13.0 °C), and the lowest in LED5 (0.7 °C). Temperature rise was higher during blue laser polymerization, especially at high intensity and with conventional curing. Preferable blue laser curing mode is co-curing at 1000mW/cm2 for 10 s.

Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface class II restorations: a 5-year randomised multi-centre study.

OBJECTIVE: To evaluate the 5-year clinical performance of a glass hybrid restorative system and a nano-hybrid resin composite in moderate to large two-surface class II cavities. MATERIALS AND METHODS: This study was carried out by dental schools in Zagreb, Croatia; Izmir, Turkey; Belgrade, Serbia; and Milan, Italy. A total of 180 patients requiring two class-II two-surface restorations in the molars of the same jaw were recruited. The teeth were randomly restored with either a nano-hybrid resin composite (Tetric EvoCeram, Ivoclar Vivadent) or a glass-hybrid material (EQUIA Forte, GC). During the 5-year follow-up, two calibrated evaluators at each centre scored the restorations annually using the FDI-2 scoring system. The survival rates were calculated using the Kaplan-Meier method and compared using non-parametric matched pair tests (p < 0.05). RESULTS: There were no statistically significant differences between the overall survival and success rates of the two types of restorations (p>0.05). The success rates (FDI-2 scores 1-3) for EQUIA Forte were 81.9% (average annual failure rate: 3.9%) and 90.7% for Tetric EvoCeram (average annual failure rate: 1.9%). The survival rates (FDI-2 scores 1-4) for EQUIA Forte and Tetric EvoCeram were 94.5% and 94.4%, respectively, with an average annual failure rate of 1.1%. CONCLUSIONS: In terms of success and survival rates, both the glass-hybrid restorative system and the nano-hybrid resin composite have been shown to perform satisfactorily. CLINICAL RELEVANCE: The results of this study indicate that EQUIA Forte can be one of the therapeutic options for moderate to large two-surface class II restorations of posterior teeth.

Efficacy of Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS) in the Removal of Different Combinations of Sealers Used with Two Obturation Techniques: A Micro-CT Study.

This study sought to evaluate the efficacy of SWEEPS in the removal of epoxy-resin-based and calcium-silicate-containing endodontic sealer combined with single-cone and carrier-based obturation techniques through a micro-CT analysis. Seventy-six single-rooted extracted human teeth with single root canal were instrumented with Reciproc instruments. Specimens were randomly divided into four groups (n = 19) according to the root canal filling material and obturation technique: (1) AH Plus sealer + Reciproc gutta-percha, (2) TotalFill BC sealer + TotalFill BC Points, (3) AH Plus sealer + Guttafusion obturator, and (4) MTA Fillapex + Guttafusion obturator. All specimens were re-treated one week later using Reciproc instruments. Following re-treatment, root canals were additionally irrigated using the Auto SWEEPS modality. The differences in the root canal filling remnants were analyzed by micro-CT scanning of each tooth after root canal obturation, after re-treatment, and after additional SWEEPS treatment. Statistical analysis was performed using an analysis of variance (p < 0.05). The additional treatment with SWEEPS significantly reduced the volume of the root canal filling materials in all experimental groups compared to the removal of root canal filling using only reciprocating instruments (p < 0.05). However, the root canal filling was not removed completely from any of the samples. SWEEPS can be used to enhance the removal of both epoxy-resin-based and calcium-silicate-containing sealers, in combination with single-cone and carrier-based obturation techniques.

Efficacy of Reciprocating Instruments in the Removal of Bioceramic and Epoxy Resin-Based Sealers: Micro-CT Analysis.

