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Suliman S, Sulaiman T, Deeb JG, Abdulmajeed A, Abdulmajeed A, Närhi T. Effect of Er:YAG laser on debonding zirconia and lithium disilicate crowns bonded with 2- and 1-bottle adhesive resin cements. J ESTHET RESTOR DENT 2024. [PMID: 38923782 DOI: 10.1111/jerd.13274] [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: 04/08/2024] [Revised: 06/12/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Erbium-doped yttrium-aluminum-garnet (Er:YAG) laser debonding of zirconia and lithium disilicate restorations is increasingly used for a range of clinical applications. Using rotary instruments to remove such restorations for any purpose has proven to be challenging. Erbium laser has been reported to be a conservative method for removing ceramic restorations. There is little data in the literature about the effect of adhesive resin cement type on the debonding time of the ceramic restoration using the Er:YAG laser. OBJECTIVES To evaluate and compare the time required for the Er:YAG laser to debond zirconia and lithium disilicate crowns bonded with a 2- and 1-bottle adhesive resin cement systems. MATERIALS AND METHODS Forty extracted premolar teeth were prepared and scanned for milled 40 CAD/CAM crowns. Teeth were randomly assigned into groups (n = 10 per group): 3 mol% yttria-partially stabilized zirconia crowns 3Y-PSZ (G1a) bonded with Panavia™ V5 (2-bottle adhesive resin cement), Zirconia 3Y-PSZ crowns (G1b) bonded with RelyX™ Ultimate (1-bottle adhesive resin cement), and for the lithium disilicate crowns bonded with the two types of cements (G2a, G2b). Each specimen was irradiated with an Er:YAG laser at 335 mJ, 15 Hz, 5.0 W, and 50-ms pulse duration (super short pulse mode). The irradiation time required for crowns to be successfully debonded was recorded for each specimen. Data were statistically analyzed using ANOVA and Tukey HSD post-hoc test (p < 0.05), at the 95 percent level of confidence. The intaglio surface of the debonded crown was analyzed using scanning electron microscopy (SEM). RESULTS The mean ± standard deviation times needed for crown debonding were 5.75 ± 2.00 min for the G1a group, 4.79 ± 1.20 min for group G1b, 1.69 ± 0.49 min for group G2a, and 1.12 ± 0.17 for group G2b. There was no statistically significant difference in debonding time between the 2- and 1- bottle adhesive resin cement within the groups G1a and b (p = 0.2914), or between groups G2a b (p = 0.7116). A statistically significant difference (p < 0.05) was found between groups G1a and G2a and b and between groups G1b and G2a and b were SEM analysis showed no changes in the microstructure of the ceramic surface after Er:YAG laser irradiation. CONCLUSION Zirconia and lithium disilicate restorations can be debonded using Er:YAG lasers in a safe and efficient manner. There is no significant difference in the debonding time between the 2- and 1- bottle adhesive resin cement systems used in this study. CLINICAL SIGNIFICANCE Retrieving zirconia and lithium disilicate ceramics can be a challenging process when using diamond rotary instruments. ER:YAG lasers may efficiently debond these ceramics from the tooth structure, independent of the bonding process used for bonding them.
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Affiliation(s)
- Sama Suliman
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Taiseer Sulaiman
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Janina Golob Deeb
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Awab Abdulmajeed
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Aous Abdulmajeed
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of Southwest, Turku, Finland
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Tu S, Sun C, Zhao N, Xiong Z. Safety and Efficacy of the Erbium Laser in Debonding Dental Accessories: A Narrative Review. Photobiomodul Photomed Laser Surg 2024; 42:327-338. [PMID: 38598279 DOI: 10.1089/photob.2023.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Objective: This article aims to review the safety and efficacy of the Er:YAG laser in debonding dental accessories. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles published between 2010 and 2022 on the removal of dental accessories using erbium laser were searched. The selected articles were then classified according to the accessories used: adhesives, brackets, restorations, or implant crowns. Enamel surface roughness, shear bond strength, adhesive remnant index, duration time (t), pulp chamber temperature (T), morphology (M), and other variables were then noted. Results: The dental accessories and adhesives used were described along with the laser parameters used, such as frequency, pulse width, irradiation time, scanning mode, water-air cooling, and other variables. Conclusions: Laser removal using Er:YAG laser of dental accessories such as brackets, crowns, and veneers is fundamentally safe, time-saving, and does not cause damage to the enamel nor the underlying dentin. However, there was no distinct advantage with laser removal seen, such as those residual adhesives of brackets on the tooth surface and temporary adhesives of restorations.
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Affiliation(s)
- Shanshan Tu
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Chunyan Sun
- School of Mathematics and Physics, Anqing Normal University, Anqing, People's Republic of China
| | - Ning Zhao
- Department of Orthodontics, Shanghai Key Laboratory of Stomatology, Shanghai No. 9 Hospital, Shanghai Jiaotong University School of Medical, Shanghai, People's Republic of China
| | - Zhengdong Xiong
- School of Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, People's Republic of China
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Khalil AS, Baowideen FA, Alhujaili AS, Alotaibi NF, Almanjhi WA, Yassin HY, Nasser MM, Alzahrani AF, Alrehaili RS. Efficacy of Lasers in Debonding Ceramic Brackets: Exploring the Rationale and Methods. Cureus 2024; 16:e61050. [PMID: 38915986 PMCID: PMC11195319 DOI: 10.7759/cureus.61050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 06/26/2024] Open
Abstract
The development of ceramic brackets in orthodontics three decades ago emerged as a response to the increasing patient demand for less visible orthodontic appliances. While these brackets provide superior aesthetics, they are characterized by lower fracture toughness and higher bond strength in contrast to metal brackets. These properties present challenges during the debonding step, including the risk of enamel micro-fractures and cracks. Historically, various strategies have been developed to address challenges associated with debonding, reduce patient discomfort, and ensure that the bond failure site is confined to the bracket-adhesive interface. This included the use of specially designed debonding pliers, electrothermal debonding, ultrasonic technique, and chemical agents. Recently, there has been a shift towards utilizing different types of laser irradiation for this purpose. The burgeoning strategy, however, requires diligent scientific scrutiny to establish a standardized protocol with particular laser parameters and ultimately achieve the goal of enhancing the patient experience by reducing discomfort. This article offers a narrative review of laser-aided debonding of ceramic brackets, aimed at comparing different laser types, presenting their benefits and downsides, validating the efficiency of each method, and summarizing the published literature on this subject. It also provides insights for orthodontists on reducing patient discomfort that usually accompanies debonding ceramic brackets by delving into the science behind the use of lasers for this purpose.
