In vitro analysis of human tooth pulp chamber temperature after low-intensity laser therapy at different power outputs. Lasers Med Sci. 2011;26:143-147. [PMID: 20148278 DOI: 10.1007/s10103-009-0752-6]

The Effect of Laser Irradiation to Surfaces of Computer-Aided Design/Computer-Aided Fabrication Resin Blocks Coated with a Silane Coupling Agent on Bond Strength between the Resin Blocks and Composite Resin

The aim of this study was to investigate the effect of laser irradiation to computer-aided design/computer-aided fabrication (CAD/CAM) resin blocks coated with a silane coupling agent on the bond strength between resin blocks and composite resin. The CAD/CAM resin blocks used in this study were Cerasmart 300 (GC) and Vita Enamic (Vita); they were cut into plates and then subjected to a series of treatments. After processing with a silane coupling agent, treatment with a semiconductor laser was performed at 3.0, 5.0, and 7.0 W, followed by bonding procedures. The control group included those exposed to silane and bonded without laser application. After bonding, a mold with a simulated cavity was formed on the specimen and filled with flowable composite resin, and they were stored for 24 h or stressed by thermal cycling for subsequent testing that assessed the shear bond strength (n = 10). The results revealed that the bond strength was significantly enhanced by laser irradiation after applying a silane coupling agent (p < 0.03), whereas significant increase was not detected between the materials (p > 0.05). Particularly, 7 W laser irradiation had a significant increase on the bond strength between the composite resin and Cerasmart block after thermal cycling (p = 0.009). The SBS of the composite resin to CAD/CAM resin blocks was significantly enhanced by laser irradiation after silane coupling agent application.

The Effects of Antimicrobial Photodynamic Therapy Used to Sterilize Carious Dentin on Rat Dental Pulp Tissue

Antimicrobial photodynamic therapy (aPDT) used to sterilize carious dentin may irritate pulp tissues because of tissue-penetrating laser and singlet oxygen generation. This study aimed to assess the effects of aPDT on rat pulp tissues. A cavity formed in a rat maxillary first molar was treated with aPDT. The combined photosensitizer and laser irradiation conditions in the aPDT groups were as follows: methylene blue and 100 mW for 60 s, brilliant blue (BB) and 100 mW for 60 s, BB and 50 mW for 120 s, and BB and 200 mW for 30 s. Each cavity was treated with an all-in-one adhesive and filled with flowable resin. aPDT was not applied for the control. In each group, the rats were sacrificed on postoperative days 1 and 14, and thin sections of the treated teeth were prepared. Pulp tissue disorganization (PTD), inflammatory cell infiltration (ICI), and tertiary dentin formation (TDF) were evaluated. At 1-day evaluation, there were significant differences between the aPDT group and controls with respect to PTD and ICI (p < 0.01); 14 days later, almost all specimens showed tertiary dentin formation. The application of aPDT caused reversible damage to the rat pulp, while in the long term, healing occurred with the formation of tertiary dentin.

The application of lasers in vital pulp therapy: a review of histological effects

Vital pulp therapy (VPT) is primarily intended to preserve the vitality of pulp tissues, which have been exposed for any reason. Various materials and techniques have been proposed to improve treatment outcomes, including the use of lasers. This study aimed to review the histological results of different dental lasers including low-level lasers, carbon dioxide (CO2), erbium-doped yttrium aluminum garnet laser (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, and diode lasers for VPT. This focused review included a comprehensive electronic search of Scopus, MEDLINE, Web of Science, and Google Scholar databases from 2000 to 2022 by two independent investigators. Different combinations of keywords were used, and reference mining of related papers was done. The review included studies related to histologic evaluation of laser-assisted vital pulp therapy that stated the laser parameters that were used. Articles with radiographic or clinical assessments or articles lacking necessary data were excluded. Non-English articles were excluded unless their abstract was in English and encompassed the necessary data. Most studies indicated the efficacy of lasers for reduction of inflammation, acceleration of healing, and increasing the thickness of dentinal bridge. According to the evidence, lasers used in combination with pulp capping agents are beneficial to enhance the success rate of VPT.