The objective of this study was to evaluate the efficacy of reciprocating instruments in the removal of bioceramic and epoxy resin-based sealers using micro-CT analysis. Root canals of 40 extracted human teeth were instrumented with a size R25 Reciproc instrument. Specimens were randomly divided into two groups (n = 20) according to the root canal filling material. In the first group, root canals were obturated with AH Plus sealer and Reciproc R25 gutta-percha. In the second group, a combination of bioceramic gutta-percha (TotalFill BC) and bioceramic sealer (TotalFill BC) was used. After one week, the retreatment of all specimens was performed using Reciproc instruments. To analyze the differences in the filling remnants, specimens were scanned in a micro-CT device after obturation and after the retreatment procedure. Statistical analysis was performed using the Mann-Whitney U test (p < 0.05). A combination of bioceramic sealer and bioceramic gutta-percha was more effectively removed from canals using a reciprocating instrument, with a filling remnants volume of 4.01 ± 3.13 mm3, in comparison to the combination of epoxy resin-based sealer and gutta-percha (6.96 ± 2.70 mm3) (p < 0.05). A reciprocating instrument was more effective in removing bioceramic sealers than epoxy resin-based sealers, although none of the root canal filling materials were completely removed from the root canals.

Compressive Strength of Conventional Glass Ionomer Cement Modified with TiO2 Nano-Powder and Marine-Derived HAp Micro-Powder.

The aim of this research was to investigate the compressive strength (CS), breaking strength (BS), and compressive modulus (CM) of conventional glass ionomer cement (GIC) modified with TiO2 nano particles, marine-derived hydroxyapatite (md-HAp) microparticles (<45 µm), and a combination of TiO2 NP and md-HAp particles. The materials used in the study were conventional GIC Fuji IX GP Extra (GC Corporation, Tokyo, Japan), TiO2 powder P25 (Degussa, Essen, Germany), and HAp synthesized from cuttlefish bone and ground in a mortar to obtain md-HAp powder. md-HAp was characterized using FTIR and SEM analysis. There were four groups of GIC samples: (i) Fuji IX control group, (ii) powder modified with 3 wt% TiO2, (iii) powder modified with 3 wt% HAp, and (iv) powder modified with 1.5 wt% TiO2 + 1.5 wt% HAp. Measurements were performed in a universal testing machine, and CS, BS, and CM were calculated. Statistical analysis was performed using ANOVA and Tukey's tests. CS, BS, and CM differed significantly between the Fuji IX control group and all experimental groups while differences between the experimental groups were not statistically significant. The addition of TiO2 NP, md-HAp micro-sized particles, and a combination of TiO2 and md-HAp reduced the CS, BS, and CM of conventional GICs when mixed at the powder/liquid (p/l) ratio recommended by the manufacturer.

Microtensile Bond Strength of Fiber-Reinforced and Particulate Filler Composite to Coronal and Pulp Chamber Floor Dentin.

This ex vivo study aimed to compare the microtensile bond strength of fiber-reinforced and particulate filler composite to coronal and pulp chamber floor dentin using a self-etching adhesive system. Coronal dentin of 40 human molar teeth was exposed by cutting occlusal enamel with a low-speed saw. Teeth were then randomly divided into two groups (n = 20). The first group was left as is, while in the second group, pulp chamber floor dentin was exposed by trepanation. After placement of a self-etching adhesive system (G-aenial Bond, GC, Tokyo, Japan), groups were further divided into two sub-groups (n = 10) according to the type of composite: fiber-reinforced composite (EP, everX Posterior, GC, Tokyo, Japan) and particulate filler composite (GP, G-aenial Posterior, GC, Tokyo, Japan). Then, composite blocks were built up. Sticks (1.0 × 1.0 mm2) were obtained from each specimen by sectioning, then microtensile bond strength (µTBS) test was performed. Statistical analysis included one-way ANOVA test and Student's t-test (p < 0.05). µTBS values were 22.91 ± 14.66 and 24.44 ± 13.72 MPa on coronal dentin, 14.00 ± 5.83 and 12.10 ± 8.89 MPa on pulp chamber floor dentin for EP and GP, respectively. Coronal dentin yielded significantly higher µTBS than pulp chamber floor dentin (p < 0.05), independently from the tested composites.

Clinical Performance of a Glass-Hybrid System Compared with a Resin Composite in the Posterior Region: Results of a 2-year Multicenter Study.

