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Atilan Yavuz S, Erturk Avunduk AT, Karatas O, Çakır Kılınç NN, Delikan E. Impact of acid and laser etching of enamel on microleakage in different adhesive systems. Lasers Med Sci 2024; 39:181. [PMID: 39008166 PMCID: PMC11249556 DOI: 10.1007/s10103-024-04120-0] [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: 02/23/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024]
Abstract
This study aimed to evaluate the microleakage of light-cured and self-cured adhesives on enamel surfaces selectively etched with Er, Cr: YSGG laser or 35% phosphoric acid. A total of 60 class V cavities were prepared 1 mm above the cemento-enamel junction (CEJ). The specimens were randomly divided into six groups. Group 1: Clearfil SE Bond with no conditioning, Group 2: Tokuyama Universal Bond with no conditioning, Group 3: Clearfil SE Bond conditioned with 35% phosphoric acid, Group 4: Tokuyama Universal Bond conditioned with 35% phosphoric acid, Group 5: Clearfil SE Bond conditioned with Er, Cr: YSGG laser and Group 6: Tokuyama Universal Bond conditioned with Er, Cr: YSGG laser. Microleakage was evaluated qualitatively (visually) and quantitatively (ImageJ). The data were analyzed using IBM SPSS V23 and submitted to Kruskal-Wallis and Wilcoxon tests. The significance level was set at p < 0.05. In all evaluation methods, the microleakage scores exhibit significant differences (p*<0.001). Group 1 and Group 3 exhibited similar and lower microleakage values than the Group 5. In the occlusal margin, the microleakage values were similar in Group 2, Group 4, and Group 6, whereas in the gingival margin Group 4 showed significantly lower leakage compared to Group 2. Regardless of the etching protocols and adhesive systems used, less microleakage was observed on the occlusal surface than on the gingival surface. Phosphoric acid etching provides better results than laser etching for enamel surface treatment on both occlusal and gingival surfaces.
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Affiliation(s)
- Sevim Atilan Yavuz
- Faculty of Dentistry, Department of Restorative Dentistry, Mersin University, Mersin, Türkiye.
| | | | - Ozcan Karatas
- Faculty of Dentistry, Department of Restorative Dentistry, Nuh Naci Yazgan University, Kayseri, Türkiye
| | | | - Ebru Delikan
- Faculty of Dentistry, Department of Pediatric Dentistry, Nuh Naci Yazgan University, Kayseri, Türkiye
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Huang Q, Li Z, Lyu P, Zhou X, Fan Y. Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10030296. [PMID: 36978686 PMCID: PMC10044917 DOI: 10.3390/bioengineering10030296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The utilization of lasers has been regarded as a novel technique for the purposes of clinical use in the dental field. Recently, numerous studies have been conducted on the potential applications of laser therapy in endodontics. Moreover, due to their ablation, penetrability, and disinfection capabilities, lasers have performed well with respect to endodontic treatments, including root canal treatment, vital pulp therapy (pulp capping and pulpotomy), dentinal hypersensitivity treatment, and management of dental pain related to pulp and periradicular disease. In particular, the superiorities of laser-aided pulp therapy are emphasized through condensed clinical controlled trials, and histological studies, in this review. Moreover, the ingenious use of laser applications with respect to aiding in the acceleration of root development and the extraction of foreign matters (i.e., broken files and fiber posts) in canals has quickly become the cutting-edge trend of current research. This review offers a summary and discussion of the current literature on all the aforementioned laser applications. Moreover, the characteristics of laser devices, including erbium lasers, neodymium-doped lasers, CO2 lasers, and diode lasers, are detailed and discussed here, providing useful references for laser application in endodontics. We also focus on the different wavelengths with respect to the lasers that are applied in endodontics. High-power lasers perform well as operative instruments; in addition, low-level lasers lead to the regulation of pulp inflammation, and the promotion of pulp healing. This narrative review provides a summary of the advanced applications of lasers in conjunction with various devices in the practice of endodontics, and aims to inspire innovative perspectives on lasers in the context of the treatment of dental diseases, especially pulp diseases, in the future.
