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Ağaccıoğlu M, Sirin Karaarslan E, Aytac Bal F, Benli İ. Bond strength comparison of a fiber-reinforced composite resin: Different dentin conditions and preparation techniques. Microsc Res Tech 2024; 87:1250-1261. [PMID: 38339919 DOI: 10.1002/jemt.24515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/31/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
This study aimed to compare the bond strength of a fiber-reinforced composite resin with traditional and bulk-fill composite resins under different dentin conditions and preparation techniques. Eighty molar teeth, excluding the mesio-distal half of the occlusal dentin surfaces of each teeth, were isolated with acid-resistant nail varnish and stored in a demineralisation solution (pH 4.5). After mechanical removal of the varnish, the teeth were buried in acrylic resin blocks. In every composite resin group, one-half of the specimens were prepared with a diamond bur and another half with Er: YAG laser. Then, the specimens were divided into four groups of composite resins (Filtek Z250, G-aenial Posterior, SonicFill 2, Ever X Posterior) (n = 10). Shear bond strengths were measured using a universal testing device, and failure types were determined with stereomicroscope images. SEM images were obtained at 1000× magnification. Data were analyzed using a three-way analysis of variance (ANOVA), and Bonferroni correction was used for multiple comparisons (p = .05). Differences in the dentin surface affected the bond strength results (p < .05), whereas there was no significant difference between cavity preparation methods (p > .05). EverX Posterior showed the highest bond strength results. Within the limitations of this study, fiber-reinforced composite resin exhibited successful bond strength results in addition to improved mechanical properties. RESEARCH HIGHLIGHTS: Fiber-reinforced composite had successful bond strength values. Bond strength values of sound dentin groups were higher than those of caries-affected dentin groups. The use of an Er: YAG laser for preparation did not lead to insufficient bond strength results.
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Affiliation(s)
- Merve Ağaccıoğlu
- Department of Restorative Dentistry, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Emine Sirin Karaarslan
- Department of Restorative Dentistry, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Fatma Aytac Bal
- Department of Restorative Dentistry, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - İsmail Benli
- Laboratory Specialist, Sugenomics Biotechnology, Ankara, Turkey
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Guan L, Cai C, Cui J, Huang Y, Zhao J, Chen X, Jiang Q, Li Y. Effect of chitosan and CMCS on dentin after Er:YAG laser irradiation: shear bond strength and surface morphology analysis. BMC Oral Health 2024; 24:402. [PMID: 38553692 PMCID: PMC10979601 DOI: 10.1186/s12903-024-04097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate the effect of chitosan and carboxymethyl chitosan (CMCS) on dentin surface morphology and bonding strength after irradiation of Er:YAG laser. METHODS Eighty-four laser-irradiated dentin samples were randomly distributed into three groups (n = 28/group) according to different surface conditioning process: deionized water for 60s; 1wt% chitosan for 60s; or 1wt% CMCS for 60s. Two specimens from each group were subjected to TEM analysis to confirm the presence of extrafibrillar demineralization on dentin fibrils. Two specimens from each group were subjected to morphological analysis by SEM. Seventy-two specimens (n = 24/group) were prepared, with a composite resin cone adhered to the dentin surface, and were then randomly assigned to one of two aging processes: storage in deionized water for 24 h or a thermocycling stimulation. The shear bond strength of laser-irradiated dentin to the resin composite was determined by a universal testing machine. Data acquired in the shear bond strength test was analyzed by one-way ANOVA with the Tukey honestly significant difference post hoc test and Independent Samples t-test (α = 0.05). RESULTS CMCS group presented demineralized zone and a relatively smooth dentin surface morphology. CMCS group had significantly higher SBS value (6.08 ± 2.12) without aging (p < 0.05). After thermal cycling, both chitosan (5.26 ± 2.30) and CMCS group (5.82 ± 1.90) presented higher bonding strength compared to control group (3.19 ± 1.32) (p < 0.05). Chitosan and CMCS group preserved the bonding strength after aging process (p > 0.05). CONCLUSIONS CMCS has the potential to be applied in conjunction with Er:YAG laser in cavity preparation and resin restoration.
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Affiliation(s)
- Lanxi Guan
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Chen Cai
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Jingheng Cui
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Yuting Huang
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Jian Zhao
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Xuan Chen
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Qianzhou Jiang
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China.
| | - Yang Li
- Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, Guangdong, 510182, China.
