Effectiveness of laser-assisted gingival troughing and conventional gingival displacement methods in fixed prosthodontics: A systematic review.

STATEMENT OF PROBLEM: High-level evidence that gingival troughing using dental lasers has better outcomes for the management of gingival tissue surrounding prepared teeth compared with conventional gingival displacement methods is lacking. PURPOSE: The purpose of this systematic review was to review in vivo studies on gingival troughing using dental lasers to compare achieved gingival displacement, influence on periodontal health, and other relevant clinical parameters with different existing gingival displacement methods. MATERIAL AND METHODS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and identified studies through January 2022. An electronic search was conducted on the digital databases PubMed/MEDLINE, Web of Science, Scopus, and Embase to identify relevant studies with no limit on publication year. RESULTS: Nine studies were included in this systematic review. Five studies measured achieved horizontal gingival displacement, where lasers show the highest pooled mean of 0.53 mm, among all other displacement methods. Six of the 9 included studies measured periodontal health parameters, with a follow-up time up to 1 year, and other clinically relevant parameters: hemorrhagic control, time needed, ease of use, tooth mobility, pain, and tooth hypersensitivity. CONCLUSIONS: Gingival displacement and bleeding control appeared to be better achieved using lasers. The time needed to achieve gingival displacement was shortest and easiest with lasers. Lasers resulted in either less or comparable gingival recession, lower impact on tooth hypersensitivity, and less pain during the procedure than other methods.

Removal of lithium disilicate veneers with Er,Cr:YSGGL laser: now? Or after ageing?

This study was purposed to assess the impact of ageing and resin cements polymerized with different modes on the removal time of lithium disilicate (LiSi) ceramics using Er,Cr:YSGG laser. Ninety LiSi slabs (6 × 6 × 1 mm) were cemented to freshly extracted bovine teeth using cements polymerized with different modes (light-curing (LC), dual-curing (DC), self-curing (SC)). The specimens were divided into subgroups according to ageing conditions (no thermal cycling, 5000 or 30,000 thermal cycling). After that, Er,Cr:YSGG laser was applied until LiSi slabs were debonded; the removal time was recorded. Vickers microhardness test, SEM and EDS analyses were performed for specimens with the longest exposure time to laser application in the groups. One uncemented sample was also used as a control. Data were analyzed with two-way ANOVA and Tukey post hoc test. Ageing and cement polymerization mode significantly affected the removal time of LiSi specimens. The removal time for the self-curing resin cement group (22.67 ± 12.68 s) was significantly longer than for cements polymerized with other methods (LC = 10.833 ± 7.28 s, DC = 12.0 ± 7.96 s). Removal time was significantly reduced after ageing in all polymerization modes; however, there were no significant differences between 5000 (11.83 ± 7.52 s) and 30,000 (11.83 ± 7.26 s) thermal cycling groups. Self-curing resin cements had prolonged the laser-aided removal time for LiSi ceramics. It can be concluded that Er,Cr:YSGG laser-aided removal of LiSi veneers after clinical use can be done more faster than its immediate removal.

Effect of Photobiomodulation Therapy on Peri-Implant Bone Healing in Extra-Short Implants in a Rabbit Model: A Pilot Study.

Objective: To evaluate the effects of photobiomodulation therapy (PBMT) at distinct energy levels on peri-implant bone healing in extra-short implants in a experimental rabbit model. Background: The effect of PBMT on peri-implant bone healing in short implants remains unclear. This explored the effect of PBMT on extra-short implants in terms of bone-implant contact (BIC) length and rate, and implant stability quotient (ISQ). Methods: Fifteen white New Zealand rabbits were randomly divided into five groups. In all groups, extra-short implants (3.5 × 4 mm; Nucleoss T6, Izmir/Turkey) were placed in both tibias of the rabbits. PBMT was performed in four groups (group 1, 5 J/cm2; group 2, 10 J/cm2; group 3, 20 J/cm2; and group 4, 25 J/cm2); no PBMT was performed in the control group. On the 30th day, the rabbits were sacrificed and peri-implant tissue samples were obtained to determine the BIC length and BIC rate. Implant stability levels were measured by resonance frequency analysis using the Osstell penguin device and were determined as ISQ values on the 1st and 30th days of the study. Results: PBMT significantly increased the BIC length and BIC rate in groups 3 and 4 (p < 0.001). For the ISQ values, there were significant differences between the 1st and 30th day (p < 0.001). On the 30th day, the ISQ values were significantly higher in groups 3 and 4 compared with the remaining groups (p < 0.001). Conclusions: In this study, PBMT improved peri-implant bone healing through increase in BIC length, BIC rate, and ISQ parameter values in extra-short implants.