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Laky M, Toth P, Laky B, Vaskovich T, Kurzmann C, Arslan M, Nguyen M, Rausch-Fan X, Moritz A, Shokoohi-Tabrizi HA. Optimized Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) Laser Parameters for the Removal of Dental Ceramic Restorations. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5835. [PMID: 37687528 PMCID: PMC10488396 DOI: 10.3390/ma16175835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVES The use of lasers for debonding adhesively luted ceramic restorations is a rather recent oral laser application in dentistry. The removal of all-ceramic restorations in the mouth can often be a troublesome task. A novel method for the debonding of ceramic restorations without damaging the restorations is Er:YAG laser irradiation. The aim of this study was to evaluate the Er:YAG laser for debonding procedures of different dental ceramics and to identify appropriate laser settings. MATERIAL AND METHODS Lithium disilicate, zirconium-reinforced lithium silicate, feldspatic ceramic, and zirconium dioxide were investigated. Ten ceramic rectangular-shaped specimens with 1 and 2 mm thickness were produced from each material. All specimens were irradiated with four different power settings 1.5; 2.5; 3.5; 4.5 W, pulse duration 50 μs, laser repetition rate 10 Hz, time of irradiation 10 s. The transmitted energy was measured with a powermeter. Additionally the suitability of the Er:YAG laser to remove the adhesively bonded ceramic and the time until loss of retention was evaluated. RESULTS The transmission rate for 1 and 2 mm platelets was determined for zirconium-reinforced lithium silicate at 54.6%/35.6%, lithium disilicate at 53.2%/35.7%, zirconium dioxide at 40.6%/32.4%, and for the feldspathic ceramic at 19.4%/10.1%. For zirconium-reinforced lithium silicate and zirconium dioxide 2.5 W (250 mJ/10 Hz) was an appropriate energy level for effective debonding. Whereas for lithium disilicate and for feldspathic ceramic, 4.5 W (450 mJ/10 Hz) is required for efficient debonding. CONCLUSIONS There are differences regarding transmission rates between ceramic types for the Er:YAG laser light and additionally depending on the type of ceramic different energy settings should be used for adequate debonding. Based on our in-vitro experiments we recommend 2.5 W for zirconium-reinforced lithium silicate and zirconium dioxide and 4.5 W for lithium disilicate and feldspatic ceramic. Transmission rates of different ceramic types and varying influences of thicknesses and bonding materials should be considered to adjust the laser parameters during laser debonding of adhesively luted all-ceramic restorations.
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Affiliation(s)
- Markus Laky
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
- Core Facility Applied Physics, Laser and CAD/CAM Technology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Peter Toth
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
| | - Brenda Laky
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Society of Regenerative Medicine, 1010 Vienna, Austria
- Austrian Research Group for Regenerative and Orthopedic Medicine (AURROM), 1050 Vienna, Austria
| | - Tom Vaskovich
- Technical Dental Laboratory, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Christoph Kurzmann
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Muazzez Arslan
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
| | - Mariano Nguyen
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria (M.A.); (M.N.); (X.R.-F.); (A.M.)
| | - Hassan Ali Shokoohi-Tabrizi
- Core Facility Applied Physics, Laser and CAD/CAM Technology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
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Zamzam MK, Hamadah O, Espana-Tost T, Arnabat-Dominguez J. Comparative Study of Transmission of 2940 nm Wavelength in Six Different Aesthetic Orthodontic Brackets. Dent J (Basel) 2023; 11:dj11030067. [PMID: 36975563 PMCID: PMC10047171 DOI: 10.3390/dj11030067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/24/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Previous studies have confirmed the superiority of using erbium lasers (2940, 2780 nm) over other lasers in the debonding of ceramic brackets due to their safety and effectiveness. The most important factor in the debonding of aesthetic brackets is the transmission of the erbium laser through the aesthetic bracket to the adhesive resin. Objective: To identify the transmission of the 2940 nm wavelength through different types of aesthetic brackets. Materials and methods: A total of 60 aesthetic brackets were divided into six equal groups (10 monocrystalline sapphire brackets—Radiance, AO; 10 monocrystalline sapphire brackets—Absolute, Star Dentech; 10 polycrystalline brackets—20/40, AO; 10 polycrystalline brackets—3M Unitek Gemini Clear Ceramic; 10 silicon brackets—Silkon Plus, AO; 10 composite brackets—Orthoflex, OrthoTech). The aesthetic brackets were mounted in a Fourier transform infrared spectrophotometer (FTIR IRPrestige-21, SHIMADZU) following the typical spectroscopy lab procedure for such samples. The transmission ratio for the 2940 nm wavelength was obtained using IRsolution software. The mean transmission values of the tested groups were compared using a one-way analysis of variance (ANOVA) test followed by a Bonferroni test (post-hoc test). Results: The highest transmission ratio was observed for the Radiance sapphire brackets (64.75%) and the lowest was observed for the 3M polycrystalline brackets (40.48%). The differences among the Aesthetic brackets were significant (p < 0.05). Conclusions: The thick polycrystalline and composite brackets have the lowest transmissibility, whereas the monocrystalline sapphire brackets have the highest transmissibility for the 2940 nm wavelength, meaning that there is a higher possibility of debonding them with a hard tissue laser through thermal ablation.