PURPOSE: To compare the clinical performance of a glass hybrid restorative system, EQUIA Forte, with that of a nanohybrid resin composite, Tetric EvoCeram, in two-surface class II cavities. MATERIALS AND METHODS: This multicenter, randomized controlled clinical study was conducted at four different dental schools. In total, 360 restorations were placed in patients in need of two class-II, two-surface restorations in the molar region of the same jaw. Each patient received one glass hybrid restoration (EQUIA Forte, GC) and one resin composite restoration (Tetric EvoCeram, Ivoclar Vivadent). Two independent evaluators performed a clinical evaluation of each site after 1 week (baseline), 1 year, and 2 years using the criteria of the FDI World Dental Federation (FDI-2). RESULTS: The estimated survival rates at the 2-year recall were 93.6% and 94.5% for EQUIA Forte and Tetric EvoCeram, respectively. There were no significant differences in the survival rates or in any of the evaluated esthetic, functional or biological properties between EQUIA Forte and Tetric EvoCeram restorations (p ˃ 0.05). CONCLUSION: Both the glass-hybrid restorative system and nanohybrid resin composite showed good clinical performance in moderate to large two-surface class II restorations in a 2-year follow-up.

Influence of different laser-assisted retrograde cavity preparation techniques on bond strength of bioceramic-based material to root dentine.

The purposes of the study were to evaluate the bond strength of bioceramic TotalFill root repair material (RRM) in retrograde cavities prepared using Er:YAG and Er,Cr:YSGG laser and steel bur, and to analyze failure modes. The root canals of 30 single-rooted teeth were endodontically treated, their root-ends were resected using a diamond bur, and the teeth were randomly divided into three groups (N = 10) according to the retrograde cavity preparation technique: (1) Er:YAG laser, (2) Er,Cr:YSGG laser, and (3) steel bur. All retrograde cavities were filled with the TotalFill RRM which was prepared according to the manufacturers' instructions. Push-out test was performed using universal testing machine, and failure mode was analyzed using a scanning electron microscope. The data were analyzed using one-way ANOVA, post hoc analysis with Bonferroni correction, and Fisher-Freeman-Halton exact test (p < 0.05). In the Er:YAG-, Er,Cr:YSGG-, and steel bur-prepared cavities, mean bond strengths (MPa) were 12.76, 8.44, and 6.01, respectively. The bond strength of the TotalFill RRM to dentin was significantly higher in the Er:YAG laser compared with the steel bur-prepared cavities (p = 0.004). The bond strength was not significantly different between the Er:YAG and Er,Cr:YSGG cavities (p = 0.074) and between the Er,Cr:YSGG and bur cavities (p = 0.648). In the cavities prepared by the Er,Cr:YSGG laser and bur, the failure mode of the TotalFill RRM was predominantly mixed, then adhesive and cohesive. In the Er:YAG laser-prepared cavities, the most common failure mode was adhesive, followed by mixed type and no cohesive failure. The bond strength of the TotalFill RRM to dentin was highest in the group of retrograde cavities prepared by the Er:YAG laser.

Bond Strength of Individually Formed and Prefabricated Fiber-reinforced Composite Posts.

PURPOSE: To investigate the micro push-out bond strength of individually formed (everStick Post) and prefabricated (GC Fiber Post) fiber-reinforced composite (FRC) posts cemented with three different types of self-adhesive composite cements. MATERIALS AND METHODS: Forty-two single-rooted human teeth were decoronated, endodontically treated, and had post spaces prepared for everStick Post (n = 21) or GC Fiber Post (n = 21). The teeth were randomly divided into three subgroups (n = 7), and posts were cemented either with G-CEM LinkAce (GC), SpeedCEM (Ivoclar Vivadent) or RelyX U200 (3M Oral Care). Specimens were then perpendicularly sectioned and divided at the cementoenamel junction into two root levels: coronal or apical. A micro push-out test was performed using an 0.8-mm-wide stainless steel plunger. Bond strength was calculated in MPa by dividing the fracture load (N) by the bonded surface area (mm2). Log-transformed data was statistically analyzed using factorial ANOVA and Tukey's post-hoc test (α < 0.05). Fracture modes were determined employing a stereomicroscope, and differences were evaluated using a likelihood ratio test and Pearson's chi-squared test. Specimens were also observed using SEM. RESULTS: Bond strengths were significantly affected by both post type and root level (p < 0.05), but not by self-adhesive cement (p > 0.05). Fracture types showed a significantly higher prevalence of adhesive fractures at the apical level, with all fractures starting at the cement-dentin interface. CONCLUSION: Individually formed FRC posts demonstrated greater bond strength than their prefabricated FRC counterparts. The apical level of the luted posts yielded lower bond strengths than the coronal level. Failures were predominantly adhesive at the cement-dentin interface.