The effect of artificial accelerated aging on the color stability, microhardness, and surface roughness of different dental laminate veneer materials.

OBJECTIVE: This study aimed to evaluate the effect of artificial accelerated aging (AAA) on color stability, surface roughness, and microhardness of three laminate veneer (LV) materials. MATERIALS AND METHODS: Specimens of ceramic LV (CLV-IPS E.max Press), hand-layered composite LV (hand-layered laminate veneer [HLV]-Tetric N-Ceram), and prefabricated composite LV (prefabricated laminate veneer [PLV]-Componeer Coltene) were prepared as discs (n = 10). CIE L*, a*, and b* color coordinates, the Vickers microhardness, and surface roughness were measured 24 hours after preparation and reevaluated after aging for 300 hours in an ultraviolet (UV)-AAA system (Ci35 Weather-Ometer). Color difference (CIEDE2000 [ΔE00 ]) was calculated. Data were statistically analyzed with the Shapiro-Wilk test and the Kruskall-Wallis test followed by the Mann-Whitney U tests (α = .05). RESULTS: All of the LV groups showed significant differences in ΔE00 after AAA (P < .001). Comparing the color changes of the HLVs with the PLVs, no significant difference could be found (P = .705). There was a statistically significant difference in the means of changes in microhardness among the LVs materials (P < .001). The changes in surface roughness results showed a significant difference after AAA in all the LVs (P < .001). CONCLUSIONS: Within the limitations of this in vitro study, the color stability, the microhardness, and surface roughness of tested LVs were influenced by AAA. CLINICAL SIGNIFICANCE: The prefabricated composite LV system does not replace the individualized ceramic LV technique, but rather offers an alternative to hand-layered LVs, which is delicate and time-consuming technique.

Comparison of surface roughness and color stainability of 3-dimensionally printed interim prosthodontic material with conventionally fabricated and CAD-CAM milled materials.

STATEMENT OF PROBLEM: Studies on the surface roughness and color stainability of interim prostheses produced with 3-dimensional-printing technology are lacking. PURPOSE: The purpose of this in vitro study was to investigate the effect of different surface treatments on the surface roughness and stainability of 3-dimensionally printed, computer-aided design and computer-aided manufacturing (CAD-CAM) milled and conventional interim materials. MATERIAL AND METHODS: A total of 320 specimens were fabricated from autopolymerizing polymethyl methacrylate, bis-acryl composite resin, CAD-CAM polymethyl methacrylate resin (milled), and 3-dimensionally printed composite resin (printed) (n=80). A group of each material was divided into 2 groups (n=40) as per the applied surface treatment procedure: conventional polishing (C) or coated with a surface sealant (B). Surface roughness values were measured with a profilometer. Each group of specimens was then divided into 4 subgroups (n=10) and stored for 1 day, 7 days, and 30 days at 37 °C in different solutions: distilled water, cola, coffee, and red wine. Color parameters were measured with a spectrophotometer before and after each storage period, and color differences (CIEDE2000 [ΔE00]) were calculated. Data were statistically analyzed with the Shapiro-Wilk test, Kruskal-Wallis test, and Mann-Whitney U test followed by the Friedman test (α=.05). RESULTS: The highest surface roughness values were determined for the polymethyl methacrylate -C, and the lowest were observed in the printed-B. After 30 days, the highest mean ΔE00 values were observed in polymethyl methacrylate-C for all staining solutions (P=.001). The highest ΔE00 for all materials was observed in the red wine group. Color change increased significantly with storage duration (P=.001). CONCLUSIONS: All tested materials had a surface roughness higher than the plaque accumulation threshold (0.2 µm). The surface roughness values of coated materials were significantly lower than those of their conventionally polished groups, except for the printed groups. The application of a surface sealant agent significantly decreased the staining of the materials.