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Affiliation(s)
- Mohammad Khare Zamzam
- Department of Odontostomatology, Faculty of Medicine, University of Barcelona, 08907 Barcelona, Spain
| | - Omar Hamadah
- Higher Institute of Laser Research and Applications, Damascus University, Damascus 222, Syria
| | - Toni Espana-Tost
- Department of Odontostomatology, Faculty of Medicine, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (T.E.-T.); (J.A.-D.); Tel.: +34-679440408 (J.A.-D.)
| | - Josep Arnabat-Dominguez
- Department of Odontostomatology, Faculty of Medicine, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (T.E.-T.); (J.A.-D.); Tel.: +34-679440408 (J.A.-D.)
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Deeb JG, Grzech-Leśniak K, Brody ER, Matys J, Bencharit S. Erbium laser-assisted ceramic debonding: a scoping review. J Prosthodont 2022; 31:e100-e124. [PMID: 36269672 PMCID: PMC10099628 DOI: 10.1111/jopr.13613] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 10/13/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Removal of ceramic restorations and appliances can be time consuming, invasive, and inconvenient. Erbium lasers offer an alternative noninvasive method for debonding of ceramic appliances. This paper aims to provide a comprehensive review of current literature on the effectiveness of erbium lasers for removal of ceramic restorations and appliances from natural teeth and dental implants. METHODS A comprehensive search of 7 databases, including Medline (Ovid), Embase, Dentistry and Oral Sciences Source (DOSS), Web of Science, Cochrane Library, and ProQuest Dissertations and Theses was performed. The inclusion and exclusion criteria were agreed prior to the literature search. Two reviewers independently screened the title and abstract. A third reviewer then broke the tie, if any. The selected articles then underwent full text review and the data was extracted. RESULTS The search identified 4117 unique articles published through June 10, 2021. Studies were assessed and categorized based on the type of restoration/appliance, type of abutment, type of laser, laser settings, efficacy of debonding, and pulpal temperature rise. Thirty-eight full-text articles were reviewed for inclusion. Time for ceramic debonding varies depending on the type of restorations and materials. Removal of zirconia crowns from teeth and implant abutments requires a longer period of time compared to lithium disilicate crowns. Temperature increases were reported as 5.5 degrees or less. Laser setting and laser type affect the debonding time and the increase in temperature. Examinations of debonded ceramics demonstrated no known structural damages resulting from laser applications. CONCLUSIONS Erbium lasers are effective noninvasive tools to remove all ceramic restorations/appliances from natural teeth and implant abutments without causing harm to abutments. Laser-assisted debonding should be considered as a viable alternative to rotary instrumentation for ceramic crowns; however, clinical studies of erbium-assisted ceramic retrieval are needed.
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Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Kinga Grzech-Leśniak
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Laser Laboratory, Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Erica R Brody
- Health Sciences Library, Virginia Commonwealth University, Richmond, Virginia
| | - Jacek Matys
- Laser Laboratory, Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Sompop Bencharit
- Department of Oral and Craniofacial Molecular Biology, Philips Institute for Oral Health Research, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia
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Mocuta DE, Miron MI, Lungeanu D, Mateas M, Ogodescu E, Todea CD. Laser Er:YAG-Assisted Debonding May Be a Viable Alternative to the Conventional Method for Monocrystalline Ceramic Brackets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14564. [PMID: 36361441 PMCID: PMC9657488 DOI: 10.3390/ijerph192114564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
In orthodontic practice, due to the increased interest among patients in smile aesthetics, different types of brackets are now being used, with those most frequently applied being ones made of polycrystalline and monocrystalline ceramic. The aim of this study was to evaluate the laser Er:YAG-assisted debonding technique compared to conventional methods for removing monocrystalline ceramic brackets from human teeth. The study sample included 60 vital teeth (frontals of the upper jaw) from 10 patients who had monocrystalline ceramic brackets and were in the final phase of orthodontic treatment. The debonding procedure was carried out following a split-mouth study design, using either the conventional technique or laser Er:YAG 2940 nm radiation. For each tooth, three variables were evaluated: the patient's sujective tooth sensitivity associated with the debonding, the time required for debonding, and pulp blood flow microdynamics after the debonding. Three evaluation instruments were used to assess and quantify the treatment effects: (i) the Wong-Baker FACES Pain Rating Scale for pain assessment; (ii) a digital stopwatch/timer to measure the time required to remove the bracket; and (iii) laser Doppler flowmetry (LDF) for recording the pulp blood flow evolution. The statistical analysis of the recorded data showed a statistically significant difference between the two debonding methods regarding the tooth sensitivity during the debonding and the time required for the procedure. The subjective tooth sensitivity was reduced from a mean ± standard deviation of 3.07 ± 1.46 to 0.47 ± 0.86 on the Wong-Baker FACES scale (Wilcoxon signed rank, p < 0.001). The necessary time for debonding was reduced by 0.697 ± 0.703 s per tooth (paired t-test, p < 0.001). There was no difference in the blood microdynamics between the two debonding techniques. According to the results of this study, the laser Er:YAG-assisted debonding technique may be a viable alternative to the conventional method for monocrystalline ceramic brackets.
