Effect of build orientation in gloss, roughness and color of 3D-printed resins for provisional indirect restorations.

OBJECTIVES: The purpose of this study was to evaluate the effect of build orientation of 3D-printed provisional resins (3DRs) on gloss (Gs), surface roughness (Sa), maximum profile valley depth (Rv), and color difference (∆E00). METHODS: PMMA CAD/CAM blocks (Vita Temp/Vita) were sectioned and served as a Control. Four 3DRs (Cosmos-SLA/Yller, Cosmos-DLP/Yller, PriZma-Bioprov/Makertech, Nanolab/Wilcos) were obtained as discs (15-mm diameter, 2.5-mm thickness) in three orientations (0°, 45°, and 90°) using different 3D printers (Form 2/Formlabs, P30/Straumann, Hunter/Flashforge, W3D/Wilcos, respectively). Samples were then cleaned with isopropyl alcohol prior to post-curing in specific post-curing units. Half of the samples' surface was covered with an adhesive tape and submitted to 10,000 toothbrushing (TB) cycles. The Gs and Sa at the brushed and not brushed surfaces were evaluated with a glossmeter (Novo-curve) and a laser confocal microscope (OLS5000) (n = 10), which also obtained the Rv and 3D representative images of the interface between not brushed and brushed surfaces. Electron microscopy images of the surface of some samples was also performed (n = 3). On another set of samples (n = 5), the coordinates of luminosity and color were obtained with a spectrophotometer (Easyshade V) at baseline and after 16.7 h and 200 h of UVB aging, to calculate the ∆E00 using CIEDE:2000 formula. Additionally, 3DRs photoinitiators were identified using a minispectrometer (USB2000 +) (n = 5). Data of Gs and Sa were submitted to three-way-, Rv to two-way-, and ∆E00 to mixed-ANOVA tests, followed by Tukey's test (α = 0.05). For all variables, results from experimental groups were compared to control using Dunnett's test (α = 0.05). Student's t-test was used to compare the control at different TB cycles (Gs, Sa) or aging periods (∆E00) (α = 0.05). RESULTS: Build orientation of 3DRs did not influence any of the variables studied. The 10,000 TB cycles resulted in a decrease in Gs and increase in Sa for all resins tested. The control showed higher Gs after 10,000 TB cycles than Cosmos-SLA and Nanolab resins. Compared to all 3DRs, Control presented lower ∆E00 after 200 h of UVB aging. All 3DRs presented higher ∆E00 than the clinically acceptable after 200 h of UVB aging. Lucirin® TPO was identified in all 3DRs, although PriZma might also present other photoinitiators and Nanolab might present Irgacure 369. SIGNIFICANCE: Alterations in build orientation are very useful and frequently performed in the day-today of 3D-printing, thus its effect in the optical properties and in the topography of 3D-printed restorations is very relevant. For the evaluated 3D-printed provisional resins, build orientation did not influence any of the variables studied (Gs, Sa, Rv, and ∆E00), even after toothbrushing cycles and UVB aging.

Laser irradiation prevents root caries: Microhardness and scanning electron microscopy analysis.

Context: A promising option for the prevention of dental caries is the use of laser irradiation. Aims: Evaluate the effects of Er:YAG, Nd:YAG, and CO2 laser irradiation, associated or not to 2% sodium fluoride (2% NaF), on root caries prevention. Material and Methods: One hundred and four human root dentin samples were divided in eight groups (n = 13). A 9-mm2-area on each dentin sample was delimited and treated as follows: G1: no treatment (control); G2: 2% NaF; G3: Er:YAG; G4: 2% NaF + Er:YAG; G5: Nd:YAG; G6: 2% NaF + Nd:YAG; G7: CO2; G8: 2% NaF + CO2. When used, the 2% NaF was applied before irradiation for 4 min. The samples were subjected to a 2-week cariogenic challenge, consisted of daily immersion in de-remineralizing solutions for 6 h and 18 h, respectively. Knoop hardness (KHN) were evaluated (10 g and 20 s) at different depths from the dentin surface. The samples (n = 3) were prepared for scanning electron microscopy (SEM). Microhardness data were analysed by one-way analysis of variance (ANOVA) and Fisher's test (α = 5%). Results: The Er:YAG laser group (KHN = 41.30) promoted an increase in acid resistance of the dentin (P < 0.05) when compared to all groups. There was no synergism between laser irradiation and 2% NaF application. Morphological changes were observed after irradiation with all lasers; carbonization and cracks were also observed, except when Er:YAG were used. Conclusions: Er:YAG laser irradiation can safely increase the acid resistance of the dentin surface of the root, since it promoted a significant increase in surface hardness. The application of 2% NaF did not result in a synergistic effect.