Inhibition of cathepsin-K and matrix metalloproteinase by photodynamic therapy.

OBJECTIVES: The objective of this study was to determine the effects of antimicrobial photodynamic therapy (aPDT) with indocyanine green (ICG) and toluidine blue (TB) on protease activity (matrix-bound cathepsin K and matrix metalloproteinase (MMP) and dentin bond strength. METHODS: Caries-free human third molars were assigned to five groups: 1-control group, 2-application of ICG with activation using an 810 nm diode (aPDT), 3-application of ICG, 4-application of TB with activation using a 660 nm diode (aPDT), and 5-application of TB. For the enzymatic investigation, dentin beams were incubated for either 3 days or 3 weeks. Aliquots of the incubation media were analyzed by ELISA for CTX (C-terminal cross-linked telopeptide of type I Collagen) and ICTP (cross-linked carboxy-terminal telopeptide of type I collagen). For microtensile bond strength testing (µTBS), composite resins were layered onto the tooth surface; the samples were then subjected to µTBS. Kruskall-Wallis and Mann-Whitney U tests were applied for statistical analysis of CTX and ICTP, one way-ANOVA and Tukey's test were applied for statistical analysis of µTBS. RESULTS: Pretreating the dentin matrices with aPDT decreased the endogenous protease activity. ICG with laser activation resulted in the highest µTBS. Therefore, aPDT should be considered as a treatment method because it can reduce MMP-mediated dentin degradation and increase the µTBS. SIGNIFICANCE: Inhibiting endogenous protease activity improves the stability of the dentin-adhesive bond and the durability of the bond strength.

Correction to: Temporary materials: comparison of in vivo and in vitro performance.

A Correction to this paper has been published: https://doi.org/10.1007/s00784-021-04067-4.

Evaluation of bond strength of resin cement to Er:YAG laser-etched enamel and dentin after cementation of ceramic discs.

The purpose of this study was to investigate the shear bond strength (SBS) of ceramic discs luted to differently etched enamel and dentin surfaces. Occlusal surfaces of 64 carious-free human molars and vestibule surfaces of 64 first maxillary incisors were ground to get flat superficial dentin and flattened enamel respectively. After generating 4 groups according to the surface etching method (37% orthophosphoric acid, Er:YAG laser-contact handpiece/scanning handpiece (1 or 2 times of scanning)), ceramic discs were luted to the surfaces with adhesive resin cement (Variolink N, Vivadent Ets., Schaan/Liechtenstein). After etching and cementation, thermocycling of 5000 cycles (Sd Mechatronik Gmbh, Feldkirchen-Westerham, Germany) and SBS test (Servopulser EHFFD1; Shimadzu, Kyoto, Japan) were performed respectively. The surface morphologies of 2 specimens, etched enamel and dentin, prepared for each group were examined with SEM analysis. Failure modes were determined under a USB digital microscope. Data were analyzed with one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). SBS values in dentin surfaces showed statistically significant differences (p < 0.05) among tested groups. The highest SBS among dentin groups was determined in the group which had 2 times etching by Er:YAG laser (11.42 MPa) by a scanning handpiece. No statistical differences were observed in the other dentin or enamel groups. Laser etching seems to be a viable alternative to acid etching on both enamel and dentin surfaces while double etching of dentin with a scanning handpiece can improve the adhesion.

Temporary materials: comparison of in vivo and in vitro performance.