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Heyder M, Sigusch B, Hoder-Przyrembel C, Schuetze J, Kranz S, Reise M. Clinical effects of laser-based cavity preparation on class V resin-composite fillings. PLoS One 2022; 17:e0270312. [PMID: 35737699 PMCID: PMC9223344 DOI: 10.1371/journal.pone.0270312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/07/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of the present clinically controlled two-year study was to investigate the influence of laser-based cavity preparation on the long-term performance of Class V resin-composite fillings. Class V non-carious lesions (n = 75) were randomly assigned to two test and one control group. Cavities in both test groups were prepared using an Er,Cr:YSGG laser (Waterlase MD, Biolase, Irvine, California, USA). The device was operated at 3 W (150 mJ, 30 J/cm2), 50% water, 60% air, 30 Hz in H mode. Subsequently, laser-prepared tooth surfaces in test group I (n = 21) were additionally conditioned by acid etching (etch-and-rinse). Laser-prepared cavities of test group II (n = 21) received no additional acid conditioning. After application of an adhesive, all cavities were restored using the resin-composite Venus®. For cavities in the control group (n = 33) conventional diamond burs were used for preparation which was followed by an etch-and-rinse step, too. The fillings were evaluated immediately (baseline) and after 6, 12 and 24 months of wear according to the C-criteria of the USPHS-compatible CPM-index. The results showed that after 24 month of wear, laser-preparation was associated with fillings of high clinical acceptability. Compared to conventional bur-based treatment, laser-based cavity preparation resulted in fillings with high marginal integrity and superior marginal ledge configurations (p = 0.003). Furthermore, laser-preparation combined with additional acid-conditioning (test group I) resulted in fillings with the best marginal integrity and the lowest number in marginal discoloration, especially at the enamel-composite margins (p = 0.044). In addition, total loss of fillings was also less frequently observed in both laser groups as compared to the control. The results clearly demonstrate that laser-based cavity preparation will benefit the clinical long-time performance of Class V resin-composite fillings. Furthermore, additional acid-conditioning after laser preparation is of advantage.
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Affiliation(s)
- Markus Heyder
- Department of Conservative Dentistry and Periodontology, University Hospital, Jena, Germany
| | - Bernd Sigusch
- Department of Conservative Dentistry and Periodontology, University Hospital, Jena, Germany
| | | | - Juliane Schuetze
- Department of Fundamental Science, University of Applied Sciences, Jena, Germany
| | - Stefan Kranz
- Department of Conservative Dentistry and Periodontology, University Hospital, Jena, Germany
- * E-mail:
| | - Markus Reise
- Department of Conservative Dentistry and Periodontology, University Hospital, Jena, Germany
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Zhang Y, Chen W, Zhang J, Li Y. Does Er,Cr:YSGG reduce the microleakage of restorations when used for cavity preparation? A systematic review and meta-analysis. BMC Oral Health 2020; 20:269. [PMID: 33023550 PMCID: PMC7541249 DOI: 10.1186/s12903-020-01252-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 09/13/2020] [Indexed: 02/06/2023] Open
Abstract
Background As the member of erbium laser family, Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) has obtained the approval for caries removal and cavity preparation by Food and Drug Administration (FDA). However, there is still controversy over the beneficial effects of Er,Cr:YSGG preparations on microleakage. The present study is the first systematic review and meta-analysis to compare the microleakage of cavities prepared by Er,Cr:YSGG lasers with that by traditional burs. In addition, the effect of acid etching on the adhesive potential of self-etch and etch-and-rinse adhesives was assessed after laser preparation. Methods An electronic search was performed in Pubmed, EBSCO, Embase, and the Cochrane Controlled Register of Trials (CENTRAL). Results Totally, 357 articles were identified. Finally, 13 met the inclusion criteria, of which 11 were selected for meta-analysis. All the included studies exhibited a moderate risk of bias. Based on the meta-analysis, no significant difference was observed between the Er,Cr:YSGG and traditional bur groups in terms of the incidence of microleakage. Self-etch adhesives, in combination with prior acid etching, showed less microleakage than those without acid etching in the laser-prepared cavities. Conclusions Current studies do not support the beneficial effects of Er,Cr:YSGG preparations on microleakage. Additional acid etching with self-etching adhesives is recommended after Er,Cr:YSGG preparations. Further high-quality studies are needed to draw a convincing conclusion in the future.