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Affiliation(s)
- Daliana-Emanuela Mocuta
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300041 Timișoara, Romania
| | - Mariana I. Miron
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300041 Timișoara, Romania
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Functional Sciences, Faculty of Medicine, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Marius Mateas
- Mechatronics Department, Polytechnic University of Timișoara, 300006 Timișoara, Romania
| | - Emilia Ogodescu
- Pediatric Dentistry Research Center, Department of Pediatric Dentistry, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Carmen D. Todea
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300041 Timișoara, Romania
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Al-Araji SI, Sulaiman AR. The efficiency of ErCr:YSGG laser on the debonding of different thicknesses of ceramic veneers. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8666952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims: To verify the efficacy of Er,Cr:YSGG laser for debonding of lithium disilicate (LD) reinforced glass ceramic veneers of different thicknesses. Methods: Forty bovine teeth were prepared and randomly divided into four groups (n=10/group) according to the ceramic disc thickness: C0.5 (Control group) and L0.5 (Laser irradiated group) in which LD discs had a thickness of 0.5mm and 5mm diameter; C1 and L1 in which LD discs had a thickness of 1mm and 5mm diameter. The lithium disilcate discs (IPS E.max®, shade HTA2) were fabricated following the manufacturer’s recommendations and cemented to the prepared tooth surface. The Er,Cr:YSGG laser was applied to the laser groups at 2.5W and 25Hz for 60seconds. Universal testing machine was used to evaluate the shear bond strength for all samples at a cross head speed of 1mm/min in an inciso-gingival direction parallel to the sample surface. After debonding, the samples were examined under stereoscope to evaluate the mode of failure according to the adhesive remnant index (ARI). Results: Laser irradiation significantly diminishes the shear bond strength from 10.868 MPa to 3.778 MPa for C0.5 and L0.5 groups respectively (p=0.00) and from 14.711 MPa to 4.992 MPa for C1 and L1 groups respectively (p=0.00). The shear bond strength required for debonding increased with increasing thickness of discs, but without significant difference (p=0.110). Higher ARI scores were seen in the laser groups (more cement remaining adhered to the tooth) when compared to the control groups. Conclusions: The Er,Cr:YSGG laser could be an effective and useful tool in debonding of lithium disilicate ceramic veneers as it decreases the shear bond strength required for veneer debonding.
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Khalil AS, Tamish NM, Elkalza AR. Assessment of chemical, ultrasonic, diode laser, and Er:YAG laser application on debonding of ceramic brackets. BMC Oral Health 2022; 22:79. [PMID: 35305631 PMCID: PMC8933975 DOI: 10.1186/s12903-022-02111-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Risk of enamel damage that often accompanies ceramic brackets debonding raises the demand of finding an optimal method for debonding of them without adverse effects. Different techniques were proposed in an attempt to facilitate their debonding. Comparison of these techniques is crucial. The aim of this study was to evaluate and compare different techniques for debonding of ceramic brackets in terms of shear bond strength and adhesive remnant index. Materials and methods A total of 100 extracted premolars were randomly allocated into 5 groups. Ceramic brackets were then bonded to teeth using light cure composite resin. Among test groups; group I: served as control, group II: chemical aided debonding via peppermint oil, group III: ultrasonic aided debonding, group IV: diode laser aided debonding, and group V: Er:YAG laser aided debonding. Brackets were shear tested using universal testing machine followed by ARI assessment and evaluation of enamel microstructure was performed using scanning electron microscopy. Results A significantly lower shear bond strength was found in ultrasonic, diode, and Er:YAG laser groups. However, no significant difference was found in the chemical group. A significantly higher adhesive remnant index was found solely in Er:YAG laser group with minimal enamel microstructure alterations. Conclusions Er:YAG laser is a promising tool in debonding ceramic brackets. Ultrasonic and diode laser significantly reduced shear bond strength. Yet, adhesive remnant index in both groups revealed no difference. Chemical aided debonding had little effect and hence, it cannot be recommended without further development.
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Matos DS, Küchler EC, Borsatto MC, Matsumoto MAN, Marques FV, Romano FL. CO2 laser irradiation for debonding ceramic orthodontic brackets. Braz Dent J 2021; 32:45-52. [PMID: 34614060 DOI: 10.1590/0103-6440202104077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/20/2020] [Indexed: 11/22/2022] Open
Abstract
This study evaluated shear bond strength (SBS), adhesive remnant index (ARI) and fracture mode of chemically and mechanically retained ceramic brackets bonded with different composite resins and irradiated with CO2 laser. The null hypothesis was that ceramic brackets bonded with different composite resins and irradiated with CO2 laser would have similar SBS values. Ninety human premolars were divided into four experimental groups according to the combination of type of composite resin (Transbond XT and Z 250) and type of ceramic bracket (Fascination and Mystique), and two control groups (n=15). In the four experimental groups, the brackets were irradiated with CO2 laser at 10 W for 3 seconds before SBS testing. Enamel surface ARI was calculated after debonding under electron microscopy scanning. ANOVA and the Mann-Whitney test were used for statistical analysis. The laser groups had lower SBS values than the non-irradiated groups (control) (p<0.05). The mechanically retained brackets (Mystique) had the higher (p<0.05) and Z250 had the lower SBS values after CO2 laser irradiation. The groups bonded with Z250 had the highest ARI. Adhesive fractures were the most prevalent. The null hypothesis was rejected. CO2 laser decreased SBS efficiently and facilitated debonding of mechanically and chemically retained ceramic brackets.