OBJECTIVE: The aim of this investigation was to compare clinical performance and in vitro wear of temporary CAD/CAM and cartridge crowns. This study is an approach to estimate the influence of in vivo use and laboratory simulation on temporary crowns. MATERIALS AND METHODS: A total of 90 crowns were fabricated from each temporary CAD/CAM or cartridge material. Also, 10 crowns of each material were clinically applied for 14 days, and 80 identical duplicate restorations were investigated in the laboratory after storage in water (14 days; 37 °C) and subsequent thermal cycling and mechanical loading (TCML, 240.000 × 50N ML, 600 × 5°C/55 °C). After in vivo application or in vitro aging, facture force, superficial wear (mean and maximum), surface roughness (Ra, Rz), thermal weight loss (TGA), and heat of reaction (DSC) were determined for all crowns. STATISTICS: Bonferroni post hoc test; one-way analysis of variance (ANOVA); α = 0.05). RESULTS: The fracture resistance of the temporary materials varied between 1196.4 (CAD in vivo) and 1598.3 N (cartridge crown in vitro). Mean (maximum) wear data between 204.7 (386.7 µm; cartridge in vitro) and 353.0 µm (621.8 µm; CAD in vitro) were found. Ra values ranged between 4.4 and 4.9 µm and Rz values between 36.0 and 40.8 µm. DSC and TG analysis revealed small differences between the materials but a strong influence of the aging process. CONCLUSIONS: Comparison of in vivo and in vitro aging led to no significant differences in fracture force and wear but differences in roughness, DSC, and TGA. SEM evaluation confirmed comparability. Comparison of CAD/CAM and cartridge temporary materials partially showed significant differences. CLINICAL RELEVANCE: In vitro aging methods might be helpful to estimate materials' properties before principal clinical application. CAD/CAM and cartridge temporary materials provided comparable good clinical performance.

Effectiveness of Different Laser-Assisted In-Office Bleaching Techniques: 1-Year Follow-Up.

Objective: The aim of this study was to evaluate color longevity after different bleaching techniques. Background: Laser-activated bleaching methods are gaining popularity due to decreased chair time and increased patient compliance. However, the longevity of such methods has not been stated clearly. Methods: Sixty patients were divided into the following three groups (n = 20); group 1: chemical bleaching with 35% hydrogen peroxide (HP) gel, group 2: bleaching with 35% HP gel with diode laser activation, and group 3: bleaching with 35% HP gel with Er,Cr:YSGG laser activation. Color changes (ΔE*) were calculated by using two different formulas: (i) CIELAB (ΔEab) and (ii) CIEDE2000 (ΔE00) with a spectrophotometer before treatment, 24 h after treatment 3, 6, and 12 months after treatment. Evaluation of postoperative sensitivity was performed before and immediately after treatment, followed by re-evaluation 24 h and 1 week after treatment. Results: For ΔEab calculation, no significant difference was observed during both intra- and inter-group evaluations (p > 0.05). For ΔE00 calculation, no significant intergroup difference was observed (p > 0.05), whereas significant intragroup differences between the values of after treatment, 6-12 months. In the chemical bleaching group, increased postoperative sensitivity was observed after 24 h (p < 0.001). In the diode-laser-activated group, postoperative hypersensitivity was detected at 24 h and 1 week. No significant hypersensitivity was observed in the Er,Cr:YSGG-laser-activated group (p > 0.05). Conclusions: All three techniques provided efficient bleaching. Chemical and diode-activated bleaching methods resulted in slight sensitivity after application, whereas Er,Cr:YSGG-laser-activated bleaching did not cause sensitivity.

Evaluation of strain distribution on an edentulous mandible generated by cobalt-chromium metal alloy fixed complete dentures fabricated with different techniques: An in vitro study.