EVALUATION OF INNOVATIVE DIGITALLY CONTROLLED ER:YAG LASER IN SURGICAL TREATMENT OF ORAL LEUKOPLAKIA - A PRELIMINARY STUDY.

The use of lasers for treatment of oral leukoplakia has gained a lot of interest in the past years, however, data on the use of Er:YAG laser are scarce. The aim of this study was to compare the efficacy of Er:YAG laser and 1% topical isotretinoin in the treatment of 27 oral leukoplakia patients. Er:YAG laser (LightWalker AT, Fotona, Slovenia) was used in 27 patients with 27 leukoplakia lesions. Postoperative pain was assessed by use of visual analog scale (VAS), and the impact of laser treatment on the quality of life was assessed by the OHIP-14 questionnaire (Croatian version). Control group consisted of the same 27 patients previously treated with 1% topical isotretionin three times a day during the period of one year. No improvement in the size of leukoplakia lesions was observed after treatment with topical isotretinoin. There were significant differences between men and women according to leukoplakia localization, number of laser sessions and VAS (p<0.05). At follow-up after six months and one year, there was no recurrence of lesions. Er:YAG laser is a successful treatment for oral leukoplakia. Topical isotretionin treatment is unsuccessful in patients with oral leukoplakia.

Cytotoxicity and Genotoxicity of Resin Based Dental Materials in Human Lymphocytes In Vitro.

The aim of this in vitro study was to evaluate cytotoxicity and genotoxicity of six different dental nanocomposite materials, three conventional ones and three flowable composite resin materials, in human lymphocytes. The following materials were tested: Tetric EvoCeram, Tetric EvoFlow, Filtek Ultimate, Filtek Ultimate Flow, G-aenial and G-aenial Flo. Cytotoxicity was evaluated for two mass concentrations (0.007 g/mL and 0.013 g/mL) of each material, non-cured and cured, after 4 hours and 24 hours. Genotoxicity was evaluated using micronucleus assay under the same conditions as applied during the investigation of cytotoxicity. Uncured forms of Tetric EvoCeram, Tetric EvoFlow and Filtek Ultimate Flow in higher mass concentration caused genotoxic effect. Uncured G-aenial Flo in higher mass concentration induced apoptosis and necrosis. Uncured Tetric EvoFlow and uncured Filtek Ultimate Flow in higher mass concentration induced early apoptosis after both test periods. None of the conventional composite resin materials tested showed cytotoxicity except for uncured G-aenial, which induced apoptosis in higher mass concentration in both test periods. In conclusion, under the conditions of this in vitro study, cured conventional composites did not show cytotoxic or genotoxic effect, which is important for clinical application of these materials, whereas uncured forms exhibited certain level of cytotoxicity and genotoxicity, mainly because of monomers in their composition.

In vitro retention of prefabricated and individually formed posts: A pilot study.