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Effect of Method of Removing Caries-Affected Dentin on the Bond Strength of Composite Resin to Root Canal Dentin. Healthcare (Basel) 2022; 10:healthcare10112143. [PMID: 36360483 PMCID: PMC9691166 DOI: 10.3390/healthcare10112143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
The adhesion of composite resin to caries-affected dentin differs from the adhesion of resin to sound dentin. We evaluated the bond strengths of dual-cure resin composites applied to caries-affected root canal dentin under various clinical conditions and using several caries removal indicators. In the dye stain 1 group, caries were removed to a pale pink stain level using a caries detector. In the dye stain 2 group, caries were removed to a stain-free level using a caries detector. In the probing group, caries were removed to the level of hardness based on probing with a sharp explorer. Additionally, a sound dentin group was used as a control. We compared the resin composite microtensile bond strengths and failure mode distribution among the groups. The bond strengths (MPa) of the probing (64.6 ± 11.9) and the sound dentin (68.7 ± 11.1) groups were significantly higher than those of the dye stain 1 (46.9 ± 7.9) and 2 (47.5 ± 8.4) groups (p < 0.05). The removal of caries-affected dentin using a dentin-hardness-based technique showed higher tensile strength than that using a dye stain technique involving removal to any color level. Thus, the caries removal technique used on root canal dentin affects the bond strength of the resin composite.
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Alsubait S, Aljarbou F. Biodentine or Mineral Trioxide Aggregate as Direct Pulp Capping Material in Mature Permanent Teeth with Carious Exposure? A Systematic Review and Meta-analysis. Oper Dent 2021; 46:631-640. [PMID: 35507905 DOI: 10.2341/20-277-lit] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the success rate of direct pulp capping (DPC) with Biodentine in mature permanent teeth with carious vital pulp exposure compared to that of DPC with mineral trioxide aggregate (MTA) by means of a systematic review and meta-analysis. DATA SOURCES The two authors searched independently the literature published through July 31, 2020, in five electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science Core Collection, the Wiley Online Library, and the SCOPUS database). STUDY SELECTION The research protocol was previously registered in the PROSPERO database (CRD42020192511). Clinical studies that met the inclusion criteria were chosen and independently screened by the authors. DATA EXTRACTION A custom-designed spreadsheet was used to extract the data. The quality of each study was evaluated by means of the revised Cochrane risk of bias (ROB) tool or the ROB of nonrandomized studies of interventions tool. DATA SYNTHESIS Three randomized controlled trials and one retrospective study met the inclusion criteria. Only one study had a high risk of bias. The included studies reported data on a total of 95 participants with an age range of 8-51 years. No significant difference was observed in the overall treatment outcome when comparing Biodentine with MTA (Risk ratio=1.00, 95% confidence interval [0.93-1.07], p=1.00). CONCLUSIONS Biodentine had comparable clinical and radiographic success to that of MTA when used as a DPC agent in mature permanent teeth with carious vital pulp exposure. Additional high-quality studies are needed.
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Affiliation(s)
- Sara Alsubait
- *Sara Alsubait, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahd Aljarbou
- Fahd Aljarbou, King Saud University, Riyadh, Saudi Arabia
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Use of the Er:YAG Laser in Conservative Dentistry: Evaluation of the Microbial Population in Carious Lesions. MATERIALS 2021; 14:ma14092387. [PMID: 34064339 PMCID: PMC8124663 DOI: 10.3390/ma14092387] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study is to investigate the Erbium:Yttrio-Aluminum-Granate (Er:YAG) laser photothermal and mechanical effects on cariogenic species concentration and on the microbial load composition of therapeutic cavities, in order to evaluate the possible micro-organisms reduction and make a comparison with manual and rotating conventional therapy (CT). A clinical trial was designed, including adults with active deep carious lesions on permanent teeth who were divided into two groups, i.e., control group and intervention group treated with CT and Er:YAG therapy, respectively. Before and after any conservative treatment, two oral samples were collected using a small sterile microbrush scrubbed within the base of the dentinal cavity tissue. The percentage of reduction and the colony-forming units (CFUs) count after Er:YAG and conventional treatments were compared for total microorganisms, including Candida spp., Streptococcus spp., and Lactobacillus spp. The microbial reduction varied from 90.2% to 100% and was significantly observed for total microorganisms and Streptococcus spp. (p < 0.05). The Er:YAG laser shows the potential for clinical applications, especially with paediatric and complicated patients, thanks to its minimally invasive properties and its effect on the reduction of microbial load.