Physical and mechanical properties of a dental resin adhesive containing hydrophobic chitin nanocrystals.

OBJECTIVES: In this paper we propose embedding natural fillers, such as pristine and functionalized chitin nanocrystals, into resin adhesives to produce photopolymerizable dental filled adhesives with enhanced biocompatibility, hydrophobicity, mechanical resistance, and anti-bacterial properties. METHODS: Chitin nanocrystals (ChNC) were functionalized with decanoyl chloride and methacrylic anhydride to produce ChNC-C10 and ChNC-MA, respectively. These hydrophobically functionalized chitin nanocrystals were incorporated into a resin adhesive at concentrations of 0.5-3.0 wt% to assess the materials' physical and mechanical properties through Fourier-transform infrared (FTIR) spectroscopy, solid-state NMR spectroscopy, X-ray diffraction (XRD), elemental analysis, scanning electron microscopy (SEM), thermogravimetric analysis (TGA), flexural strength, microhardness, and water sorption tests. RESULTS: The analytical techniques confirmed the successful preparation of chitin nanocrystals from commercial chitin powder derived from shrimp shells and the efficient hydrophobization of their surface. Electron microscope images indicated that the increased hydrophobicity of ChNC-C10 promotes the formation of layered structures throughout the resin adhesive, while ChNC-MA tends to form aggregates in the matrix. Adhesives filled with ChNC-C10 enhanced their flexural strength, microhardness, and thermal stability and decreased their water sorption and degree of conversion. Adhesives filled with ChNC-MA resulted in improvements in microhardness, in water sorption and degree of conversion, although they did not exhibit augmentation of their flexural strength and thermal stability. SIGNIFICANCE: In light of the improved physical and mechanical properties with respect to the control, resin adhesives filled with anti-bacterial chitin nanocrystals are promising new materials for dental applications, especially those filled with low/moderate amounts of ChNC-C10.

Phosphoric acid containing proanthocyanidin enhances bond stability of resin/dentin interface.

Proanthocyanidin (PA) is a promising dentin biomodifier due to its ability to stabilize collagen fibrils against degradation by matrix metalloproteinases (MMPs); however, the most effective protocol to incorporate PA into bonding procedures is still unclear. This study evaluated the effect of dentin biomodification with a PA acid etchant on MMP activity, adhesive interface morphology and resin-dentin microtensile bond strength. Sound extracted human molars were flattened to expose dentin and acid-etched for 15 s according to the groups: EXP - experimental phosphoric acid; EXP+PA - experimental phosphoric acid 10% PA; TE - total-etching system; SE - self-etching system. Samples were restored with composite resin and stored in distilled water (37ºC). MMP activity and interface morphology were analyzed after 24 h by in situ zymography (n=6) and scanning electron microscopy (n=3), respectively. The resin-dentin microtensile bond strength (µTBS) was evaluated after 24 h and 6 months storage (n=6). Significantly higher MMP activity was detected in etched dentin compared with untreated dentin (p<0.05), but no difference among acid groups was found. Resin tags and microtags, indicative of proper adhesive system penetration in dentinal tubules and microtubules, were observed along the hybrid layer in all groups. There was no difference in µTBS between 24 h and 6 months for EXP+PA; moreover, it showed higher long-term µTBS compared with TE and EXP (p<0.05). The results suggest that 15 s of biomodification was not sufficient to significantly reduce MMP activity; nonetheless, EXP+PA was still able to improve resin-dentin bond stability compared with total- and self-etching commercial systems.