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Affiliation(s)
- Denise Souza Matos
- School of Dentistry of University Center of Patos de Minas, Patos de Minas, MG Brasil
| | - Erika Calvano Küchler
- Department of Child Clinic, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, SP Brasil
| | - Maria Cristina Borsatto
- Department of Child Clinic, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, SP Brasil
| | - Mirian Aiko Nakane Matsumoto
- Department of Child Clinic, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, SP Brasil
| | - Fernanda Vicioni Marques
- Department of Child Clinic, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, SP Brasil
| | - Fábio Lourenço Romano
- Department of Child Clinic, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, SP Brasil
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11
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Giraldo-Cifuentes H, España-Tost A, Arnabat-Dominguez J. Er,Cr:YSGG Laser in the Debonding of Feldspathic Porcelain Veneers: An In Vitro Study of Two Different Fluences. Photobiomodul Photomed Laser Surg 2020; 38:640-645. [PMID: 32758060 DOI: 10.1089/photob.2019.4752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: New applications in laser technology in aesthetic restorative dentistry merit further research. This study compares the debonding strength and failure mode of feldspathic ceramic veneers using either Er,Cr:YSGG (erbium,chromium:ytrrium-scandium-gallium-garnet) laser at two levels of fluency or no laser (control group). Methods: An in vitro comparative study was carried out using bovine teeth that were randomly distributed into 3 groups of 21 specimens each: (a) experimental group 1 (EG1): irradiated with Er,Cr:YSGG (Waterlase iPlus®; Biolase, Irvine) at an energy density per pulse of 4 J/cm2, using a handpiece (Turbo; Biolase) with a sapphire tip (MX7) and applying the beam perpendicular to the specimen at a distance of 4 mm for 60 sec; (b) experimental group 2 (EG2): irradiated as in EG1, but at 2.7 J/cm2; and (c) control group (CG): debonding without laser irradiation. Results: The stress required for veneer debonding was 8.19 MPa in CG, 0.91 MPa in EG1, and 0.48 MPa in EG2. The difference between the control and both experimental groups was statistically significant (p < 0.001). The percentages of adhesive failure were 40%, 61.9%, and 96%, respectively. Conclusions: Using the Er,Cr:YSGG laser at 4 or 2.7 J/cm2 requires significantly less force to debond ceramic veneers. The percentage of adhesive failures in the two experimental protocols was higher than in the control group. Application of the Er,Cr:YSGG laser using the parameters in this study may be useful in removing feldspathic ceramic veneers, avoiding damaging them and protecting the enamel.
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Affiliation(s)
- Hernan Giraldo-Cifuentes
- Department of Prosthodontics, Fundación Universitaria CIEO-UniCIEO, Bogotá, Colombia
- Faculty of Medicine and Health Sciences, European Master Degree in Oral Laser Applications (EMDOLA), University of Barcelona, Barcelona, Spain
| | - Antonio España-Tost
- Faculty of Medicine and Health Sciences, European Master Degree in Oral Laser Applications (EMDOLA), University of Barcelona, Barcelona, Spain
- IDIBELL Institute, Barcelona, Spain
| | - Josep Arnabat-Dominguez
- Faculty of Medicine and Health Sciences, European Master Degree in Oral Laser Applications (EMDOLA), University of Barcelona, Barcelona, Spain
- IDIBELL Institute, Barcelona, Spain
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12
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Evaluation of Enamel Topography after Debonding Orthodontic Ceramic Brackets by Different Er,Cr:YSGG and Er:YAG Lasers Settings. Dent J (Basel) 2020; 8:dj8010006. [PMID: 31936500 PMCID: PMC7175227 DOI: 10.3390/dj8010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/17/2022] Open
Abstract
In the last decade, the success of lasers in simplifying many dental procedures has heightened the need for research in the orthodontic field, in order to evaluate the benefits of laser-assisted ceramic brackets debonding. Conventional ceramic brackets removal delivers a high shear bond strength (SBS), which might lead to enamel damage. Nowadays, debonding ceramic brackets by Er:YAG laser seems a viable alternative technique; however, there is no data on the use of Er,Cr:YSGG in the literature. We aimed to evaluate the difference in enamel topography derived from different erbium laser settings used during debonding. One hundred and eighty bovine incisors teeth were randomly divided into fifteen experimental groups, according to different erbium laser settings using scanning methods. SBS testing was performed after debonding; stereomicroscopic and SEM analyses were done after cleaning the remaining adhesive so as to assess the incidence of enamel microcracks formation and enamel loss. There were no statistically significant differences between the proportions of teeth with normal enamel topography within the control group when compared with any of the Er:YAG groups. However, the proportion of teeth with a normal enamel topography in Er,Cr:YSGG was 4 W/20 Hz (83.3%) and in Er:YAG was 5 W/20 Hz (91.7%), which was statistically significantly higher than the control group (41.7%). The selection of erbium lasers' optimal parameters during debonding influences the enamel topography. When considering the evaluation of both microscopic and statistical analyses, irradiation by Er:YAG (120 mJ/40 Hz) displayed a significant reduction in microcracks compared with conventional debonding, even though some microstructural changes in the enamel could be noted. Er,Cr:YSGG (4 W/20 Hz) respected the enamel topography the most out of the studied groups.