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Affiliation(s)
- Yali Zhang
- Department of Stomatology, The First People's Hospital of Qujing, Qujing, 655000, China
| | - Wenfei Chen
- Department of Stomatology, The Second People's Hospital of Qujing, Qujing, 655000, China
| | - Jinrui Zhang
- Department of Ophthalmology and Otorhinolaryngology, Zhanyi People's Hospital of Qujing, Qujing, 655000, China
| | - Yanhui Li
- Department of Stomatology, The Second People's Hospital of Qujing, Qujing, 655000, China.
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Comparison of laser- and bur-prepared class I cavities restored with two different low-shrinkage composite resins: a randomized, controlled 60-month clinical trial. Clin Oral Investig 2019; 24:357-368. [DOI: 10.1007/s00784-019-02931-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
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Aydın U, Aksoy F, Tosun S. Fracture resistance of root-filled teeth after cavity preparation with conventional burs, Er: YAG and Er,Cr: YSGG lasers. Eur Oral Res 2019; 52:59-63. [PMID: 30775703 DOI: 10.26650/eor.2018.442] [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: 01/05/2017] [Revised: 02/03/2017] [Accepted: 02/21/2017] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of the present study is to compare the fracture resistance of teeth after access cavity preparation with conventional rotary burs, Erbium-doped yttrium aluminum garnet laser (Er:YAG) and Erbium, cromium: yttrium scandium gallium garnet laser (Er,Cr:YSGG) lasers. Materials and methods Fifty five intact mandibular molars were divided into 3 negative groups (groups 1, 2, 3; n=5 for each), 3 study groups (groups 4, 5, 6; n=10 for each) and 1 positive control group (intact teeth; n=10). Access cavities of groups 1, 2 and 3 were prepared with conventional burs, Er:YAG laser and Er,Cr:YSGG laser respectively. After root canal obturation, their coronal portions were left non-restored. Access cavities of groups 4, 5 and 6 were prepared by using the same equipment but their coronal portions were restored with composite resinafter root canal obturation. Following thermocycling, fracture strength was evaluated with a Universal Testing Machine. Mean force at which each sample is fractured was recorded in Newton unit and statistically analyzed. Results Fracture resistance of group 7 (intact teeth) was significantly higher than all other groups (p<0.001). Differences among the fracture resistance values of groups 4, 5 and 6 were not significantly different but they were significantly higher than those of groups 1, 2 and 3 (p<0.001). No significant difference was found between Groups 1, 2 and 3. Conclusion Preparing access cavities with either laser or bur has no effect on the fracture resistance of teeth with root canal treatment.
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Affiliation(s)
- Uğur Aydın
- Department of Endodontics, Gaziantep University Faculty of Dentistry, Gaziantep, Turkey
| | - Fatih Aksoy
- Department of Endodontics, Adıyaman University Faculty of Dentistry, Adıyaman, Turkey
| | - Samet Tosun
- Higher School of Health Services Gaziantep University, Gaziantep, Turkey
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Ergin E, Oz FD, Gurgan S. Comparison of Er,Cr:YSGG Laser Handpieces for Class II Preparation and Microleakage of Silorane- or Methacrylate-Based Composite Restorations. Photomed Laser Surg 2018; 36:499-505. [PMID: 30188252 DOI: 10.1089/pho.2018.4459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of cavity preparation with different Er,Cr:YSGG laser handpieces on microleakage of different posterior composite restorations. METHODS Fifty-four extracted intact human premolars were randomly assigned to three groups according to cavity preparation method: Bur Group: high-speed diamond bur (Diatech), MD Group: Er,Cr:YSGG laser Waterlase MD handpiece (Biolase Millennium II), and Turbo Group: Er,Cr:YSGG laser Waterlase MD TURBO handpiece (Biolase Millennium II). One hundred eight Class II slot cavities were prepared on the mesial and distal proximal surfaces of each tooth, and the cavity preparation times required were determined. The groups were then subdivided according to the restorative systems used (n = 12): a conventional methacrylate-based microhybrid composite (Filtek P60+Adper Single Bond 2/3M); a silorane-based resin composite (Filtek Silorane+Silorane System Adhesive/3M); and a nanohybrid methacrylate-based composite (Kalore+G-Bond/GC). The restorative systems were applied according to the manufacturers' recommendations. Following thermocycling (X5000; 5°C-55°C), the teeth were coated with nail varnish except the restoration margins, immersed in 0.5% basic fuchsin dye solution, and sectioned in a mesiodistal direction. Dye penetration was evaluated under a light microscope for occlusal and cervical margins. Data were analyzed with one-way ANOVA and chi-square tests (p < 0.05). RESULTS The cavity preparation time (mean ± SD) required for Bur, MD, and Turbo group was 31.25 ± 3.82, 222.94 ± 15.85, and 92.5 ± 7.42 sec, respectively, and the differences among the groups were statistically significant (p < 0.05). Comparing the occlusal and cervical microleakage scores, no statistically significant differences were found among the groups and subgroups (p > 0.05). CONCLUSIONS Er;Cr:YSGG laser cavity preparation with the Turbo handpiece needed shorter time than the MD handpiece, although it needed longer time than the conventional diamond bur. The use of different handpieces of Er,Cr:YSGG laser did not differ from conventional preparation with diamond bur in terms of microleakage with the tested methacrylate- and silorane-based posterior composite restorative systems.