Phosphoric acid containing proanthocyanidin enhances bond stability of resin/dentin interface

Abstract Proanthocyanidin (PA) is a promising dentin biomodifier due to its ability to stabilize collagen fibrils against degradation by matrix metalloproteinases (MMPs); however, the most effective protocol to incorporate PA into bonding procedures is still unclear. This study evaluated the effect of dentin biomodification with a PA acid etchant on MMP activity, adhesive interface morphology and resin-dentin microtensile bond strength. Sound extracted human molars were flattened to expose dentin and acid-etched for 15 s according to the groups: EXP - experimental phosphoric acid; EXP+PA - experimental phosphoric acid 10% PA; TE - total-etching system; SE - self-etching system. Samples were restored with composite resin and stored in distilled water (37ºC). MMP activity and interface morphology were analyzed after 24 h by in situ zymography (n=6) and scanning electron microscopy (n=3), respectively. The resin-dentin microtensile bond strength (μTBS) was evaluated after 24 h and 6 months storage (n=6). Significantly higher MMP activity was detected in etched dentin compared with untreated dentin (p<0.05), but no difference among acid groups was found. Resin tags and microtags, indicative of proper adhesive system penetration in dentinal tubules and microtubules, were observed along the hybrid layer in all groups. There was no difference in μTBS between 24 h and 6 months for EXP+PA; moreover, it showed higher long-term μTBS compared with TE and EXP (p<0.05). The results suggest that 15 s of biomodification was not sufficient to significantly reduce MMP activity; nonetheless, EXP+PA was still able to improve resin-dentin bond stability compared with total- and self-etching commercial systems.

Resumo A proantocianidina (PA) é um biomodificador dentinário promissor devido a sua capacidade de estabilizar as fibrilas colágenas contra a degradação por metaloproteinases da matriz (MMPs); no entanto, o protocolo mais eficaz para a incorporação de PA em procedimentos adesivos ainda não está claro. Este estudo avaliou o efeito da biomodificação da dentina com um condicionador ácido contendo PA na atividade de MMPs, morfologia da interface adesiva e resistência à microtração resina-dentina. Molares humanos extraídos foram lixados para exposição da dentina e condicionados com ácido por 15 s de acordo com os grupos: EXP - ácido fosfórico experimental; EXP+PA - ácido fosfórico experimental com 10% PA; TE - sistema total-etch; SE - sistema self-etch. As amostras foram restauradas com resina composta e armazenadas em água destilada (37ºC). A atividade de MMP e morfologia da interface foram analisadas após 24 h por zimografia in situ (n=6) e microscopia eletrônica de varredura (n=3), respectivamente. A resistência à microtração resina-dentina (μTBS) foi avaliada após 24 horas e 6 meses de armazenamento (n=6). Atividade de MMP detectada na dentina condicionada foi significativamente maior em comparação com a dentina não tratada (p <0,05), mas não houve diferenças entre os diferentes ácidos. Tags e microtags de resina, indicativos de uma penetração adequada do sistema adesivo nos túbulos e microtúbulos dentinários, foram observadas ao longo da camada híbrida em todos os grupos. Não houve diferença entre os valores de μTBS de 24 h e 6 meses para EXP+PA; além disso, EXP+PA apresentou maiores valores de μTBS após 6 meses em comparação com TE e EXP (p <0,05). Os resultados sugerem que a biomodificação por 15 s não foi suficiente para reduzir significativamente a atividade de MMP; apesar disso, EXP + PA foi capaz de melhorar a estabilidade da interface resina-dentina em comparação com sistemas total- e self-etch comerciais.

Characterization of polymethylmethacrylate microspheres loaded with silver and doxycycline for dental materials applications.

OBJECTIVES: The manufacturing of polymethylmethacrylate(PMMA) microspheres loaded with doxycycline(DOX) and/or silver sulfate(Ag2SO4) to be incorporated into glass ionomer cement(GIC). METHODS: PMMA microspheres were manufactured with Ag2SO4(1-5%) and/or DOX(5-15%). Particle size, encapsulation efficiency and drug release were measured by light microscope, ICP, and HPLC. Microspheres were added to a dental GIC(20%w/w). Drug release and DTS were investigated. Minimum inhibitory concentration and antibacterial effects of PMMA microspheres into GIC materials were tested. RESULTS: The median diameter of 50 µm was obtained for microspheres. DOX was encapsulated at an efficiency of 8.3% using a theoretical loading of 15%DOX + 5%Ag2SO4. The Ag2SO4 encapsulation efficiency was 0.63% using a theoretical loading of 5%AgSO4. All groups showed burst release within the first day and continued released up to 15 days, with 60-83% of DOX and approximately 30% of silver. For GIC, approximately 15% of DOX and 0.18% of silver were released in a 7-day period. Microbiological results showed an antimicrobial effect against S. mutans when the lead formulation of microspheres was added. The DTS was reduced by the inclusion of microspheres. SIGNIFICANCE: PMMA microspheres containing DOX and Ag2SO4 offer a sustained antimicrobial activity for dental applications and promising potential for the biomedical field.