Power Output of Two Semiconductor Lasers: An Observational Study

The objective of this study was to evaluate the power output of two dental devices. The study examined two semiconductor lasers, namely, SIROLaser Blue (445 nm, 970 nm) and Picasso (810 nm). The power output performance was studied at the maximum output power of the devices. The study compared the preset power output measured by a power meter in a continuous-wave mode and in pulsed mode at 50% duty cycles. Ten 60 s measurements were performed for each setting. The largest difference between the stipulated and the actual output power at continuous-wave (D-cw) and pulsed (D-p) modes was calculated. Moreover, the percentage variations in the mean output power at continuous-wave (%D-cw) and pulsed (%D-p) modes were calculated. The D-cw values for 445 nm, 970 nm, and 810 nm lasers were 0.7 W, 0.5 W, and −0.3 W, respectively, and %D-cw values were 21%, 23%, and −8%, respectively. The D-p values for 445 nm, 970 nm, and 810 nm lasers were 1.1 W, 0.5 W, and −0.1 W, respectively, whereas the %D-p values were 37%, 26%, and −3%, respectively. This study found that the actual power is not necessarily lower but can be higher than the displayed power output. Clinicians are recommended to calibrate the laser output by using a power meter before use.

Thermal, morphological, and spectral changes after Er, Cr:YSGG laser irradiation at low fluences on primary teeth for caries prevention

The aim of this study was to determine the temperature increase in the pulp chamber and possible thermal effects on molecular structure of primary teeth during the irradiation with Er,Cr:YSGG laser. Primary central incisors were divided into three groups (n = 20). Labial surfaces in each group were irradiated by Er,Cr:YSGG laser within different power and frequencies as following groups: I: 0.25 W, 20 Hz, II: 0.50 W, 20 Hz, III: 0.75 W, 20 Hz. A thermocouple was placed inside the pulp chamber so that the temperature increments were recorded during the enamel irradiation. Morphological changes of enamel surfaces were experimentally evaluated by SEM. Fourier-transform infrared spectroscopy and RAMAN analyses were carried out to determine the differentiations in the molecular structure. The experimental results obtained were analyzed statistically by means of one-way analysis of variance. Statistically significant differences were detected between groups (p < .05). Group III exhibited the highest values for the temperature parameters. Besides, the conical craters, cracks, and formation of ablation areas were observed for all the groups. Also, it was obtained that the hydroxyapatite lost the hydroxyl ions due to the thermal effect of the laser. Temperature rise throughout the Er,Cr:YSGG laser irradiation for prevention of primary enamel demineralization presented a positive correlation with the laser output power level. The formations of adverse morphological and spectral changes were detected on the surface of teeth after the laser application. On this basis, the Er,Cr:YSGG laser applications should be treated with much more caution considering enamel surface and pulpal tissues in primary teeth.

Analysis of Human Tooth Pulp Chamber Temperature After 670 nm Laser Irradiation: In Vitro Study

OBJECTIVE

One of the limiting factors of employing laser radiation on dental therapies is the potential of causing thermal injuries to pulp tissues. The purpose of this study was to evaluate intra-chamber temperature increase on extracted human teeth exposed to 670 nm wavelength InGaAlP laser diode radiation.

MATERIALS AND METHODS

In vitro intra-chamber temperature measurements of 12 standardized human teeth (incisors, canines, premolars, and molars; n = 3) were taken both before and after laser radiation. A type-K thermocouple fast-response thermocouple wire with a 0.5 mm diameter probe was inserted into the tooth pulp chamber (ICEL-Manaus-brand). The laser device Lasotronic-brand InGaAlP laser diode was used to irradiate tooth enamel, perpendicularly to the external surface for 30 sec, with power of levels of 340, 272, 204, 136, and 68 mW. The measurements were taken at three time points: 0, 30 sec, and 3 min after the laser irradiation. Measurements were repeated 24 h after removal and reinsertion of the probe in the pulp chamber. The temperature gradient (ΔT in °C) was calculated (ΔT = final temperature-initial temperature) for each group. Data of ΔT were statistically analyzed by two-way analysis of variance (ANOVA) at the 95% confidence level and compared by Tukey post hoc test (α = 0.05).

RESULTS

ANOVA showed statistically significant differences to the interaction of factors (p < 0.05). The highest ΔT values obtained were observed to incisors with 340 mW, 272 mW; 204 mW of power (respectively 4.7°C, 4.2°C, and 3.1°C); and canines presented the lowest ΔT (0.8°C-0.3°C) with no influence of power output.

CONCLUSIONS

Since the thermal increase was observed in this study, especially in incisors, attention should be paid to avoid pulpal damage.

Evaluation of temperature change during antimicrobial photodynamic therapy with two different photosensitizers in dental caries

INTRODUCTION

Many attempts have been made in elimination of bacteria in infected and demineralized dentin to not only provide efficient bactericidal potential, but to have minimal damage for tooth structure. The aim of this study was to assess the temperature change during aPDT with ICG and TBO compared with conventional Diode laser irradiation.