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13
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Grzech-Leśniak K, Matys J, Żmuda-Stawowiak D, Mroczka K, Dominiak M, Brugnera Junior A, Gruber R, Romanos GE, Sculean A. Er:YAG Laser for Metal and Ceramic Bracket Debonding: An In Vitro Study on Intrapulpal Temperature, SEM, and EDS Analysis. Photomed Laser Surg 2018; 36:595-600. [PMID: 29905504 DOI: 10.1089/pho.2017.4412] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the effects of bracket removal using an erbium laser on the pulp temperature and enamel surface. BACKGROUND Removal of orthodontic brackets with conventional debonding pliers may result in enamel cracks. To avoid damage to the enamel surface and effectively remove metal or ceramic brackets, different types of lasers, such as Nd:YAG, CO2, TM:YAP, diode laser, or Er:YAG, have been introduced for debonding. MATERIALS AND METHODS A total of 55 brackets (n = 55; 20 metal and 35 ceramic ones) were bonded to 55 caries-free premolars extracted for orthodontic indications. Brackets were irradiated with Er:YAG laser (Morita, Irvine, CA) with a wavelength of 2940 nm at a power of 3.4 W, energy 170 mJ, frequency 20 Hz, pulse duration 300 μs, tip diameter 0.8 mm, air/fluid cooling 3 mL/s, and time of irradiation: 6 sec. Debonding was made by scanning (n = 15; 6 sec irradiation at distance of 2 mm from the bracket with an "S" shape movement) and circular (n = 15; 6 sec irradiation at distance of 1 mm from the bracket) motion technique in ceramic brackets or the circular motion technique in metal brackets (n = 15). The number of 10 nonirradiated teeth with ceramic (n = 5) or metal brackets (n = 5) was used as a control in SEM test and EDS analysis. The damage in tooth enamel surface and the calcium percentage were analyzed by means of scanning electron microscope (JEOL 6610LV, JEOL, Japan) and energy dispersive X-ray spectroscopy (EDS, Oxford, United Kingdom). Temperature changes in the pulp were measured by K-type thermocouple. Evaluation of the Adhesive Remnant Index (ARI) on the enamel surface of each tooth was examined after bracket debonding. RESULTS The scanning method has caused significantly lower temperature increase (mean: 0.83°C) compared with circular motion technique around the ceramic brackets (mean: 1.78°C; p = 0.0001) or the metal brackets (mean: 1.29°C; p = 0.015). ARI score showed no differences between the study groups (p = 0.57). SEM analysis revealed no cracks on enamel surface after laser-assisted debonding in comparison with the control samples where cracks were found. EDS showed a higher mean percentage of the calcium (30.7-85.8%) for all test groups compared with control samples (mean: 7%; p = 0.0002). The amount of the calcium elements was higher for metal brackets in comparison with ceramic ones (p = 0.0002). CONCLUSIONS Er:YAG laser-assisted debonding causes a minor increase in the pulp temperature and reduced the risk of enamel damage compared with conventional bracket removal.
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Affiliation(s)
| | | | | | | | - Marzena Dominiak
- 1 Department of Dental Surgery, Wroclaw Medical University , Wroclaw, Poland
| | | | - Reinhard Gruber
- 6 Department of Oral Biology, Medical University of Vienna , Vienna, Austria .,7 Department of Periodontology, School of Dental Medicine, University of Bern , Bern, Switzerland
| | - Georgios E Romanos
- 8 Department of Periodontology, School of Dental Medicine, Stony Brook University , Stony Brook, New York
| | - Anton Sculean
- 7 Department of Periodontology, School of Dental Medicine, University of Bern , Bern, Switzerland
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Arima S, Namura Y, Tamura T, Shimizu N. Easy Debonding of Ceramic Brackets Bonded with a Light-Cured Orthodontic Adhesive Containing Microcapsules with a CO 2 Laser. Photomed Laser Surg 2017; 36:162-168. [PMID: 29173028 DOI: 10.1089/pho.2017.4346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE An easy debonding method for ceramic brackets using a light-cured Bis-GMA resin containing heat-expandable microcapsules and CO2 laser was investigated. BACKGROUND Ceramic brackets are used frequently in orthodontic treatment because of their desirable esthetic properties. However, the application of heavy force to ceramic brackets in debonding can fracture the tooth enamel and ceramic brackets, causing tooth pain. MATERIALS AND METHODS In total, 60 freshly extracted bovine permanent mandibular incisors were divided randomly into 10 groups of 6 specimens each, corresponding to the number of variables tested. Ceramic brackets were bonded to bovine permanent mandibular incisors using an orthodontic bonding agent containing heat-expandable microcapsules at different levels (0-30 wt%) and resin composite paste, and cured by a curing device. The bond strengths were measured before and after CO2 laser irradiation, and the temperature increase in the pulp chamber in fresh human first premolars was also evaluated. RESULTS With CO2 laser irradiation for 5 sec to the bracket, the bond strength in the 25% microcapsule group decreased significantly, to ∼0.17-fold, compared with that of the no-laser group (p < 0.05). The maximum temperature increase in the pulp chamber was 5.3°C with laser irradiation, which was less than the level that induces pulp damage. CONCLUSIONS From these results, it seems likely that the combined use of a light-cured orthodontic bonding agent containing microcapsules and a CO2 laser is a simple debonding system for ceramic brackets, with less debonding time and enamel damage.