Effects of prolonged use of over-the-counter bleaching agents on enamel: An in vitro study.

This study evaluated the effects of four over-the-counter (OTC) bleaching products on the properties of enamel. Extracted human molars were randomly assigned into four groups (n = 5): PD: Poladay (SDI), WG: White Teeth Global (White Teeth Global), CW: Crest3DWhite (Procter & Gamble), and HS: HiSmile (HiSmile). The hydrogen peroxide (H2 O2 ) content in each product was analyzed via titration. Twenty teeth were sectioned into quarters, embedded in epoxy resin, and polished. Each quarter-tooth surface was treated with one of the four beaching times: T0: control/no-bleaching, T14: 14 days, T28: 28 days, and T56: 56 days. Materials were applied to enamel surfaces as recommended. Enamel surfaces were examined for ultramicrohardness (UMH), elastic modulus (EM), superficial roughness (Sa), and scanning electron microscopy (SEM). Ten additional teeth were used to evaluate color and degree of demineralization (DD) (n = 5). Data were statistically tested by two-way ANOVA and Tukey's tests (α = 5%). Enamel surfaces treated with PD and WG presented UMH values significantly lower than the controls (p < .05). Elastic modulus (E) was significantly reduced at T14 and T28 for PD, and at T14 for HS (p < .05). A significant increase in Sa was observed for CW at T14 (p < .05). Color changes were observed in the PD and WG groups. Additionally, DD analysis showed significant demineralization at T56 for CW. Overall, more evident morphological alterations were observed for bleaching products with higher concentrations of H2 O2 (p < .05), PD, and WG. Over-the-counter bleaching products containing H2 O2 can significantly alter enamel properties, especially when application time is extended.

Radiotherapy Activates Matrix Metalloproteinases in the Dentinoenamel Junction of Primary Teeth.

Purpose: Radiation-related caries is characterized by enamel delamination near the dentinoenamel junction (DEJ). We investigated the activity and expression of the matrix metalloproteinases (MMPs) -2 and -9 in order to understand disease pathogenesis in teeth submitted or not to radiotherapy (RT).
Methods: In situ zymography and immunofluorescence assays were performed to evaluate the activity and expression of MMPs -2 and -9, respectively. Twelve primary second molars were randomly assigned into two experimental subgroups: irradiated and nonirradiated. Dental fragments were exposed to radiation at a dose fraction of two Gy for five consecutive days until reaching the total dose of 60 Gy. The percentage of fluorescence in the DEJ was evaluated in three distinct regions of the tooth (cervical, cusp, and pit). The regions were photographed under fluorescence microscopy at 1.25× and 5× magnification.
Results: The intensity of fluorescence per mm 2 in the DEJ was higher in the cervical region of irradiated primary teeth (P <0.05) versus nonirradiated ones. In these areas, immunofluorescence revealed expression of MMPs -2 and -9.
Conclusion: Radiotherapy can increase the activity of MMPs -2 and -9 in the cervical region of the DEJ of primary teeth.

Effect of manual and electrical brushing on the enamel of sound primary teeth and teeth with induced white spot lesions.

PURPOSE: To evaluate the effect of different electrical brushing systems on the surface roughness and wear profile of the enamel of sound primary teeth and teeth with induced white spot lesions. METHODS: 45 specimens were obtained from sound primary incisors, and the buccal surface was divided into four parts: sound enamel; enamel with white spot lesions; sound enamel with brushing; and enamel with white spot lesions and brushing. Specimens were randomly divided into three groups (n =15), according to the different brushing systems: Group 1 - Electric rotating toothbrush (Kid's Power Toothbrush - Oral B); Group 2 - Sonic electric toothbrush (Baby Sonic Toothbrush); and Group 3 - Manual toothbrush (Curaprox infantil) (control). The specimens were analyzed for surface roughness and wear profile. Data were analyzed by appropriate statistical tests, with a significance level of 5%. RESULTS: Regarding the surface roughness, no significant difference was observed between the groups. However, with respect to the wear profile, Group 1 caused significantly higher wear in the sound tooth enamel and in the presence of white spot lesions, in comparison to the other brushing systems (2 and 3) (P< 0.05), which did not cause wear. Manual and electric brushing (rotational and sonic) did not increase surface roughness in primary tooth enamel. However, the electric rotational brushing caused significant wear of the sound and demineralized enamel surface of primary teeth. CLINICAL SIGNIFICANCE: None of the toothbrushing systems tested caused significant alterations on sound dental enamel. However, rotational toothbrushing on enamel of primary teeth with white spot lesion increased wear.

