Response of feline intradental nerve fibers to tooth cutting by Er:YAG laser

Cavity Preparation by Laser in Primary Teeth: Effect of 2 Levels of Energy Output on the Shear Bond Strength of Composite Restoration to Dentin

Introduction: One of the main applications of laser in dentistry is the removal of dental caries and preparation of restorative cavities. The morphology and wettability of laser prepared surfaces are different from that of those prepared with conventional method which may affect the quality of the adhesive potential of bonding agents in these surfaces. This study aimed to assess the shear bond strength of a total-etch and self-etch adhesive system to primary tooth dentin prepared by two different energy densities of Er:YAG laser in comparison with surfaces prepared by bur. Methods: A total of 60 human primary second molars extracted for orthodontic purposes were selected and randomly divided into 3 main groups of equal (n=20). Group A: Preparation of dentin surface by bur; group B: Preparation of dentin surface by laser with 300 mJ energy level; group C: Preparation of dentin surface by laser with 400 mJ energy level. In each of the main groups, the teeth were randomly assigned to 2 subgroups. Composite resin material was bonded with the total-etch adhesive system in subgroups A1, B1, and C1 and with the self-etch adhesive system in subgroups A2, B2, and C2. The samples were thermo-cycled, and composite restorations shear bond strength was measured in MPa. Data were analyzed using two-way analysis of variance (ANOVA), and P values less than 0.05 were considered statistically significant. Results: The highest and the lowest shear bond strength values were observed in group A2 (Preparation by bur- Composite resin material bonded by Clearfil SE Bond) and group C2 (Preparation by laser with 400 mJ energy level - Composite resin material bonded by Clearfil SE Bond), respectively. The results showed no statistically significant differences between the study subgroups (P > 0.05). Conclusion: It is concluded that in terms of shear bond strength to dentin, Single Bond and Clearfil SE Bond adhesive agents adequately perform in primary tooth dentin prepared by Er: YAG laser with energy levels of 300 and 400 mJ and frequency of 10 Hz.

Thermal effects and morphological aspects of human dentin surface irradiated with different frequencies of Er:YAG laser

This study reports the effects on micromorphology and temperature rise in human dentin using different frequencies of Er:YAG laser. Sixty human dentin fragments were randomly assigned into two groups (n = 30): carious or sound dentin. Both groups were divided into three subgroups (n = 10), according to the Er:YAG laser frequency used: 4, 6, or 10 Hz (energy: 200 mJ; irradiation distance: 12 mm; and irradiation time: 20 s). A thermocouple adapted to the tooth fragment recorded the initial temperature value (°C); then, the temperature was measured after the end of the irradiation (20 s). Morphological analysis was performed using images obtained with scanning electron microscope. There was no difference between the temperatures obtained with 4 and 6 Hz; the highest temperatures were achieved with 10 Hz. No difference was observed between carious and sound dentin. Morphological analyses revealed that all frequencies promoted irregular surface in sound dentin, being observed more selectively ablation especially in intertubular dentin with tubule protrusion. The caries dentin presented flat surface for all frequencies used. Both substrates revealed absence of any signs of thermal damage. It may be concluded that the parameters used in this study are capable to remove caries lesion, having acceptable limits of temperature rise and no significant morphological alterations on dentin surface.

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I-4 Hz; II-6 Hz, and III-10 Hz. Specimens in group B were submitted to a pH-cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal-Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin.

Assessment of Thermal Alteration during Class V Cavity Preparation Using the Er:YAG Laser

OBJECTIVE

The aim of this study was to evaluate in vitro the pulp thermal alterations during class V cavity preparations using the Er:YAG laser and high-speed water flow.

MATERIALS AND METHODS

Forty human teeth were selected and prepared for the thermocouple adaptation in the pulp chamber. The specimens were assigned to four groups: (1) laser 300 mJ/3 Hz, (2) laser 300 mJ/4 Hz, (3) high-speed 9 mL/min water flow, and (4) high-speed 100 mL/min water flow. The temperature was measured before the beginning and at the end of the preparation, as well as during the procedures. The groups were analyzed by scanning electron microscopy.

RESULT

Data analysis disclosed temperature reduction at high-speed drilling with the high-speed total water flow group, and these values were statistically different from the other groups. The results of the 9-mL/min water flow group were similar to those of the 300-mJ/3-Hz group and different from the 300-mJ/4-Hz laser group.

CONCLUSION

The laser promoted a greater increase in temperature only when compared with high-speed handpiece and water flow rate of 100 mL/min.