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Affiliation(s)
- Shiori Arima
- 1 Department of Orthodontics, Nihon University School of Dentistry , Tokyo, Japan
| | - Yasuhiro Namura
- 2 Department of Orthodontics, Nihon University School of Dentistry , Tokyo, Japan .,3 Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
| | - Takahiko Tamura
- 2 Department of Orthodontics, Nihon University School of Dentistry , Tokyo, Japan .,3 Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
| | - Noriyoshi Shimizu
- 2 Department of Orthodontics, Nihon University School of Dentistry , Tokyo, Japan .,3 Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
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15
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Romano FL, Pessoti G, Galo R, Gomes-Silva JM, Lucisano MP, Borsatto MC, Nelson-Filho P. Does the CO2 laser reduce bond strength in different types of ceramic brackets? Dental Press J Orthod 2017; 22:55-60. [PMID: 28658356 PMCID: PMC5484270 DOI: 10.1590/2177-6709.22.2.055-060.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 10/14/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: The aim of this study was to assess in vitro the influence of the CO2 laser and of the type of ceramic bracket on the shear bond strength (SBS) to enamel. METHODS: A total of 60 enamel test surfaces were obtained from bovine incisors and randomly assigned to two groups, according to the ceramic bracket used: Allure (A); Transcend (T). Each group was divided into 2 subgroups (n = 15): L, laser (10W, 3s); C, no laser, or control. Twenty-four hours after the bonding protocol using Transbond XT, SBS was tested at a crosshead speed of 0.5 mm/min in a universal testing machine. After debonding, the Adhesive Remnant Index (ARI) was evaluated at 10 x magnification and compared among the groups. Data were analyzed by one-way ANOVA, Tukey’s, Mann-Whitney’s and Kruskal-Wallis tests (α = 0.05). RESULTS: Mean SBS in MPa were: AL = 0.88 ± 0.84; AC = 12.22 ± 3.45; TL = 12.10 ± 5.11; TC = 17.71 ± 6.16. ARI analysis showed that 73% of the specimens presented the entire adhesive remaining on the tooth surfaces (score 3). TC group presented significantly higher SBS than the other groups. The lased specimens showed significantly lower bond strength than the non-lased groups for both tested brackets. CONCLUSION: CO2 laser irradiation decreased SBS values of the polycrystalline ceramic brackets, mainly Allure.
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Affiliation(s)
- Fábio Lourenço Romano
- Professor, Universidade de São Paulo, Ribeirão Preto Dental School, Department of Pediatric Clinics, Ribeirão Preto/SP, Brazil
| | - Giovanna Pessoti
- Dental surgeon, Universidade de São Paulo, Ribeirão Preto Dental School, Ribeirão Preto/SP, Brazil
| | - Rodrigo Galo
- Professor, Universidade Federal dos Vales do Jequitinhonha e Mucuri, School of Biological and Health Sciences, Department of Dentistry, Diamantina/MG, Brazil
| | - Jaciara Miranda Gomes-Silva
- Dental surgeon, Universidade de São Paulo, Ribeirão Preto Dental School, Department of Pediatric Clinics, Ribeirão Preto/SP, Brazil
| | - Marília Pacífico Lucisano
- Dental surgeon, Universidade de São Paulo, Ribeirão Preto Dental School, Department of Pediatric Clinics, Ribeirão Preto/SP, Brazil
| | - Maria Cristina Borsatto
- Full professor, Universidade de São Paulo, Ribeirão Preto Dental School, Department of Pediatric Clinics, Ribeirão Preto/SP, Brazil
| | - Paulo Nelson-Filho
- Full professor, Universidade de São Paulo, Ribeirão Preto Dental School, Department of Pediatric Clinics, Ribeirão Preto/SP, Brazil
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16
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Yilanci H, Yildirim ZB, Ramoglu SI. Intrapulpal Temperature Increase During Er:YAG Laser-Aided Debonding of Ceramic Brackets. Photomed Laser Surg 2017; 35:217-222. [PMID: 28068189 DOI: 10.1089/pho.2016.4198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the temperature changes in the pulp chamber while using a newly introduced application of Er:YAG laser to debond ceramic brackets in a study model with a pulpal circulation with and without thermocycled samples. BACKGROUND DATA An esthetic alternative to stainless steel brackets, ceramic brackets have been proposed. However, because of their low fracture resistance and high bond strengths, ceramic brackets can cause a problem when they are being removed using conventional techniques. MATERIALS AND METHODS Experimental Groups A and B were established for samples with or without thermocycling. The same 20 maxillary central incisor and 20 premolar teeth were used in both groups. Pulpal blood microcirculation was simulated using an apparatus described in a previous study. Monocrystalline brackets were bonded by using Transbond XT. In Group A, brackets were debonded using the Er:YAG laser (600 mJ, 2 Hz, long pulse, and no air or water spray) after being stored in distilled water for 24 h. In Group B, brackets were debonded using the same laser system as that used in Group A after being stored in distilled water for 24 h and then thermocycled for a total of 5000 cycles between 5°C and 55°C. The laser irradiation duration and intrapulpal temperature changes were measured. RESULTS In Group B, the intrapulpal temperature increase of the central incisors was significantly higher than that of the premolar teeth. In the central incisor and premolar teeth groups, there were no statistically significant difference between Groups A and B (p > 0.05). A positive correlation was found between laser irradiation duration and temperature increase (p < 0.01). CONCLUSIONS The use of Er:YAG laser is an effective method for debonding the monocrystalline ceramic brackets. This method can be used safely under the consideration of intrapulpal temperature changes.