Peracetic acid as a single endodontic irrigant: effects on microhardness, roughness and erosion of root canal dentin.

The aim was to assess the effects of 1% peracetic acid (PAA) as a single endodontic irrigant on microhardness, roughness, and erosion of root canal dentin, compared with 2.5% sodium hypochlorite (NaOCl) and with 2.5% NaOCl combined with 17% EDTA. Forty human, single-rooted tooth hemisections were submitted to Knoop microhardness test, before and after the following irrigation protocols: PAA = 1% PAA; NaOCl = 2.5% NaOCl; NaOCl-EDTA-NaOCl = 2.5% NaOCl +17% EDTA +2.5% NaOCl; and SS = saline. Another 40 roots were instrumented, irrigated with the same protocols, and sectioned longitudinally. The roughness analysis was performed on the mesial section using a confocal laser scanning microscope, whereas erosion was analyzed on each third of the distal section, using a scanning electron microscope. The data were analyzed using ANOVA and Tukey post-tests, and Kruskal-Wallis and Dunn post-tests (α = .05). The PAA and NaOCl-EDTA-NaOCl groups showed no significant differences (p > .05); both promoted reduction in microhardness and increase in roughness, compared with the NaOCl and SS groups (p < .05). NaOCl-EDTA-NaOCl promoted higher erosion in the cervical and middle thirds than the other groups (p < .05); there was no difference among PAA, NaOCl, and SS (p > .05). There was also no difference among the groups regarding the apical third (p > .05). PAA used as a single endodontic irrigant caused reduction in root canal dentin microhardness and increase in roughness in a similar way to NaOCl-EDTA-NaOCl; however, PAA caused less erosion than NaOCl-EDTA-NaOCl.

Influence of Er,Cr:YSGG laser on dentin acid resistance after erosive challenge.

PURPOSE: To evaluate the influence of the Er,Cr:YSGG laser with or without the 5% fluoride varnish on the acid resistance of dentin after erosive challenge. METHODS: 36 incisors were selected and sectioned, obtaining 72 specimens of 4 mm × 4 mm and randomly divided into eight groups (n = 9). In G1: application of Er,Cr:YSGG (0.1W; 5Hz, air 55%); G2: laser (0.25W; 5Hz, air 55%); G3: fluoride varnish + laser (0.1W; 5Hz, air 55%); G4: fluoride varnish + laser (0.25W, 5Hz, air 55%); G5: fluoride varnish + laser (0.1W; 5Hz, without air); G6: fluoride varnish + laser (0.25W, 5Hz, without air); G7: fluoride varnish and G8: no treatment. When used, the laser was irradiated without water cooling, scanning mode during 10 seconds. The surface roughness data were subjected to ANOVA. For wear profile, we used Kruskal-Wallis test and Dunn post-hoc, all with α= 0.05. RESULTS: The results showed no statistically significant difference when comparing the groups as regards to the surface roughness (P> 0.05). Regarding the percentage of lost volume, the G5 and G6 groups presented the best results (G5 = 7.8% and G6 = 8.5%), with the lowest loss of dentin volume compared to other groups (P< 0.05). The G8 group (no treatment) had the highest lost volume (G8 = 39.1% followed by the G7 group (fluoride varnish), which had 25.9%. CLINICAL SIGNIFICANCE: The use of Er,Cr:YSGG laser and fluoride varnish can be an effective method to increase the acid resistance of dentin after erosive challenges, and limit problems related to hypersensitivity.

Biomechanical behavior of maxillary premolars with conservative and traditional endodontic cavities.