MATERIALS AND METHODS

48 premolar teeth which were selected for this study. A class I cavity was drilled in each teeth, with dimensions of 2mm width, 4mm length and depth of 2.5-3.5mm, providing a dentinal wall of approximately 0.5mm for pulp chamber. Then teeth were randomly allocated in 4 experimental groups (n=12); Group 1: TBO+LED, Group 2: ICG+Diode Laser, Group 3: Diode laser with output power of 0.5W, Group 4: Diode laser with output power of 1W. Thermocouple device was held by experimenter hand and the sensor was in pulp chamber of the teeth. Heat generated during irradiation was reported on LCD screen by NUX Plus software. Repeated measure ANOVA was used in order to compare the temperature before and after laser application. Tukey HSD was used to compare the results between groups.

RESULTS

Temperature was risen for about 0.54±0.05°C for group 1, 1.67±0.14°C for group 2, 4.21±0.83°C for group 3, and 4. 50±0.32°C for group 4. The difference between group 1 & 2, 1 & 3 and 1 & 4 was significant (p<0.0001).

CONCLUSION

According to results of this study, Diode (with or without photosensitizer- 0.5 and 1W) can be safely used as alternative approach for disinfection after caries removal in thermal point of view.

Effect of low level laser therapy on dental pulp during orthodontic movement

AIM: To validate the protocol described here to be used in future clinical trials related to the effect of laser therapy on dental pulp.

METHODS: Histologically treated samples from eight human healthy premolar teeth obtained from the middle root level were distributed in four groups: group 1 (G1) absolute control; group 2 (G2) only laser irradiation; group 3 (G3) exposed only to orthodontics; and group 4 (G4) treated with orthodontics and laser. Laser treatment was performed at 830 nm wavelength, 100 mW (energy 80 J/cm², 2.2 J), for 22 s in the vestibular surface and 22 s in the palatal surface, 1 mm away from the dental root mucosa. Three staining methods were performed: hematoxylin-eosin (HE), Masson’s Trichrome method and Gomori’s method.

RESULTS: The pulp histology parameters were evaluated and the results classified in to 3 parts: an inflammatory response, soft tissue response (dental pulp) and hard tissue response (dentin and predentin). There was no inflammation (chronic or acute) in any of the evaluated groups. The zones of pulp necrosis were found in one premolar of G3 and in one of G4; in groups G2 and G4 there was higher angiogenesis than in the other two groups. G4 group presented the highest level of vascularization. A reduced nerve density was observed in G3. A G2 specimen showed increased nerve density. A higher rate of calcification was observed in G1 compared to G2. Denticles, either real or false, were observed in G1, G2 and G3. Sclerosis of dentin and focal dentin loss was observed among all the groups. Secondary dentin was present in one sample in G1 and G2. A necrosis zone was found in one sample of G3 and G4. No differences between groups were observed in the odontoblast irregularity layer but the layer was wider in the group treated with laser only. A notable difference was detected in reduction of the cell-free layer between the groups G1 and G4. The findings in pulp tissue favor its adaptative response against dental movement induced by orthodontics. No definitive conclusions may be derived as this is a pilot study.

CONCLUSION: The protocol described here was shown to be an effective method to evaluate changes in dental pulp submitted to low level laser in teeth under orthodontic movement.

Experiment and simulation of resistance of nanoporous dentin biomaterial to CO₂ laser irradiation

The resistance of nanoporous dentin biomaterial to CO₂ laser irradiation was investigated by experiment and simulation for potential tooth hypersensitivity treatment. The controlled parameters including laser power of 0.03-0.150 W, scanning speeds of 11.4-34.2 mm/s and focus/defocus modes were used for studying interaction between laser energy and dentin of human tooth. Most of the dentin specimens were etched after CO₂ laser irradiation with the power larger than 0.12 W at a scanning speed of 11.4 mm/s. Compared with the simulation results of temperature distribution, the maximum temperature at laser powers from 0.12 to 0.15 W is increased from 1961 to 2245°C, which exceeded the melting point (1570°C) of dentin's main content hydroxyapatite (HA). Increasing scanning speed can reduce the linear density of laser output energy for just locally melting porous microstructure of dentin surface without etching. Varying focus mode can also improve the damage of nanoporous dentin microstructure. At parameters of 0.150 W power and 34.2 mm/s scanning speed under defocus operation, laser treatment was successfully performed on the nano-HA coated dentin with well-molten sealing on tubules of porous microstructure at a simulate surface temperature of about 574°C, which was the potential for dentin hypersensitivity cure application.