STATEMENT OF PROBLEM: Fixed complete dentures (FCDs) have been used in the treatment of completely edentulous patients for over 40 years. However, few reports have investigated misfit values and strain distribution in the context of FCDs fabricated with new technologies. PURPOSE: The purpose of this in vitro study was to evaluate misfit values and strain distribution in FCDs and their relation to the fabrication technique of the cobalt-chromium (Co-Cr) metal framework. MATERIAL AND METHODS: Four implants were placed in the interforaminal region of a mandibular cast at the bone level. The Co-Cr metal alloy frameworks were fabricated using the following techniques: computer-aided design and computer-aided manufacturing (CAD-CAM), milling from hard blocks, CAD-CAM milling from soft blocks, and direct metal laser sintering (DMLS). The superstructures of equal sizes with acrylic resin bases and acrylic resin denture teeth were fabricated on the Co-Cr metal alloy framework, and a digital microscope was then used to measure the misfit between the abutments and the implants. The stress formed after the application of torque was measured with a strain-gauge stress analysis technique. Data were statistically analyzed using 1-way ANOVA and the Tukey Honestly Significant Difference test (α=.05). The correlation between the misfit and the strain values was evaluated with the Pearson Correlation test (α=.001). RESULTS: The lowest mean misfit values (99 ±17 µm) were observed in the hard block group (P<.05) and the highest in the DMLS group (139 ±29 µm). A statistically significant positive relationship was found between the misfit and the stress distribution after torque application (P<.05). Moreover, the lowest misfit group, hard blocks, had the lowest mean strain values (81.1 ±54 MPa) after torque application. CONCLUSIONS: Within the limitations of this in vitro study, the fabrication technique used for Co-Cr metal alloy frameworks appears to influence the passive fit significantly (P<.05). The hard-block technique was found to be the most precise fabrication technique for Co-Cr metal alloy frameworks. A significant relationship was observed between the amount/distribution of misfit and the strain on the FCD (P<.05).

Effects of New Generation All-Ceramic and Provisional Materials on Fibroblast Cells.

PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxic and apoptotic effects of seven new-generation all-ceramic materials for CAD/CAM (Lava Ultimate [LU], VITA Mark II [VM], InCoris TZI [IC], IPS e.max CAD [EM], VITA Suprinity [VS], Cerasmart [CS], IPS Empress CAD [EC]) and six provisional materials (Protemp 4 [PT], Telio CAD [TC], CAD-Temp [CT], Telio Lab [TL], Temdent Classic [TD], Telio CS C&B [TS]) on L929 mouse fibroblast cells. MATERIALS AND METHODS: 24 disc-shaped specimens (∅ = 5 mm, h = 2 mm) were prepared from each test material. Medium extracts were collected at the 1st, 3rd, and 7th days for each group and tested using the L929 cell line. Cytotoxicity was evaluated using XTT assay, and apoptosis was determined by Annexin-V/PI staining. Data were analyzed using one-way ANOVA, Tukey's multiple comparison tests at a significance level of p < 0.05. RESULTS: The cell viability results among all-ceramic material groups after the 1st and 7th days of incubation periods showed statistically significant differences (p < 0.05). There were significant differences within the ceramic groups in different incubation periods regarding apoptosis rate (p < 0.05). Throughout the entire test period, LU and VM from the CAD/CAM all-ceramic materials and PT and TC from the provisional restoration materials showed cell viability higher than 90%. EC and TD showed the lowest cell viability and highest apoptosis rates in their own groups. For the provisional materials, there were significant differences in cell viability and apoptosis rate in all the incubation periods for each material (p < 0.05). CONCLUSIONS: Although some new-generation CAD/CAM and provisional restoration materials display slight cytotoxicity values, the results are still within the reliable range, and they can safely be used in clinical conditions.

In vitro comparison of an Er:YAG laser-activated bleaching system with different light-activated bleaching systems for color change, surface roughness, and enamel bond strength.

