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Background: The world of esthetic dentistry is constantly making efforts toward the management of tooth staining. Laser-assisted bleaching is needed before adhesive restorations and has become common and advantageous as it accelerates bleaching action, reduces postoperative sensitivity, and promotes recrystallization of enamel. Aim: The study aimed to evaluate and compare the bond strength of diode (Biolace: EpicX) and neodymium-doped:yttrium aluminum garnet (Nd:YAG) (LightWalker, Fotona, Slovenia) assisted bleached (Pola Office, SDI) enamel with nanofilled composite (GC Solare Sculpt). Materials and Methods: The samples were divided into three groups (n = 11): Group A - Conventionally bleached enamel, Group B - Diode laser-assisted bleached enamel, Group C - Nd:YAG laser-assisted bleached enamel. After storing samples in Artificial Saliva for 2 weeks, bonding was performed, and nanofilled composite resin was applied through an incremental method. Samples were subjected to shear bond strength (SBS) analysis. Conclusion: The use of Nd:YAG laser on bleached enamel significantly increases the bond strength with nanofilled composite resin.
RESUMO
BACKGROUND: Preventing the apical extrusion of debris during instrumentation is of paramount importance to reduce the occurrence of flare-ups in endodontically treated teeth. Furthermore, an essential requirement for the longevity and strength of an endodontically treated tooth and its ability to resist fracture is the preservation of residual dentin thickness during instrumentation. The aim of this study was to compare the amount of debris extrusion, remaining dentin thickness at the coronal third, middle third, apical third, and the fracture resistance of the teeth using rotary (TruNatomy; Dentsply Sirona, Charlotte, NC) and reciprocating (WaveOne Gold; Dentsply Sirona) endodontic file systems. METHODS: An in vitro study included 52 single-rooted, oval canal shaped teeth that underwent exploration and initial cleaning with a no. 15 K-file. The prepared canals were then randomly assigned to two groups: Group I, with instrumentation with the TruNatomy rotary file (n=26) and Group II, with instrumentation with the WaveOne Gold reciprocating file. Parameters like debris extrusion, remaining dentin thickness, and fracture resistance were evaluated in both the groups. Analysis was performed using a paired t-test for the assessment of difference between groups and one-way ANOVA test followed by the post-hoc Tukey test for difference between the coronal, middle and apical third for each study group. RESULTS: The results revealed no significant difference (t=0.454, p=0.652) between the TruNatomy rotary file and WaveOne Gold reciprocating file in apical extrusion of debris after their use in root canal therapy. For the remaining dentin thickness, a significant difference was present between the TruNatomy rotary file and WaveOne Gold reciprocating rotary file at the coronal (t=5.766, p<0.0001) and middle (t=3.690, p=0.001) levels. The mean fracture resistance was significantly more (t=15.877, p<0.0001) with the TruNatomy rotary file compared to the WaveOne Gold reciprocating rotary file. CONCLUSION: The TruNatomy rotary file system outperformed the WaveOne Gold reciprocating file system in terms of maintaining the remaining dentin thickness and providing improved fracture resistance. Nevertheless, debris extruded apically was comparable between the TruNatomy rotary file system and the WaveOne Gold reciprocating file system.
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Context: Smear layer clearance and sealer penetration into dentinal tubules play a crucial role in root canal treatment. Hence, efficient irrigation is a crucial component of the root canal debridement. This in vitro study's objective was to assess the effectiveness of passive ultrasonic activation and Erbium: yttrium-aluminum-garnet (Er: YAG) laser-activated irrigation on irrigation solution penetration and sealer penetration into dentinal tubules. Aims: The aim of this study was to evaluate and compare the dentinal tubule penetration of epoxy resin-based sealer and bioceramic sealer after ultrasonic agitation and Er: YAG laser activation of the irrigant. Settings and Design: This was an in vitro study. Materials and Methods: Extracted tooth samples (n = 42) into 06 groups (Group A-F) with 7 samples in each group. Postobturation transverse section was made and assessed under a confocal laser scanning microscope for the total dentinal tubule penetration area and recorded as the mean apical, middle, and coronal penetration. Statistical Analysis: One-way analysis of variance test, followed by post hoc was used. Results: The intergroup comparison showed that Group E and Group F have significantly more penetration as compared to the controls and ultrasonic irrigation, P < 0.001 and P < 0.01, respectively. Conclusions: Er: YAG laser with AH plus sealer has the highest penetration in all the sections of tooth, followed by CeraSeal sealer.
RESUMO
Bleaching agents can cause certain surface alterations on the enamel, such as depressions, surface porosity, and surface irregularities; this makes the dentin more susceptible to post-operative tooth sensitivity (PoS). In addition, the presence of flawed or leaky restorations, gingival recession, or defects in the cementoenamel junction can also cause severe tooth sensitivity post tooth bleaching.Hence, the current study aimed to perform a systematic review to determine the efficacy of various desensitizing agents (DA) in managing post-operative tooth sensitivity and color alteration when applied before in-office bleaching procedures. Randomized clinical trials were searched to conduct an SR where the post-operative tooth sensitivity was evaluated after in-office bleaching with various desensitizing agents used before the procedure. Post-operative pain assessment was measured using the Visual Analogue Scale (VAS). Outcomes were evaluated up to an hour and 24 hours post the procedure. Out of 163 articles, only 13 titles were selected that met the eligibility criteria. Eight hundred and forty-one adult patients with vital pulp status were included. The participants receiving prior desensitizing agent applications reported significantly lower pain scores in the VAS reports. The most significant reduction of post-operative sensitivity was observed in the immediate (up to an hour) and 24 hours after the in-office bleaching. The popular desensitizing agent that could manage post-operative tooth sensitivity (TS) is 5% potassium nitrate and 2% sodium fluoride used before the in-office bleaching procedure.