OBJECTIVE: The objective was to evaluate the effects of the configuration of endodontic cavities with parallel or divergent walls, versus traditional endodontic cavities, on stress distribution, fracture resistance, and fracture mode of maxillary premolars by using both fracture-strength and finite element tests. METHOD AND MATERIALS: Thirty-two maxillary first premolars were divided into four groups (n = 8), according to the type of endodontic cavities: without endodontic cavities (control); conservative; conservative with diverging walls; and traditional. After performing root canal treatment and restoration, fracture resistance was evaluated by oblique compressive load. The stress distribution was evaluated by nonlinear finite element analysis by means of micro-computed tomography, operated at 50 kV and 800 mA. The fracture resistance data were analyzed by statistical software. RESULTS: Higher stress concentration was observed on the coronal portion of the palatal cusp and the palatal root dentin. Stress concentration on the palatal root dentin was similar for all groups. The stress level on the palatal cusp and at the proximal crests was slightly increased in the traditional endodontic cavities group compared with conservative endodontic cavities. Stress distribution in restored teeth was similar to that of intact teeth. No significant differences were observed in the fracture resistance among different endodontic cavities' design (P = .32). All groups had values similar to those of the control group (P > .05). CONCLUSIONS: Regardless of the cavity design, conservative endodontic cavities that preserve marginal ridge integrity did not affect the resistance to fracture, failure mode, or stress distribution in maxillary premolars restored with composite resin. Endodontically treated teeth displayed biomechanical behavior similar to sound teeth.

Surface roughness and bacterial adhesion on root dentin treated with diode laser and conventional desensitizing agents.

The treatments for dentin hypersensitivity (DH) may change the surface roughness of the root dentin, which can lead to biofilm accumulation, increasing the risk of root caries. The aim was to compare the surface roughness of root dentin after different treatments of DH and the biofilm formation on those surfaces. After initial surface roughness (Sa) assessment, 50 bovine root fragments received the following treatments (n = 10): G 1-no treatment; G2-5% sodium fluoride varnish; G3-professional application of a desensitizing dentifrice; G4-toothbrushing with a desensitizing dentifrice; and G5-diode laser application (908 nm; 1.5 W, 20 s). The Sa was reevaluated after treatments. Afterward, all samples were incubated in a suspension of Streptococcus mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted using a stereoscope, and the results were expressed in CFU/mL. The one-way ANOVA and the Tukey's tests compared the roughness data and the results obtained on the bacterial adhesion test (α = 5%). G2 (2.3 ± 1.67%) showed similar Sa variation than G1 (0.25 ± 0.41%) and G5 (5.69 ± 0.99%), but different from group G3 (9.05 ± 2.39%). Group 4 showed the highest Sa variation (30.02 ± 3.83%; p < 0.05). Bacterial adhesion was higher in G4 (2208 ± 211.9), suggesting that bacterial growth is greater on rougher surfaces. The diode laser and the conventional treatments for DH may change the surface roughness of the root dentin, but only brushing with desensitizing dentifrice induced a higher bacteria accumulation on root dentin surface.

In Vitro Evaluation of Dentin Hydraulic Conductance After 980 nm Diode Laser Irradiation.

BACKGROUND: Dentin hypersensitivity treatments are based on the physical obliteration of the dentinal tubules to reduce hydraulic conductance. The aim of the present study is to evaluate the hydraulic conductance of bovine root dentin after irradiation with a 980-nm diode laser, with or without associated fluoride varnish. METHODS: Sixty bovine root dentin specimens were divided into six groups (n = 10 in each group): G1, G3, and G5 (0.5 W, 0.7 W, and 1 W diode laser, respectively); G2, G4, and G6 (fluoride varnish application + 0.5 W, 0.7 W, and 1 W diode laser, respectively). The dentin hydraulic conductance was evaluated at four time periods with a fluxmeter: 1) with smear layer, 2) after 37% phosphoric acid etching, 3) after the treatments, and 4) after 6% citric acid challenge. After the dentinal fluid flow measurements, specimens were also evaluated for mineral composition using energy dispersive X-ray spectroscopy (EDS). RESULTS: Analysis demonstrated a better result with increased irradiation power (P < 0.001), especially if the diode laser irradiation was associated with the application of fluoride varnish (P < 0.001), ensuring a greater reduction in permeability. Considering the groups treated only with laser irradiation, the 1 W group was superior when compared with the 0.5 W and 0.7 W irradiated groups immediately after treatment (P < 0.001). After citric acid testing, all groups showed similar results, except when comparing the 1 W groups with the 0.5 W groups (P = 0.04). EDS results of the irradiated groups showed an increase in the proportion of calcium and phosphorus ions, which demonstrates a superficial composition modification after laser treatments. CONCLUSION: Laser irradiation of exposed dentin promoted significant reduction in the dentin hydraulic conductance, mainly with higher energy densities and association with fluoride varnish.

In vitro assessment of the acid resistance of demineralized enamel irradiated with Er, Cr:YSGG and Nd:YAG lasers.