To compare an Er:YAG laser-activated bleaching system with different light-activated in-office bleaching systems for color change, surface roughness, and post-bleaching enamel bond strength. 51 enamel slabs were prepared from the sound buccal enamel of extracted bovine teeth. The teeth were randomly divided into three groups according to different light-activated office bleaching systems (n = 17): diode laser (Epic, Biolase) (940 nm, 7 W, continuous mode), Er:YAG laser (LightWalker, Fotona) (2940 nm, 50 mJ, 10 Hz, 1000 µs), and LED (Radii Plus) (440-480 nm, 1500 mW/cm2). All systems were used with their compatible bleaching agents according to manufacturers' recommendations. The tooth color and surface roughness (Ra) were assessed at baseline and after bleaching using a spectrophotometer and a surface profilometer, respectively. The color change was determined by the CIE L*a*b* system (ΔE, ΔL*, Δa*, Δb*). Kruskal-Wallis test was used for color change whereas Kruskal-Wallis and Wilcoxon tests were used to analyze the roughness data. For shear bond strength test (SBS), composite cylinders were bonded on bleached enamel samples 14 days after bleaching procedures and stored in water (37 °C). Specimens were then debonded with a universal testing machine at 1 mm/min and data were analyzed by using Kruskal-Wallis test. All the tested bleaching systems were effective on color change (ΔE > 3.3) and produced similar color change (p > 0.05). There were no significant differences among the Ra values of the groups neither at baseline nor after bleaching (p > 0.05). However, comparing the baseline and after bleaching Ra values, a significant increase was observed for all tested groups (p < 0.05). Significant differences were also found among all systems for SBS (p < 0.05). The highest values were obtained in Er:YAG group, whereas the LED group revealed the lowest values (p < 0.05). All tested bleaching systems were effective on tooth whitening, whereas they all led to an increase on surface roughness. Although the current Er:YAG laser-activated bleaching system did not differ from other tested bleaching systems according to color change and surface roughness, it appears to provide better results in terms of SBS.

Color change of CAD-CAM materials and composite resin cements after thermocycling.

STATEMENT OF PROBLEM: The color of resin cements and computer-aided-design and computer-aided-manufacturing (CAD-CAM) restorations may change with aging. PURPOSE: The purpose of this in vitro study was to analyze the influence of thermocycling on the color of CAD-CAM materials with underlying resin cement. MATERIAL AND METHODS: Seven different CAD-CAM materials, composite resins and glass-ceramics were cut into 0.7-mm and 1.2-mm thicknesses (n=10) and cemented with a dual-polymerizing resin cement, a light-polymerizing resin cement, and a preheated composite resin (N=420). Color values were measured by using spectrophotometry. Specimens were subjected to thermocycling (5°C and 55°C; 5000 cycles). The measured color difference (ΔE) data were analyzed by using descriptive statistics. Normality of data distribution was tested by using the Kolmogorov-Smirnov test. Three-way and 1-way ANOVA followed by the Scheffé post hoc test and unpaired 2-sample Student t test were computed to determine the significant differences among the tested parameters (α=.05). RESULTS: ΔE values were significantly influenced by the CAD-CAM material (ηp2=0.85, P<.001) and the resin composite cement (ηP2=0.03, P=.003) but were not influenced by thickness (P=.179). Significant interactions were present among thickness, cement, and CAD-CAM materials (P<.001). Vita Suprinity and GC Cerasmart showed significantly the lowest ΔE values (P<.001). The highest ΔE values were observed for IPS Empress CAD. The dual-polymerizing resin cement showed significantly lower ΔE values than the preheated composite resin (P=.003). CONCLUSIONS: Restoration materials and composite resin cement types used for cementation influence the amount of color change due to aging.

Clinical and histological evaluation of the efficacy of antimicrobial photodynamic therapy used in addition to antibiotic therapy in pericoronitis treatment.