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Valério RA, Galo R, Galafassi D, Corona SAM, Borsatto MC. Four-year clinical prospective follow-up of resin composite restoration after selective caries removal using Er:YAG laser. Clin Oral Investig 2019; 24:2271-2283. [PMID: 31686235 DOI: 10.1007/s00784-019-03082-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 09/22/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to longitudinally evaluate, after a 4-year period, the clinical longevity of composite resin restoration compared to the baseline, after selective caries removal in permanent molars using Er:YAG laser or bur preparation with biomodification of dentin with the use of chlorhexidine. METHODS Selective caries removal was performed on 80 teeth of 20 individuals who each had at least four active carious lesions. These lesions, located on occlusal surfaces of permanent molar counterparts, were removed using (i) Er:YAG laser biomodified with chlorhexidine, (ii) Er:YAG laser and application of deionized water, (iii) bur preparation biomodified with chlorhexidine, and (iv) bur preparation and application of deionized water. At the end of 4 years, 64 of the 80 restorations were evaluated in 16 individuals (n = 16). The restorations were evaluated, both clinically and photographically, using scanning electron microscopy (SEM) and pulp vitality analysis. The experimental data were statistically evaluated by kappa, Fisher's, and chi-square tests, with a significance level of 5%. The Kaplan-Meier test and the Cox regression analysis were used to evaluate the survival of the restorations. RESULTS After 4 years of follow-up, there was a statistically significant difference in marginal discoloration criteria for all of the groups evaluated. For marginal adaptation criteria, there was a statistically significant difference for the Er:YAG laser group biomodified with chlorhexine (p = 0.050). For clinical and radiographic evaluation of pulp vitality, there were no statistically significant differences among the groups (p = 0.806). CONCLUSION Er:YAG laser can be used for selective caries removal, regardless of dentin biomodification with chlorhexidine or application of deionized water, once it produced promising results in composite resin restorations after 4 years of follow-up, according to the criteria evaluated. The selective caries removal using Er:YAG laser or bur and the biomodification of dentin with the use of chlorhexidine did not influence the survival of composite resin restorations after the 4-year follow-up period. CLINICAL RELEVANCE Composite resin restorations applied after selective caries removal using Er:YAG laser or burs, regardless of dentin biomodification with the use of chlorhexidine or application of deionized water, showed adequate clinical behavior after 4 years of follow-up.
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Affiliation(s)
- Rodrigo Alexandre Valério
- Clinical Pediatric Dentistry Department, Ribeirão Preto School of Dentistry / São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | - Rodrigo Galo
- Department of Dentistry, Universidade Federal do Vale do Jequitinhonha e Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, Diamantina, Minas Gerais, 39100-000, Brazil
| | - Daniel Galafassi
- Department of Restorative Dentistry, School of Dentistry, Meridional College-IMED, Senador Pinheiro, 304, Cruzeiro, Passo Fundo, Rio Grande do Sul, 99070-220, Brazil
| | - Silmara Aparecida Milori Corona
- Restorative Dentistry Department, Ribeirão Preto School of Dentistry / São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | - Maria Cristina Borsatto
- Clinical Pediatric Dentistry Department, Ribeirão Preto School of Dentistry / São Paulo University, Café Avenue, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil.
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Silva AC, Melo P, Ferreira J, Oliveira S, Gutknecht N. Influence of grape seed extract in adhesion on dentin surfaces conditioned with Er,Cr:YSGG laser. Lasers Med Sci 2019; 34:1493-1501. [PMID: 30830558 DOI: 10.1007/s10103-019-02749-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 02/12/2019] [Indexed: 11/26/2022]
Abstract
The proanthocyanidin (PA)-rich grape seed extract (GSE) is a collagen cross-linking agent that can perform a chemical bond with the dentin's collagen. The objective of this study was to evaluate the influence on shear bond strength (SBS) of the pre-conditioning of GSE, on human dentin surfaces conditioned with Er,Cr:YSGG laser. The sample consisted of 64 non-carious human teeth, divided into eight groups, four groups conditioned with Er,Cr:YSGG laser (4.5 W, 50 Hz, 50 μs, 70% air, 90% water) and four prepared with conventional methods (control). In both groups, a GSE solution was applied before using the two adhesives tested: Clearfil™ SE Bond (CSE) and Scotchbond™ Universal (SU). Subsequently, a SBS test, a scanning electron microscopy, and a statistical analysis were performed. In the laser groups, the best SBS mean (20.08 ± 4.01 MPa) was achieved in the group treated with GSE and CSE. The control group with the application of CSE showed the highest SBS mean (24.27 ± 10.28 MPa), and the group treated with laser and SU showed the lowest SBS mean (12.94 ± 6.51 MPa). Between these two groups there was a statistically significant difference (p = 0.05). However, this was not observed among the laser or control groups. The type of dentin surface preparation can influence the SBS. The CSE showed better SBS in laser and control groups. The presence of GSE did not improve the adhesion on surfaces conditioned with laser, but more studies should be carried out in the future to confirm this conclusion.