PURPOSE: This study's purpose was to evaluate the acid resistance of demineralized enamel irradiated with high-intensity lasers. METHODS: Enamel fragments were demineralized and treated as follows (N=10): Group 1-no treatment; Group 2-five percent sodium fluoride (NaF) varnish; Group 3-Er, Cr:YSGG laser (8.92 J/cm2, 0.5 W, 20 Hz, 30 seconds); Group 4-NaF and Er, Cr:YSGG laser; Group 5-Er, Cr:YSGG laser and NaF; Group 6-Nd:YAG laser (84.9 J/cm2, 0.5 W, 10 Hz, 30 seconds); Group 7-NaF and Nd:YAG laser; and Group 8-Nd:YAG laser and NaF. The samples were subjected to pH-cycling and assessed by microhardness (analysis of variance; α equals five percent) at different depths from the outer enamel surface. Samples were observed using polarized light microscopy (PLM) and scanning electron microscopy (SEM). RESULTS: There were no significant differences among the experimental groups in any of the subsurface layers evaluated. PLM observation revealed that the extent of demineralization of the irradiated samples was similar to the samples for Group 1 (control). SEM observation showed that irradiated surfaces were ablated and presented areas of melting. CONCLUSIONS: Laser irradiation, with or without applying five percent sodium fluoride, was not capable of increasing the enamel white spot lesions' acid resistance.

Influence of laser irradiation on pits and fissures: an in situ study.

OBJECTIVE: The aim of this in situ study was to analyze the influence of the Er:YAG, Nd:YAG, and CO(2) lasers on the enamel acid resistance of pits and fissures. BACKGROUND DATA: The laser tissue interaction has been studied as a method of preventing occlusal caries. METHODS: Thirteen volunteers wore palatal acrylic appliances containing human occlusal enamel blocks that were divided into four groups (G1, control; G2, Er:YAG; G3, Nd:YAG; G4, CO(2)). Each palatal acrylic appliance was used in the four studied groups and was used for 14 consecutive days. A sucrose solution was applied to the specimens six times per day. The specimens were then sectioned in half, and a microhardness test was applied. The other halves were analyzed using polarized light microscopy to measure the caries-like lesion areas, and a morphological analysis was conducted using a scanning electron microscope (SEM). RESULTS: For the statistical analysis of the data obtained from the microhardness test (Knoop hardness number. [KHN]) (α=5%), Fisher's exact test was performed, and the group means were as follows: G1, 247±71; G2, 258±70; G3, 272±73; and G4, 298±56. The results demonstrated that the control group was significantly different from G3 and G4, which presented higher microhardness values. The Wilcoxon signed-rank test was used to analyze the data obtained from the caries-lesion area measurements (mm(2)) (α=5%) (G1, 0.01±1.08; G2, 0.13±0.18; G3, 0.05±0.17; and G4, 0.09±0.22). The results no showed significant differences among the groups in this analysis. CONCLUSIONS: Based on the results from the present study, it may be concluded that the CO(2) and Nd:YAG lasers increased the enamel acid resistance in pits and fissures.

Effect of sodium hypochlorite under several formulations on root canal dentin microhardness.

AIM: The aim of the present study was to evaluate the effect of three different formulations of sodium hypochlorite on the microhardness of root canal dentin in cervical and apical segments. METHODS: Twenty-four extracted human teeth had their roots sectioned along their long axes in a buccolingual direction. One half of each root was selected, and transversely sectioned resulting in two segments, cervical and apical, with similar lengths. The specimens were divided into three groups (n = 16), according to the sodium hypochlorite formulation used: (a) group 1, 2.5% sodium hypochlorite; (b) group 2, Chlor-XTRA; and (c) group 3, 5.5% sodium hypochlorite gel. These groups were subdivided in two subgroups (n = 8): cervical and apical root segments. Before testing the substances, dentin microhardness was measured on each section, 100 µm from the root canal with a Knoop tester. After 15 min of application, a new measurement was performed on each segment. Data were collected and registered for statistical treatment. RESULTS: In both segments, the substances reduced dentin microhardness. No differences were observed between the groups, independent of the analyzed segment (P > 0.05). CONCLUSIONS: All substances reduced dentin microhardness. Chlor-XTRA and 5.5% sodium hypochlorite gel promoted a reduction similar to the 2.5% sodium hypochlorite solution.

Effect of different root caries treatments on the sealing ability of conventional glass ionomer cement restorations.