BACKGROUND: Although antimicrobial efficacy of photodynamic therapy has been studied several times, there is no study investigating its efficacy on pericoronitis. This study aimed to determine whether antimicrobial photodynamic therapy combined with antibiotic therapy is clinically and histologically superior to antibiotic therapy alone in pericoronitis treatment. METHODS: Patients (n = 40) with pericoronitis were divided into two groups (20 patients for each) to receive either antibiotic + indocyanine green + 810 nm wavelength diode laser (antimicrobial photodynamic therapy group) or antibiotic alone. Initial biopsy samples were obtained from the affected tissue of the patients at their first presentation to the clinic before any intervention. The second biopsy samples were obtained on the 3rd day of treatment in both groups from the tissue part not biopsied before; tooth extraction was then performed. All tissue samples were histologically examined to assess inflammatory cell response. Patients' pain (using Visual Analogue Scale) and lymphadenopathy (presence or absence) were clinically evaluated in the first 3 days and on the 7th day of treatment. RESULTS: In the antimicrobial photodynamic therapy group, 100% improvement was achieved regarding pain and lymphadenopathy at the end of the 7th day. Comparison of the inflammatory cell scores of the 2nd biopsy samples between the antibiotic alone and antimicrobial photodynamic therapy groups revealed a significant difference in favor of antimicrobial photodynamic therapy group. CONCLUSIONS: Antimicrobial photodynamic therapy combined with antibiotic therapy for pericoronitis treatment was found to be more successful as compared with the antibiotic therapy alone regarding clinical and histological outcomes.

The potential etiologic factors influencing tinnitus intensity in patients with temporomandibular disorders.

OBJECTIVES: To investigate the potential relationships between the intensity of tinnitus associated with temporomandibular disorders (TMD) and potential etiologic factors, including age, gender, freeway space, sleep bruxism (SB), joint clicking, and headache. METHODS: The sample was comprised of 90 patients without any hearing loss, as confirmed by otorhinolaryngology, who self-reported subjective tinnitus and simultaneous TMD, based on the Research Diagnostic Criteria for TMD (RDC/TMD). RESULTS: The results showed a positive, weak correlation between the intensity of tinnitus and age (r = 0.225, p = 0.033). The presence of SB and headache were seen in higher proportions in the present sample, at 75.5% (n = 68) and 66.6% (n = 60), respectively. CONCLUSIONS: In a population of patients with subjective tinnitus and TMD, no significant associations were found between tinnitus intensity and age, freeway space, SB, clicking presence, and headache, though gender did show a weak correlation with tinnitus intensity.

Evaluation of residual monomer release and toxicity of self-adhesive resin cements.

The aim of this study was to evaluate the amount of leached residual monomers from self-adhesive resin cements and evaluate their toxicity in-vitro. A total of 60 disk-shaped specimens (5 mm in diameter and 0.5 mm in thickness) were prepared from each cement (RelyX U200, SpeedCEM, G-Cem) (n=20). Specimens were immersed in artificial saliva and the amount of released monomers [urethane dimethacrylate (UDMA) and triethyleneglycol dimethacrylate (TEGDMA)] was identified. Then, the cytotoxicity and genotoxicity effect on cells were evaluated using the defined amounts of released monomers from cements. The highest monomer release was detected in G-Cem (p<0.05). The highest cytotoxicity value was identified from SpeedCEM (p<0.01) and the highest genotoxicity values were calculated from RelyX U200 (p<0.05). Released UDMA and TEGDMA from self-adhesive resin cements induced cytotoxicity and genotoxicity effect on cells.

Can We Improve the Laser Etching with the Digitally Controlled Laser Handpiece-Xrunner?

OBJECTIVE: The aim of this study was to compare the shear bond strength (SBS), enamel surface characteristics, and the adhesive remnant index (ARI) scores of different etching methods. BACKGROUND DATA: Laser etching changes the physical characteristics of the enamel surface and these alterations hold promise for the conditioning of enamel for bonding procedures. A new Er:YAG laser handpiece is unique in its ability to digitally control size, shape, and depth of irradiated enamel area. MATERIALS AND METHODS: Ninety-eight premolar teeth were used in this study. Eighty of 98 teeth were divided into four experimental groups of 20 teeth each for SBS testing: (1) 37% phosphoric acid, (2) manual Er:YAG laser (120 mJ, 10 Hz, and 1.2 W), (3) manual Er,Cr:YSGG laser (45 mJ, 50 Hz, and 2.25 W), and (4) digitally controlled Er:YAG laser (Xrunner; 100 mJ, 10 Hz, 1 W). The SBS values and ARI scores were recorded. Eighteen teeth were used to evaluate the surface morphology with scanning electron microscopy and atomic force microscopy after etching and following debonding and restoration. RESULTS: Mean SBS value was 7.75 ± 2.5 MPa for Xrunner and 8.11 ± 3.5, 9.47 ± 3.3, and 7.11 ± 3.7 MPa for the acid, Er,Cr:YSGG, and Er:YAG groups, respectively (p = 0.148). However, the acid etching group demonstrated significantly higher ARI scores (p < 0.001). CONCLUSIONS: All etching methods caused enamel surface irregularities and were effectively restored to its original gloss. Laser etching was found to be an alternative to acid etching; however, the clinical success should be evaluated with further studies.