STATEMENT OF PROBLEM: Data on the retention of individually formed fiber-reinforced composite posts (everStick) cemented with self-adhesive cement are lacking. PURPOSE: The purpose of this in vitro study was to investigate the pull-out strength of 2 different fiber-reinforced composite posts (prefabricated and individually formed) cemented into extracted teeth with self-adhesive resin cement. MATERIAL AND METHODS: Thirty extracted single-rooted human teeth were decoronated, endodontically treated, and prepared with post spaces of equal length. Prepared specimens were divided into 2 groups (n=15 each) based on the type of post: commercially prefabricated fiber posts (GC) and individually formed resin posts (using GC reinforcing fibers). Self-adhesive resin cement (G-CEM LinkAce; GC) was used to cement all posts. Each post was held with moderate pressure, and root surfaces were light polymerized for 20 seconds (650 mW/cm2). After cementation, the specimens were stored in saline solution for 30 days. Treated teeth were kept in water for 24 hours before pull-out testing parallel to the longitudinal axis of the posts. Data were analyzed using the Student t test (α=.05) and the coefficient of variance as the ratio of the standard deviation to the mean. RESULTS: The mean pull-out retention strength was 185.7 ±61.2 N for the prefabricated fiber posts and 98.9 ±56.5 N for the individually formed fiber posts (P=.026). CONCLUSIONS: The prefabricated fiber posts exhibited significantly higher retention forces than the individually formed posts.

Push-out bond strength of three different calcium silicate-based root-end filling materials after ultrasonic retrograde cavity preparation.

OBJECTIVE: The aim of this study was to evaluate the bond strength of three calcium silicate-based root-end filling materials. MATERIALS AND METHODS: The root canals of 30 single-rooted teeth were endodontically treated; their root ends were resected and root-end cavities were prepared using ultrasonic tip. The teeth were randomly divided into three groups according to the material: (1) Micro-Mega mineral trioxide aggregate (MM-MTA), (2) Biodentine, and (3) TotalFill root repair material (RRM). Push-out test was performed using universal testing machine, and failure mode was analyzed by stereomicroscope. The data were statistically analyzed using Kruskal-Wallis and Man-Whitney post hoc tests. All p values < 0.05 were considered significant. RESULTS: TotalFill RRM exhibited significantly higher bond strength (12.69 MPa) than Biodentine (9.34 MPa, p = 0.023) and MM-MTA (7.89 MPa, p = 0.002). The difference between Biodentine and MM-MTA was not significant (p = 0.447). Mixed failures were the most noted in all three groups. MM-MTA had more adhesive failures than Biodentine and TotalFill, and no cohesive failures, but without statistical significance (p = 0.591). CONCLUSION: The bond strength was the highest for TotalFill RRM. CLINICAL RELEVANCE: In order to provide a persistent apical seal, root-end filling materials should resist dislodgement under static conditions, during function and operative procedures. TotalFill RRM exhibited higher bond strength to dentin than MM-MTA and Biodentine.

Mandibular Osteonecrosis due to the Pulpal-Periodontal Syndrome: a Case Report and Review of the Literature.

OBJECTIVE: Ishemic bone disease has multifactorial etiologies. Cronic dental infections should be eliminated to prevent osteonecrosis of the jaw. CASE REPORT: We report an unusual case of osteonecrosis due to the pulpal-peridontal syndrome and subsequent pulp necrosis. A case of 38 year old woman who presented with exposed bone, 8 mm in diameter, in the lingual area of the right lower third molar. The patient was otherwise healthy and was not taking any medications. A detailed medical history showed no previous diseases. Patient denied any type of local trauma. A complete blood count showed no abnormalities. The panoramic radiograph revealed a deep periodontal pocket between teeth 47 and 48. The CBCT revealed a deep periodontal pocket between molars and bone sequestrum of the lingual plate. Topical treatment consisted of adhesive periodontal dressing based on the cellulose and bethamethasone oitnment together with orabase, without improvement. Therefore, peroral amoxycillin was prescribed for a week. Since there was no improvement, the third molar was removed as well as necrotic bone; the alveolar bone was remodelled and sutures were placed. After suturing, the whole area was covered using intraoral resorbable bandage. Microbial swab of the wound aspirate did not reveal polymorphonuclears or the presence of microorganisms. Microbial swab of the biopsy specimen of the necrotic bone particle and sequestrum showed a large amount of gram-positive coccae, however, polymorphonuclears were not found. Histopathological analysis revealed acute chronic inflammation. One week after the surgery, the area healed completely. CONCLUSION: This case highlights the fact that in some patients bone exposure might develop due to the pulpal-periodontal syndrome i.e. pulp necrosis.