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Affiliation(s)
- Ana C Silva
- Department of Operative Dentistry, Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal.
| | - Paulo Melo
- Department of Operative Dentistry, Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
| | - João Ferreira
- Department of Operative Dentistry, Faculdade de Medicina Dentária da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
| | - Sofia Oliveira
- Department of Dental Biomaterials, Faculdade de Medicina Dentária da Universidade de Lisboa, Rua Professora Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal
| | - Norbert Gutknecht
- Department of Operative Dentistry, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Silva AC, Melo P, Ferreira JC, Oliveira T, Gutknecht N. Adhesion in Dentin Prepared with Er,Cr:YSGG Laser: Systematic Review. Contemp Clin Dent 2019; 10:129-134. [PMID: 32015655 PMCID: PMC6975010 DOI: 10.4103/ccd.ccd_302_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: In dentistry, cavities prepared with Erbium lasers present more advantages, compared to traditional methods, but there is still a lack of investigation about the adhesion in dentin surfaces prepared with Erbium lasers, especially with Erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. Aim: The purpose of this systematic review was to find out which might be “The most adequate adhesive and laser parameters for adhesion in dentin prepared with Er,Cr:YSGG laser.” Methods: An electronic search was performed in the PubMed database. The search was limited to studies between 2009 and 2016. Results: Ten articles were selected to the systematic review according to TRANSPARENT REPORTING of Systematic Reviews and Meta-ANALYSES checklist. Conclusions: The adhesive that showed the best bond strength results in dentin prepared with Er,Cr:YSGG laser was the self-adhesive Clearfil™ SE (Kuraray), with preconditioning with 40% phosphoric acid. The settings 2 W, 75% water, 60% air, 140 μs pulse duration, and 20 Hz showed the best adhesion outcome.
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Affiliation(s)
- Ana Catarina Silva
- Department of Operative Dentistry, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Paulo Melo
- Department of Operative Dentistry, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - João Cardoso Ferreira
- Department of Operative Dentistry, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Teresa Oliveira
- Department of Operative Dentistry, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Norbert Gutknecht
- Department of Operative Dentistry, University Hospital RWTH Aachen, Aachen, Germany
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Caries removal in deciduous teeth using an Er:YAG laser: a randomized split-mouth clinical trial. Clin Oral Investig 2015; 20:65-73. [PMID: 25877234 DOI: 10.1007/s00784-015-1470-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/03/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of the present clinical randomized split-mouth study was to evaluate the effectiveness and efficiency of an Er:YAG laser for caries removal in primary molars, microbiological dentin analysis, and clinical restorations after 1 year in 29 children. MATERIALS AND METHODS The children's teeth were randomized into two groups: (I) an Er:YAG laser group and (II) a bur preparation group. The efficiency of the treatments (the time necessary for the removal of carious tissue) was evaluated based on the time spent on caries removal in the deciduous molars. The effectiveness (caries removal capacity) of the caries removal was determined by means of a blind test in which the examiner performed a tactile and visual examination of the dentin. Microbiological analysis was performed by counting the Streptococcus mutans and Lactobacillus sp in the remaining dentin. Clinical analysis of restorations was performed using the USPHS method in combination with photographs of restored teeth, 7 days after the restorative procedure and again after 1 year. All cavities were restored with the Adper Single Bond 2/Filtek Z350 system. The obtained data were analyzed with a significance level of 5 %. RESULTS The Er:YAG laser was less effective and had the same efficacy as bur preparation during caries removal at the pulpal wall of deciduous molars. In the surrounding walls, bur preparation was the more effective method. Regardless of the method employed, the affected dentin in the pulpal wall had similar amounts of S. mutans and Lactobacillus sp. The restorations were clinically accepted by the USPHS method over a 1-year period. CONCLUSION It can be concluded that caries removal with an Er:YAG laser has no influence on the clinical behavior of restorations. CLINICAL RELEVANCE Irradiation with an Er:YAG laser is appropriate for caries removal in primary teeth.
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