Surgical lasers and hard dental tissue

The cutting of dental hard tissue during restorative procedures presents considerable demands on the ability to selectively remove diseased carious tissue, obtain outline and retention form and maintain the integrity of supporting tooth tissue without structural weakening. In addition, the requirement to preserve healthy tissue and prevent further breakdown of the restoration places the choice of instrumentation and clinical technique as prime factors for the dental surgeon. The quest for an alternative treatment modality to the conventional dental turbine has been, essentially, patient-driven and has led to the development of various mechanical and chemical devices. The review of the literature has endorsed the beneficial effects of current laser machines. However utopian, there is additional evidence to support the development of ultra-short (nano- and femto-second) pulsed lasers that are stable in use and commercially viable, to deliver more efficient hard tissue ablation with less risk of collateral thermal damage. This paper explores the interaction of laser energy with dental hard tissues and bone and the integration of current laser wavelengths into restorative and surgical dentistry.

Basic study on vibrations during tooth preparations caused by high-speed drilling and Er:YAG laser irradiation

BACKGROUND AND OBJECTIVES

An Er:YAG laser effectively removes dental hard substance, and causes less pain during tooth preparations than high-speed drilling. This laser was introduced to eliminate the noise, vibration, pressure, and heat associated with the high-speed drilling. However, the difference in tooth vibration caused by the Er:YAG laser and the high-speed drill is unclear. Therefore, the aim of this study was to evaluate tooth vibration obtained with the Er:YAG laser and high-speed drill.

STUDY DESIGN/MATERIALS AND METHODS

Each of the five extracted permanent upper first premolars were built up in a plaster box. In this study, a silicone impression material was selected to simulate periodontal tissue. The vibration speed was measured by using a laser Doppler vibrometer.

RESULTS

The Er:YAG laser irradiation energy was 50, 100, 145, 199, 300, and 350 mJ. As irradiation energy increased, vibration of the tooth also rose; a high-correlation coefficient was observed between them. We found that only a small amount of the tooth vibration occurred with the Er:YAG laser preparations. The mean vibration speed and standard deviation with the laser were 166 +/- 28 microm/second when the output energy was 145 mJ, whereas those with the high-speed drill were 65 +/- 48 mm/second. The frequency characteristic approached 230 Hz and 5 kHz, respectively.

CONCLUSIONS

These results show that the high-speed drilling causes greater tooth vibration and has a frequency spectrum near the high sensitivity of hearing compared to the Er:YAG laser. This suggests a potential factor in provoking pain and displeasure during tooth preparation. Future study to examine the relationship of pain and amount of tooth vibration will be planned.

Effects of Er:YAG laser irradiation on human dentin: polarizing microscopic, light microscopic and microradiographic observations, and FT-IR analysis

BACKGROUND AND OBJECTIVES

The effects of Er:YAG laser irradiation on dentin have not been sufficiently investigated. The purpose of this study was to investigate the effects of Er:YAG laser irradiation on dentin.

STUDY DESIGN/MATERIALS AND METHODS

After cavities were prepared using Er:YAG laser irradiation or rotary cutting instruments, histological observations of cavity-floor dentin utilizing polarizing microscopy, microradiography and light microscopy, and analysis of composition of cavity-floor dentin using Fourier-transformed (FT-IR) spectrometry were conducted.

RESULTS

In the laser-treated side, a deeply stained basophilic layer was observed. The number of odontoblastic processes present was obviously less in the laser-treated side than in the bur-treated side. FT-IR analysis revealed that compared to the bur-treated side, a broad background peak at around 1,600 cm(-1) was present.

CONCLUSIONS

Er:YAG laser irradiation might have denatured the organic materials of dentin.

Pulpal response to exposure with Er:YAG laser

OBJECTIVE

The purpose of this study was to evaluate the pulpal response to the Er:YAG laser after accidental exposure of the pulp.

STUDY DESIGN

Cavities were prepared, and pulps were exposed by either Er:YAG laser or mechanically by a slow-speed conventional handpiece (control group) in 76 maxillary first molars of male Wistar rats. Rats were killed immediately, at 3 days, 1 week, and 2 weeks. Histopathologic examinations of the pulp at the exposure site were performed and evaluated with the Mann-Whitney U test (P <.05).

RESULTS

The Er:YAG laser group showed no bleeding and no dentin chips at the exposure site immediately after pulp exposure. However, they displayed an area of blood extravasation near the exposure site. Subsequently, the Er:YAG laser group formed dentin bridges at the exposure site more frequently than the control group. The Er:YAG laser group demonstrated more reparative dentin formation near the exposure site than the control group, especially at 2 weeks, which was highly significant (P <.01).

CONCLUSION

According to the results of this study, Er:YAG laser-exposed pulp tissue demonstrated good healing capacity with the formation of a dentin bridge and reparative dentin. However, further investigations are suggested to study the effect of the blood extravasation, which appeared near the laser exposure sites.