Efficacy of Three Different Lasers on Eradication of Enterococcus faecalis and Candida albicans Biofilms in Root Canal System.

OBJECTIVE: The objective was to compare the efficacy of three different lasers in disinfection of root canals inoculated with Enterococcus faecalis and Candida albicans biofilms. BACKGROUND: Endodontic space disinfection depends on the type of root canal irrigant used and the way it is delivered and agitated because irrigants have limited ability to reach all parts of root canal system. MATERIALS AND METHODS: Thirty single-rooted human teeth were selected. Root canals were instrumented and root surfaces were sealed using adhesive and the apical openings with adhesive and composite resin. Roots were fixed in Eppendorf tubes and sterilized in autoclave. The specimens were randomly divided into three experimental groups (n = 10) and inoculated with E. faecalis and C. albicans. After 7 days of incubation period, the number of E. faecalis and C. albicans colony-forming units (CFUs) was determined for each root canal. In the first experimental group, Er:YAG laser (0.3 W) with photon-induced photoacoustic streaming technique was used for root canal disinfection, in the second, Nd:YAG laser (1.5 W), and in the third, Er,Cr:YSGG (1.25 W) laser was used. After different root canal disinfection protocols, the number of E. faecalis and C. albicans CFUs was determined again for each root canal. RESULTS: Er:YAG and Er,Cr:YSGG lasers eradicated significant number of E. faecalis and C. albicans CFUs (p < 0.05), while Nd:YAG laser irradiation did not result in statistically significant reduction (p > 0.05). Er,Cr:YSGG laser eradicated significantly more microorganisms in comparison with Er:YAG laser (p < 0.05). CONCLUSIONS: Er,Cr:YSGG laser was the most efficient tool in eradication of E. faecalis and C. albicans biofilms.

Cytotoxicity of Two Bioactive Root Canal Sealers.

OBJECTIVE: The aim of this study was to investigate the cytotoxicity of two different bioactive root canal sealers: one based on mineral trioxide aggregate, MTA Fillapex (Angelus, Solucoes Odontologicas, Londrina, PR, Brazil), and the other based on bioceramics, Endosequence BC Sealer (Brasseler, Savannah, Georgia, USA), in culture of mouse L929 fibroblasts. MATERIALS AND METHODS: Mouse fibroblasts (L929), obtained from subcutaneous connective tissue of mouse line C3Hf, were cultivated in plastic culture flasks in an incubator at 37sC, with 5% CO2 and 90% humidity. Freshly mixed Endosequence BC Sealer and MTA Fillapex (0.1 g each) were placed on sterile teflon discs, 6 mm in diameter. Teflon discs with the materials as well as empty discs serving as control were placed in wells of 12-well plate. After incubation times of 1, 6, 20 and 24 hours, the teflon discs were removed from the wells and the number of viable cells was determined using trypan blue in Neubauer chamber. RESULTS: In comparison to the control group, MTA Fillapex had significantly less viable cells for all incubation periods (p≤0.05), while Endosequence BC sealer had significantly less viable cells after 6, 20, and 24 hours of incubation (p≤0.05). MTA Fillapex comprised significantly less viable cells in comparison to Endosequence BC sealer after the first hour and after 20 hours of incubation (p≤0.05), while for the other incubation periods there were no significant differences (p≥0.05). CONCLUSION: MTA Fillapex and Endosequence BC sealer were both cytotoxic in cultures of mouse L929 fibroblasts.

Esthetic Intracanal Posts.

The primary function of an endodontic post is to provide retention for the core and enable full sealing of the coronal portion of the root canal. Traditionally used metal posts do not meet the requirements of modern dental medicine due to some fairly significant drawbacks such as color, corrosion potential, non-adhesive bonding and high modulus of elasticity which can lead to root fracture. Recently, esthetic ceramic and fiber reinforced posts have been manufactured in order to avoid such imperfections. Since much attention has been devoted to the esthetic aspects of dental medicine, the use of these posts with composite/ceramic cores is very common in restorative dentistry and it is actually becoming a standard. This is due to the fact that, apart from being an esthetically pleasing material, they are also biocompatible, have good physical properties and the capacity of adhesive bonding to tooth tissue and core buildup. Nonetheless, a good clinician should know how to spot the difference between them in order to select and use the appropriate post system in each specific situation.