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Affiliation(s)
- Esra Ergin
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
| | - Fatma Dilsad Oz
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
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Malekafzali B, Asnaashari M, Javadi F. Comparison of marginal microleakage of flowable composite restorations in primary canine teeth prepared with high-speed diamond bur, Er:YAG laser and Er,Cr:YSGG laser. Laser Ther 2017; 26:195-202. [PMID: 29133967 DOI: 10.5978/islsm.17-or-15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/14/2017] [Indexed: 11/06/2022]
Abstract
Background and Objectives Adhesive restorations have become highly popular in pediatric dentistry, and novel methods of cavity preparation with minimal patient discomfort including Er:YAG and Er,Cr:YSGG laser preparations have greatly advanced. This study aimed to compare the microleakage of composite restorations of class V cavities prepared in primary canine teeth with high-speed bur and Er:YAG and Er,Cr:YSGG lasers. Materials and Methods This in vitro study was conducted on 30 class V cavities prepared on the buccal surfaces of primary canine teeth in three groups (n = 10) of bur preparation, Er:YAG laser and Er,Cr:YSGG laser. The cavities were etched, bonded and restored with Grandio flowable composite according to the manufacturer's instructions. After thermocycling, the teeth were immersed in 1% methylene blue dye for 24 hours to detect microleakage. The teeth were evaluated under a stereomicroscope at ×32 magnification to assess the depth of penetration of methylene blue. The data were analyzed using SPSS version 19 and non-parametric Kruskal-Wallis and Mann Whitney tests. Results Non-parametric Kruskal-Wallis test showed no significant difference in dye penetration among the three groups (P > 0.05). Pairwise comparisons of occlusal and gingival margins by nonparametric Mann Whitney test revealed no significant difference in microleakage either (P > 0.05). Conclusion Use of Er:YAG and Er,Cr:YSGG lasers can decrease microleakage to the level of bur preparation. Bur and laser cavity preparations are not significantly different in terms of microleakage at the enamel or dentin margins. Thus, considering the advantages of laser, it may serve as a suitable alternative to bur preparation in pediatric dentistry.
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Affiliation(s)
- Beheshteh Malekafzali
- Department of Pediatric dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fateme Javadi
- Department of Pediatric, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Synarellis A, Kouros P, Koulaouzidou E, Strakas D, Koliniotou-Koumpia E. In vitro microleakage of class v composite restorations prepared by Er,Cr:YSGG laser and carbide bur. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The aim of this in vitro study was to compare the degree of microleakage on enamel and dentin margins of class V cavities prepared with either a high-speed drill or an Er,Cr:YSGG laser (2780 nm) and to associate their use with a beveling method for the margin. Method and Materials: Sixty bovine incisors were randomly distributed into three groups. Group 1 (G1) cavities were laser prepared and bur beveled, group 2 (G2) cavities were bur prepared and beveled, while cavities of group 3 (G3) were laser prepared and beveled. Cavities were restored with selective enamel etching, using the same bonding agent and nano-hybrid resin composite for all groups. After thermocycling, microleakage was assessed using a methylene blue dye penetration method. Results: Statistical analysis (Mann-Whitney, Kruskal-Wallis and post-hoc Dunn’s multiple comparison tests) demonstrated significantly higher microleakage for dentin compared to enamel margins in G1. Enamel margin microleakage was found to be significantly higher at G3 compared to G1 (p=0.032) and G2 (p=0.001), while no significant differences were found between G1 and G2 (p=0.850). Regarding dentin margins, G2 group performed significantly better than G1 and G3 (p<<0.001), while there was no significant difference among G1 and G3 scores (p=1.000). Conclusions: The conventional cavity preparation method seems to perform better in terms of microleakage than the Er,Cr;YSGG laser. Laser-prepared cavities could perform better in terms of microleakage if an additional step of enamel bur-beveling is performed prior to restoration.