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Affiliation(s)
- Hilal Yilanci
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University , Istanbul, Turkey
| | - Zeynep Beyza Yildirim
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University , Istanbul, Turkey
| | - Sabri Ilhan Ramoglu
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University , Istanbul, Turkey
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17
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Ghazanfari R, Nokhbatolfoghahaei H, Alikhasi M. Laser-Aided Ceramic Bracket Debonding: A Comprehensive Review. J Lasers Med Sci 2016; 7:2-11. [PMID: 27330690 DOI: 10.15171/jlms.2016.02] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Different techniques have been introduced for the removal of ceramic brackets. Since the early 1990s, lasers have been used experimentally for debonding ceramic brackets. The goal of this study is to give a comprehensive literature review on laser-aided ceramic bracket debonding. PubMed and Google Scholar databases were used to identify dental articles with the following combination of key words: Ceramic brackets, Debonding, and Laser. Sixteen English articles from 2004 to 2015 were selected. The selected studies were categorized according to the variables investigated including the intrapulpal temperature, shear bond strength, debonding time, enamel damage and bracket failure. Most articles reported decreased shear bond strength and debonding time following laser irradiation without any critical and irritating increase in pulpal temperature. There were no reports of bracket failure or enamel damage. Laser irradiation is an efficient way to reduce shear bond strength of ceramic bracket and debonding time. This technique is a safe way for removing ceramic bracket with minimal impact on intrapulpal temperature and enamel surface and it reduces ceramic bracket failure.
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Affiliation(s)
- Rezvaneh Ghazanfari
- Department of Dental Prosthesis and Implants, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Nokhbatolfoghahaei
- Laser Research Center of Dentistry, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Alikhasi
- Dental Research Center, Laser Research Center of Dentistry, Dental Implant Research center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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18
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Pulpal thermal changes following Er-YAG laser debonding of ceramic brackets. ScientificWorldJournal 2014; 2014:912429. [PMID: 25197718 PMCID: PMC4146348 DOI: 10.1155/2014/912429] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 07/15/2014] [Indexed: 11/23/2022] Open
Abstract
Lasers are effective in debonding ceramic brackets. Unfortunately, while reducing the adhesive bond strength, lasers are also reported to increase pulpal temperature. The aim of this study was to evaluate the shear bond strengths and temperature increase levels after debonding ceramic brackets using an Er-YAG laser with or without water-cooling. Sixty polycrystalline upper premolar ceramic brackets were placed on the labial surface of sixty human premolar teeth which were randomly divided into three groups of twenty. A laser pulse at 5 W for 9 seconds was delivered to each bracket in both study groups either with water-cooling (water group) or without water-cooling (waterless group) using an Er-YAG laser. Debonding was performed 45 seconds after laser exposure and shear bond strengths were measured. Data comparison revealed a statistically significant difference between the groups. Mean temperature increases of 2.41°C and 4.59°C were recorded for the water and waterless laser groups, respectively. The shear bond strength value for the control group was 22.76 MPa and 10.46 and 6.36 MPa for the water and waterless laser groups, respectively. The application of Er-YAG laser with water-cooling was an efficient and safe method of debonding ceramic brackets.
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Saito A, Namura Y, Isokawa K, Shimizu N. CO2 laser debonding of a ceramic bracket bonded with orthodontic adhesive containing thermal expansion microcapsules. Lasers Med Sci 2013; 30:869-74. [PMID: 24220847 DOI: 10.1007/s10103-013-1482-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/23/2013] [Indexed: 10/26/2022]
Abstract
We have been studying an easy bracket debonding method using heating of an orthodontic adhesive containing thermal expansion microcapsules. However, heating with a high-temperature heater brings obvious risks of burns around the oral cavity. Thus, we examined safer and more effective bracket debonding methods. The purpose of this in vitro study was to examine the reduction in debonding strength and the time taken using a bracket bonded with an orthodontic adhesive containing thermal expansion microcapsules and a CO2 laser as the heating method while maintaining safety. Ceramic brackets were bonded to bovine permanent mandibular incisors using bonding materials containing various microcapsule contents (0, 30, and 40 wt%), and the bond strengths were measured after laser irradiation for 4, 5, and 6 s and compared with nonlaser-treated groups. Subsequently, the temperature in the pulp chamber during laser irradiation was measured. After laser irradiation for 5 or 6 s, the bond strengths of the adhesive containing 40 wt% microcapsules were significantly decreased to ∼0.40 - 0.48-fold (4.6-5.5 MPa) compared with the nonlaser groups. The mean temperature rise of the pulp chamber was 4.3 °C with laser irradiation for 6 s, which was less than that required to induce pulp damage. Based on these results, we conclude that the combined use of a CO2 laser and an orthodontic adhesive containing thermal expansion microcapsules can be effective and safe for debonding ceramic brackets with less enamel damage or tooth pain.
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Affiliation(s)
- Ayano Saito
- Nihon University Graduate School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
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A report on the use of Er:YAG laser for pilot hole drilling prior to miniscrew insertion. Lasers Med Sci 2013; 30:605-9. [PMID: 23793415 DOI: 10.1007/s10103-013-1374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
The aim of the present in vitro study was to investigate the required time period of the Er:YAG laser that is used for drilling through cortical bone when pilot hole drilling is needed before miniscrew insertion. Even though Er:YAG laser is used in various in vivo and in vitro studies, there is no accepted procedure of laser for depth control during drilling through cortical bone. The study sample consisted of 120 cortical bone segments having 1.5 and 2.0 mm of cortical bone thickness. An Er:YAG laser, with a spot size of 1.3 mm and an air-water spray of 40-50 ml/min, was used. The laser was held 2 mm away from and perpendicular to the bone surface with different laser settings. Twelve specimens were prepared for each subgroup. As the cortical bone thickness increased, the time needed to drill through the bone increased. Frequency increase directly caused a decrease in irradiation duration. When three different frequency, three different energy, and four different power values were tested for both the 1.5- and 2-mm cortical bone thicknesses, the shortest duration needed to drill through cortical bone was seen in the 3.6-W (300 mJ-12 Hz) setting. When pilot holes are drilled prior to miniscrew placement in 1.5 to 2 mm of cortical bone using Er:YAG laser, the most appropriate value is found with the 3.6-W (300 mJ-12 Hz) setting.
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