Effect of photon induced photoacoustic streaming (PIPS) on bond strength to dentine of two root canal filling materials.

OBJECTIVES: The aim of this study was to evaluate the effect of photon induced photoacoustic streaming (PIPS) technique in combination with EDTA on bond strength of gutta-percha/AH Plus and Resilon/RealSeal SE root canal fillings to root dentine. MATERIALS AND METHODS: Forty freshly extracted human maxillary anterior teeth with intact straight roots, were instrumented endodontically with rotating ProTaper instruments and randomly divided into two experimental groups. In group 1 (n = 20), root canals were rinsed for 1 minute with 2 ml of 17% EDTA. In group 2 (n = 20), Er:YAG laser, with a 14 mm long 400 µ diameter tapered PIPS tip, was used for 1 minute with 2 ml of 17% EDTA. The laser parameters used were: 20 mJ per pulse, 15 Hz, 50 microsecond. In each experimental group, half of the root canals (n = 10) were obturated with gutta-percha/AH Plus and other half (n = 10) with Resilon/RealSeal SE. A micropush-out test was performed on sectiond specimens of the filled roots using a universal testing machine and resistance to failure plus failure modes were determined. RESULTS: Both gutta-percha/AH Plus groups had higher bond strength to root dentin than the Resilon/RealSeal SE groups (P < 0.05). The smear layer removal protocol, with EDTA only or combining PIPS technique with EDTA, had no influence on bond strength of either gutta-percha/AH Plus, or Resilon/RealSeal SE (P > 0.05). CONCLUSION: Within the limitations of this study, it was found that the application of the PIPS technique did not have an affect on the push-out bond strength of Resilon/RealSeal SE root canal filling to dentin nor on the gutta-percha/AH Plus. A significant difference in bond strength was noted between the two root canal filling materials. Lasers Surg. Med. 48:951-954, 2016. © 2016 Wiley Periodicals, Inc.

Ablative Potential of Er:YAG Laser in Dentin: Quantum Versus Variable Square Pulse.

OBJECTIVE: The primary objective of this study was to compare the dentin ablation volume and ablation rate of quantum square pulse (QSP), using two different pulse energy settings plus a new digitally controlled dental laser handpiece (X-Runner), with those of variable square pulse (VSP), using three different pulse durations. The secondary objective was to examine, by scanning electron microscopy (SEM), the surface effects of ablation with the different Er:YAG laser modes on the dentin surfaces. BACKGROUND DATA: The available literature has limited data on the efficiency of different operating modes, pulse durations, and the new digitally controlled handpiece of the Er:YAG laser on human dentin. MATERIALS AND METHODS: Freshly extracted human molars (n = 72) were divided into two experimental groups (n = 36 each): (1) QSP group, and (2) VSP group. Each group was randomly divided into three subgroups (n = 12 each). In the QSP group, preparations in dentin were performed using 250 and 500 mJ of pulse energy with the conventional handpiece, and with the X-Runner handpiece set at 250 mJ pulse energy. In the VSP group, cavity preparations were performed using three pulse variables: super short pulse (SSP), micro short pulse (MSP), and short pulse (SP). Cavity preparations were made in dentin at time intervals of 1, 2, and 5 sec. A laser triangulation profilometer was used to determine cavity volumes. Surface analysis of the ablated dentin specimens was performed by SEM. RESULTS: For time intervals of 1 and 2 sec, ablated volume and ablation rate for QSP-500 mJ were significantly higher than for all other groups (p < 0.0001). For the 5-sec time interval, X-Runner and QSP-500 mJ were the most efficient in dentin ablation (p < 0.0001). Dentin surfaces were free of smear layer in all groups. CONCLUSIONS: The most efficient modes of dentin ablation in the study were the QSP-500 mJ and X-Runner groups. Dentin surfaces were free of smear layer in all groups.