Er:YAG laser activation of sodium hypochlorite for root canal soft tissue dissolution.

BACKGROUND AND OBJECTIVE: The aim of this in vitro study was to investigate the effect of Er:YAG laser irradiation on the ability of sodium hypochlorite (NaOCl) to dissolve soft tissue during endodontic procedures. MATERIALS AND METHODS: Two acrylic glass plates, each containing a semi-canal, were bolted together to form a complete canal. This geometry permitted one semi-canal to be filled with fine liver sausage of bovine origin dyed by methylene blue and the other with NaOCl (4.00-4.99% available chlorine; Sigma-Aldrich Corporation, St. Louis, MA), which was then activated by Er:YAG laser irradiation (KEY Laser 3; KaVo, Biberach, Germany) using a plain-ended fiber tip and a range of output energy and repetition rate. To achieve relatively low output energy from high input energy, the laser beam was attenuated by placing glass slides in the beam path. The resultant images acquired were analyzed using pixel-based analysis. Samples were statistically analyzed (two-way ANOVA, P < 0.05, univariate, bifactorial; IBM SPSS Statistics 19, SPSS Inc., Chicago, IL). RESULTS: Both output energy and repetition rate significantly influenced the tissue dissolution ability of NaOCl (P < 0.05). CONCLUSION: Within the limitations of this in vitro study, we conclude that laser activation of NaOCl at 200 mW output power leads to effective soft tissue dissolution. This finding can be of use to endodontists pursuing effective soft tissue dissolution from their irrigants.

Comparison of different focusing fiber tips for improved oral diode laser surgery.

BACKGROUND AND OBJECTIVES: State of the art for use of the fiber guided diode laser in dental therapy is the application of bare fibers. A novel concept with delivery fiber and exchangeable fiber tips enables the use of tips with special and optimized geometries for various applications. The aim of this study is the comparison of different focusing fiber tips for enhanced cutting efficacy in oral surgery. MATERIAL AND METHODS: For this purpose various designs of tip geometry were investigated and optimized by ray tracing simulations. Two applicators, one with a sphere, and another one with a taper, were realized and tested on porcine gingiva (diode laser, 940 nm, 5 W/cw; 7 W/modulated). The cutting depth and quality were determined by light microscope. Histological sections of the cuts were prepared by a cryo-microtome and microscopically analyzed to determine the cut depths and thermal damage zones. RESULTS: The simulations show that, using a sphere as fiber tip, an intensity increase of up to a factor of 16.2 in air, and 13.2 in water compared to a bare 200 µm fiber can be achieved. Although offering high focusing factor in water, the cutting quality of the sphere was rather poor. This is probably caused by a derogation of the focusing quality due to contamination during cutting and light scattering. Much better results were achieved with conically shaped fiber tips. Compared to bare fibers they exhibit improved handling properties with no hooking, more regular and deeper cuts (5 W/cw: 2,393 ± 468 µm, compared to the cleaved bare fiber 5 W/cw: 711 ± 268 µm). The thermal damage zones of the cuts are comparable for the various tips and fibers. CONCLUSIONS: In conclusion the results of our study show that cutting quality and efficiency of diode laser on soft tissue can be significantly improved using conically shaped fiber tips.

Development and verification of a snapshot dental intraoral three-dimensional scanner based on chromatic confocal imaging.

We describe the development and verification of an optical, powder-free, intraoral scanner based on a chromatic confocal imaging system, which has been realized in a single-shot multifocal approach. The system is based on a combination of micro-optical and dispersion optical elements. The methodology of recording and analyzing the acquired data are discussed in detail. A proof of concept with the application in intraoral scanning is provided. According to the current findings, the measurement uncertainty, scan speed, and overall performance of the device can well compete with the state-of-the-art of commercially available intraoral scanners.

Phase function measurements on nonspherical scatterers using a two-axis goniometer.

We present a two-axis goniometer for measuring the phase function of scattering media with an angular resolution of about 0.2 deg having 12 decades of dynamic range and covering almost the full solid angle. The setup is evaluated with polystyrene spheres and with perpendicularly and obliquely illuminated thin glass cylinders. The scattering pattern and its intensity distribution are in excellent agreement with analytical theory. A multiple scattering configuration composed of two parallel cylinders is also examined. Finally, the phase function of dentin slabs is measured and its dependence on the dental microstructure is discussed.

The effect of surface treatment and clinical use on friction in NiTi orthodontic wires.

OBJECTIVES: Since the low friction of NiTi wires allows a rapid and efficient orthodontic tooth movement, the aim of this research was to investigate the friction and surface roughness of different commercially available superelastic NiTi wires before and after clinical use. The surface of all of the wires had been pre-treated by the manufacturer. MATERIALS: Forty superelastic wires (Titanol Low Force, Titanol Low Force River Finish Gold, Neo Sentalloy, Neo Sentalloy Ionguard) of diameter 0.016 x 0.022 in. were tested. The friction for each type of NiTi archwire ligated into a commercial stainless steel bracket was determined with a universal testing machine. Having ligated the wire into the bracket, it could then be moved forward and backwards along a fixed archwire whilst a torquing moment was applied. The surface roughness was investigated using a profilometric measuring device on defined areas of the wire. Statistical data analysis was conducted by means of the Wilcoxon test. RESULTS: The results showed that initially, the surface treated wires demonstrated significantly (p < 0.01) less friction than the non-treated wires. The surface roughness showed no significant difference between the treated and the non-treated surfaces of the wires. All 40 wires however showed a significant increase in friction and surface roughness during clinical use. SIGNIFICANCE: Whilst the Titanol Low Force River Finish Gold (Forestadent, Pforzheim, Germany) wires showed the least friction of all the samples and consequently should be more conservative on anchorage, the increase in friction of all the surface treated wires during orthodontic treatment almost cancels out this initial effect on friction. It is therefore recommended that surface treated NiTi orthodontic archwires should only be used once.