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The Effect of Energy Densities on the Shear Bond Strength of Self-Adhering Flowable Composite to Er:YAG Pretreated Dentin. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6507924. [PMID: 27830151 PMCID: PMC5086511 DOI: 10.1155/2016/6507924] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/18/2016] [Indexed: 11/18/2022]
Abstract
Objective. To investigate the shear bond strength of self-adhering flowable resin composite, to dentin, after exposing it to Er:YAG laser radiation, at different energy densities. Materials and Methods. Sixty freshly extracted human third molars were randomly divided into five groups (n = 12). In the control group, dentin was left unirradiated, whereas, in the other four groups, dentin was irradiated with Er:YAG laser in noncontact mode (MSP mode = 100 µs; 10 Hz; beam diameter: 1.3 mm; speed of 1 mm/second; air 6 mL/min; and water 4 mL/min), and respectively, with the following level of energy (50 mJ, 60 mJ, 80 mJ, and 100 mJ). Then, self-adhering flowable resin composite was bonded to all prepared dentin surfaces. Shear bond strength (SBS) was applied and fractured surfaces were examined using scanning electron microscopy. Results. SBS values showed significant differences in 60 mJ (P < 0.05) compared to other groups. Morphological evaluation revealed tags or plugs in dentinal tubules, especially when 60 mJ and 80 mJ were used. All four groups tended to leave more residues on the dentin surface, than the control group. Conclusion. Er:YAG dentin irradiation may enhance SBS of the self-adhering flowable resin composite when it is used at the appropriate low level of energy density.
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Mozaffari HR, Ehteshami A, Zallaghi F, Chiniforush N, Moradi Z. Microleakage in Class V Composite Restorations after Desensitizing Surface Treatment with Er:YAG and CO 2 Lasers. Laser Ther 2016; 25:259-266. [PMID: 28765670 DOI: 10.5978/islsm.16-or-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aims: Glutaraldehyde, CO2 and Er:YAG lasers can be used for treatment of dentin hypersensitivity. However, their application may have adverse effects on the clinical service of restorations. This study aimed to assess the microleakage in composite restorations following surface treatment with Glutaraldehyde desensitizer, CO2 and Er:YAG laser irradiation for treatment of dentin hypersensitivity. Materials and methods: This experimental study was conducted on 60 extracted sound human teeth. Class V cavities were prepared measuring 3×3 mm using a diamond bur. Specimens were randomly divided into 4 groups of 15. Group one:no surface treatment, Group two:applying Glutaraldehyde desensitizer, Groups of three and four were irradiated with CO2 and Er:YAG lasers, respectively. Surfaces were restored with bonding agent (Single Bond 2, 3M, USA) and Z250 composite (3M, USA). Specimens were thermocycled and immersed in 1% methylene blue solution for 24 hours. Microleakage scores were assessed under a stereomicroscope at ×20 magnification. Data were analyzed using SPSS and the Kruskal Wallis test (P=0.05). Results: There was no significant difference between microleakage of groups in enamel margins (P=0.694). The difference in microleakage at the dentin margin was significant between groups (P=0.018). Conclusions: Application of Glutaraldehyde-desensitizer and CO2 laser irradiation of surfaces prior to composite restoration do not increase microleakage at the enamel or dentin margins but tooth surface treatment with Er:YAG laser significantly increased the microleakage at the dentin margins.
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Affiliation(s)
- Hamid Reza Mozaffari
- Oral Medicine Department, School of Dentistry, Kermanshah University of Medical Sciences
| | | | | | - Nasim Chiniforush
- Laser Research Center of Dentistry, Tehran University of Medical Sciences
| | - Zohreh Moradi
- Operative Department, School of Dentistry, Tehran University of Medical Sciences
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