Efficacy of Low-Level Laser Therapy in Subjective Tinnitus Patients with Temporomandibular Disorders.

OBJECTIVE AND BACKGROUND: Tinnitus is an apparent sound, perceived in the ear with no stimulus. It has been described as a sound originating from the brain. It affects 17% of the general population. Etiological factors for tinnitus include temporomandibular joint disorders (TMJ, TMD) and Costen's syndrome. The aim of treatment is to eliminate the tinnitus or at least decrease its apparent volume. MATERIALS AND METHODS: In total, 46 patients referred to our department with bilateral subjective tinnitus with TMDs were selected for this study. Low-level laser therapy (LLLT) with an neodymium-doped yttrium aluminum garnet (Nd:YAG) (1064 nm) laser, LLLT with a diode laser (810 nm), and placebo treatment were applied to the patients. There were 15 patients each in the Nd:YAG and placebo groups and 16 patients in the 810 nm diode laser group. LLLT was applied for 10 days, once per day. A visual analog scale (VAS) was used, with values between 0 and 10. VAS scores were recorded before treatment, on the last day of treatment, and 1 month after treatment. The VAS scores were the same on the last day of treatment and 1 month after treatment. The VAS scores before treatment and at 1 month after treatment were compared in a statistical analysis. RESULTS: There were statistically significant differences in the Nd:YAG laser (p = 0.001) and 810 nm diode laser groups (p = 0.005), but no difference in the placebo group (p = 0.065). CONCLUSIONS: Both the Nd:YAG and 810 nm diode lasers were effective for the treatment of subjective tinnitus related to TMDs.

The Effect of Luting Cement and Titanium Base on the Final Color of Zirconium Oxide Core Material.

PURPOSE: To evaluate the effects of different types of luting cements and different colors of zirconium cores on the final color of the restoration that simulates implant-supported fixed partial dentures (FPDs) by using a titanium base on the bottom. MATERIALS AND METHODS: One hundred and twenty zirconium oxide core plates (Zr-Zahn; 10 mm in width, 5 mm in length, 0.5 mm in height) were prepared in different shades (n = 20; noncolored, A2, A3, B1, C2, D2). The specimens were subdivided into two subgroups for the two types of luting cements (n = 10). The initial color measurements were made on zirconium oxide core plates using a spectrometer. To create the cement thicknesses, stretch strips with holes in the middle (5 mm in diameter, 70 µm in height) were used. The second measurement was done on the zirconium oxide core plates after the application of the resin cement (U-200, A2 Shade) or polycarboxylate cement (Lumicon). The final measurement was done after placing the titanium discs (5 mm in diameter, 3 mm in height) in the bottom. The data were analyzed with two-way ANOVA and Tukey's honestly significant differences (HSD) tests (α = 0.05). RESULTS: The ∆E*ab value was higher in the resin cement-applied group than in the polycarboxylate cement-applied group (p < 0.001). The highest ∆E*ab value was recorded for the zirconium oxide core-resin cement-titanium base, and the lowest was recorded for the polycarboxylate cement-zirconium oxide core (p < 0.001). CONCLUSION: The luting cement, the presence of titanium, and the color of zirconium are all important factors that determine the final shade of zirconia cores in implant-supported FPDs.