Changes in chemical composition and collagen structure of dentine tissue after erbium laser irradiation.

Erbium laser radiation has a great affinity for the water molecule, which is present in quantity in biological hard tissues. The objective of this work is to identify chemical changes by infrared spectroscopy of irradiated dentine by an Er:YAG-2.94 microm laser. The irradiation was performed with fluences between 0.365 and 1.94 J/cm2. For the infrared analysis a Fourier transform infrared spectrometer was used. After the irradiation were observed: loss of water, alteration of the structure and composition of the collagen, and increase of the OH- radical. These alterations can be identified by a decrease in intensity of the water band between 2800-3800 cm(-1), OH- band at 3575 cm(-1) and bands ascribed to organic matrix between 2800-3400 cm(-1) and 1100-1400 cm(-1).

Light propagation in dentin: influence of microstructure on anisotropy.

We investigated the dependence of light propagation in human dentin on its microstructure. The main scatterers in dentin are the tubules, the shape of which can be approximated as long cylinders. We calculated the scattering of electromagnetic waves by an infinitely long cylinder and applied the results in a Monte Carlo code that simulates the light propagation in a dentin slab considering multi-scattering. The theory was compared with goniometric measurements. A pronounced anisotropic scattering pattern was found experimentally and theoretically. In addition, intensity peaks were measured which are shown to be caused by light diffraction by the tubules.

Matrix-dependent regulation of AKT in Hepsin-overexpressing PC3 prostate cancer cells.

The serine-protease hepsin is one of the most prominently overexpressed genes in human prostate carcinoma. Forced expression of the enzyme in mice prostates is associated with matrix degradation, invasive growth, and prostate cancer progression. Conversely, hepsin overexpression in metastatic prostate cancer cell lines was reported to induce cell cycle arrest and reduction of invasive growth in vitro. We used a system for doxycycline (dox)-inducible target gene expression in metastasis-derived PC3 cells to analyze the effects of hepsin in a quantitative manner. Loss of viability and adhesion correlated with hepsin expression levels during anchorage-dependent but not anchorage-independent growth. Full expression of hepsin led to cell death and detachment and was specifically associated with reduced phosphorylation of AKT at Ser(473), which was restored by growth on matrix derived from RWPE1 normal prostatic epithelial cells. In the chorioallantoic membrane xenograft model, hepsin overexpression in PC3 cells reduced the viability of tumors but did not suppress invasive growth. The data presented here provide evidence that elevated levels of hepsin interfere with cell adhesion and viability in the background of prostate cancer as well as other tissue types, the details of which depend on the microenvironment provided. Our findings suggest that overexpression of the enzyme in prostate carcinogenesis must be spatially and temporally restricted for the efficient development of tumors and metastases.

Mechanism of high-power NIR laser bacteria inactivation.

Lasers are used in dentistry for a variety of indications. One of these is the disinfection of root canals or the sterilization of residual caries. Many studies have demonstrated the capacity to kill bacteria for lasers but the fundamental mechanism of the laser effect remains quite unclear. With our experiments we wanted to determine whether high-power NIR laser bacterial killing is caused by the light itself (photochemical effect) or by a photothermal process. In order to differentiate between mechanisms we heated bacteria suspensions of a nonpathogenic strain of E. coli by a water bath and by a diode laser (940 nm) with the same temporal temperature course. Furthermore, bacteria suspensions were irradiated while the temperature was fixed by ice water. Killing of bacteria was measured via fluorescence labelling. Comparison of killing rates between laser and water-based heating shows no significant differences. The most important parameter is the maximum temperature. Laser irradiation of bacteria at low temperatures does not result in killing. Our experiments show that at least for E. coli bacteria inactivation by high-power laser irradiation is solely based on a thermal process.

Thermal effects of white light illumination during microsurgery: clinical pilot study on the application safety of surgical microscopes.

Modern operating microscopes offer high power illumination to ensure optimal visualization, but can also cause thermal damage. The aim of our study is to quantify the thermal effects in vivo and discuss conditions for safe use. In a pilot study on volunteers, we measured the temperature at the skin surface during microscope illumination, including the influence of anaesthesia and the effects of staining, draping, or moistening of the skin. Irradiation within the limit given by safety regulations (200 mW/cm(2)) results in skin surface temperature of 43 degrees C. Higher intensities (forearm 335 mW/cm(2), back 250 mW/cm(2)) are tolerated, resulting in reversible hyperaemia. At a very high illumination intensity (750 mW/cm(2)), pain occurs within 30 s at temperatures of 46 degrees C+/-1 degrees C (hand and forearm), and 43 degrees C+/-2 degrees C (back), respectively. Anaesthesia has no distinct effect on the temperature, whereas staining and drapes result in much higher temperatures (>100 degrees C). Moistening at practicable flow rates can reduce temperature efficiently when combined with a light absorbing and water absorbent drape. In conclusion, surgeons must be aware that surgical microscope illumination without protective means can cause skin temperatures to rise much above pain threshold, which in our study serves as a (conservative) benchmark for potential damage.

Light guiding in biological tissue due to scattering.

For a description of light propagation in biological tissue it is usually assumed that tissue is a random medium. We report a pronounced light guiding effect in cubes of human dentin that cannot be described by this standard model. Monte Carlo simulations which consider the microstructure of dentin are performed and successfully compared to experiments. Contrary to explanations so far, we show that light guiding is due to scattering by the tissue's microstructure. Exploiting this concept, light can be guided in arbitrary directions or locations without involving reflections or wave effects.