In this study we compared the microleakage of conventional glass ionomer cement (GIC) restorations following the use of different methods of root caries removal. In vitro root caries were induced in 75 human root dentin samples that were divided in five groups of 15 each according to the method used for caries removal: in group 1 spherical carbide burs at low speed were used, in group 2 a hand-held excavator was used, and in groups 3 to 5 an Er,Cr:YSGG laser was used at 2.25 W, 40.18 J/cm(2) (group 3), 2.50 W, 44.64 J/cm(2) (group 4) and 2.75 W, 49.11 J/cm(2) (group 5). The air/water cooling during irradiation was set to 55%/65% respectively. All cavities were filled with GIC. Five samples from each group were evaluated by scanning electron microscopy (SEM) and the other ten samples were thermocycled and submitted to a microleakage test. The data obtained were compared by ANOVA followed by Fisher's test (p≤0.05). Group 4 showed the lowest microleakage index (56.65 6.30; p<0.05). There were no significant differences among the other groups. On SEM images samples of groups 1 and 2 showed a more regular interface than the irradiated samples. Demineralized dentin below the restoration was observed, that was probably affected dentin. Group 4 showed the lowest microleakage values compared to the other experimental groups, so under the conditions of the present study the method that provided the lowest microleakage was the Er,Cr:YSGG laser with a power output of 2.5 W yielding an energy density of 44.64 J/cm(2).

In vitro assessment of laser efficiency for caries prevention in pits and fissures.

This study aimed to assess the in vitro efficacy of the lasers Er:YAG, Nd:YAG, and CO(2) operating in the low energy mode for caries prevention in pits and fissures. Forty-five caries-free enamel occlusal sections were randomly divided into three groups: G1 - Er:YAG (80 mJ/2 Hz); G2 - Nd:YAG Laser (1 W and 10 Hz); and G3 - CO(2) Laser (0.4 W and 20 Hz). After surface treatment, the samples were submitted to challenge with acid consisting of a 10-day immersion in demineralizing (6 h) and remineralizing solution (18 h). Next, enamel demineralization was quantitatively evaluated by subsurface microhardness test and polarized-light microscopy (PLM, mm(2)) and qualitatively assessed by scanning electron microscopy. The Wilcoxon test was used for comparison of each group with its own control. ANOVA (α = 5%) was employed for comparison among groups, and Fisher's LSD multiple comparison test was applied, to check the difference in means. Concerning the microhardness analyses, statistical difference between control, and experimental areas was only detected for the CO(2) group. Experimental values were higher than the controls. As for PLM analyses, smaller demineralized areas were measured for G2 (Nd:YAG) and G3 (CO(2)) compared with the control areas. In conclusion, the present findings suggest that the CO(2) laser should be selected in order to increase the enamel resistance to acid in pits and fissures.

Influence of the irradiation distance and the use of cooling to increase enamel-acid resistance with Er:YAG laser.

OBJECTIVES: The aim of this study was to assess the influence of irradiation distance and the use of cooling in the Er:YAG laser efficacy in preventing enamel demineralization. METHODS: 84 enamel blocks were randomly assigned to seven groups (n=12): G1: control group - no treatment, G2-G7: experimental groups treated with Er:YAG laser (80mJ/2Hz) at different irradiation distances with or without cooling: G2: 4mm/2mL; G3: 4mm/no cooling; G4: 8mm/2mL; G5: 8mm/no cooling; G6: 16mm/2mL; G7: 16mm/no cooling. The samples were submitted to an in vitro pH cycles for 14 days. Next, the specimens were sectioned in sections of 80-100microm in thickness and the demineralization patterns of prepared slices were assessed using a polarized light microscope. Three samples from each group were analyzed with scanning electronic microscopy. Analysis of variance and the Fisher test were performed for the statistical analysis of the data obtained from the caries-lesion-depth measurements (CLDM) (alpha=5%). RESULTS: The control group (CLDM=0.67mm) was statistically different from group 2 (CLDM=0.42mm), which presented a smaller lesion depth, and group 6 (0.91mm), which presented a greater lesion depth. The results of groups 3 (CLDM=0.74mm), 4 (CLDM=0.70mm), 5 (CLDM=0.67mm) and 7 (CLDM=0.89mm) presented statistical similarity. The scanning electronic microscopy analysis showed ablation areas in the samples from groups 4, 5, 6 and 7, and a slightly demineralized area in group 2. CONCLUSIONS: It was possible to conclude that Er:YAG laser was efficient in preventing enamel demineralization at a 4-mm irradiation distance using cooling.