Influence of final irrigation protocols and type of resin cement on bond strength of glass fiber posts in root dentin previously treated with photodynamic therapy

The adhesive strength of fiber post-to-canal dentin with Aniline green, Fotoenticine activated by PDT, green tea, and ozone as a final irrigant

AIM

The effect of novel final disinfection protocols Malachite green (MG), Fotoenticine® (FTC), Green tea extract (GTE), and Ozonated water (OW) on the bond strength of prefabricated glass fiber posts (PGFP) adhered to canal dentin.

MATERIAL AND METHOD

The canals of fifty premolars with closed apices were cleansed and obturated. The specimens were randomly assigned to one of five groups based on the final irrigant used, with the control group receiving NaOCl+EDTA and the experimental groups receiving MG, FTC, OW, and GTE. The GFP was cemented with a self-etching, dual-cure paste; the bond strength was estimated with a universal testing machine; and failure analysis was conducted with a stereomicroscope.

RESULTS

The highest PBS was observed in the coronal third of Group 4 (using ozonated water as the final irrigant), whereas the lowest bond integrity was observed in the apical section of Group 2 (1.02-0.54 MPa) using Malachite green as the final irrigant. Group 1, Group 4, and Group 5 exhibited no significant difference in the bond integrity of GFP to dentin when compared to Group 2 (p>0.05). In addition, comparable bond score values were obtained for Groups 2 and 3 (p>0.05).

CONCLUSION

The results of this study suggest that OW and GTE may be effective final disinfectants for root canals, as they increase the bond strength of resin-luting cement.

Influence of photodynamic therapy, different final irrigants, and ultrasonic activation on the bond strength of glass fiber posts to root dentin

OBJECTIVE

To evaluate the influence of photodynamic therapy (PDT), different final irrigants, and ultrasonic activation (US) on the bond strength of glass fiber posts (GFP) to root dentin.

METHODS

One hundred twenty bovine roots were divided into 12 groups according to PDT application, the type of final endodontic irrigant, and US. The samples were divided into 12 groups (n = 10): G1-DW(distilled water); G2-DW+US; G3-17% EDTA; G4-17% EDTA+US; G5-17% GA (glycolic acid); G6-17% GA+US; G7-PDT+DW; G8-PDT+DW+US; G9-PDT+17% EDTA; G10-PDT+17% EDTA+US; G11-PDT+17% GA; G12-PDT+17% GA+US. After cementing the glass fiber posts with resin cement, roots were sectioned into 2-mm-thick slices. One slice from the cervical third and another from the middle third were used for the push out test (PO), and the other two for the diametral compression test (DC). Thus, 10 samples were obtained per third for each mechanical test (n = 10). Kruskal-Wallis and Student-Newman-Keuls tests were used to analyze PO and DC data, and Pearson's correlation test was used to verify the relationship between the variables. Failure patterns were analyzed with chi-square test.

RESULTS

Significant differences were found in the PO test among the experimental groups (p < 0.001; power=1.00). PDT improved bond strength when using EDTA. PDT and US increased bond strength when using GA. Favorable failure patterns occurred more frequently in Group GA+US. There was no correlation between data obtained with PO and DC tests (r = 0.112; p = 0.729).

CONCLUSION

PDT provided the highest bond strength values of GFP to root dentin when associated with GA and US or when associated only with EDTA.

Global research trends on photodynamic therapy in endodontics: A bibliometric analysis

BACKGROUND

Photodynamic therapy (PDT) is an adjunctive treatment that aims to inactivate microorganisms through an oxidative reaction produced by irradiating a photosensitizing agent. The quest for improved root canal disinfection has sought supplementary methods when performing chemomechanical procedures. From this perspective, PDT protocols were proposed as an auxiliary approach in endodontics. Thus, the aim of this study was to investigate publication metrics and research trends related to this scope.

METHODS

This review is reported in accordance with the PRISMA 2020 recommendations. Two blinded and independent reviewers systematically searched five electronic databases until December 2021. The acquired bibliometric parameters were analyzed through descriptive statistics and graphical mappings with VOSViewer software.

RESULTS

The search retrieved 342 studies from 84 journals originating from 33 countries. About 85% of the included studies were published over the last decade. Most of the available evidence is laboratory-based (74.5%), and the main clinical outcomes evaluated were microbiological load reduction and postoperative pain. Mayram Pourhajibagher is the researcher with the most publications as the first author (n = 16). Tehran University of Medical Sciences carried out the highest number of studies (n = 29), and Photodiagnosis and Photodynamic Therapy is the journal that most published on the theme (n = 111).

CONCLUSIONS

This bibliometric analysis mapped and discussed the scientific progress and publication metrics in PDT in endodontic research. Additionally, future perspectives were highlighted and should focus on discovering new photosensitizer agents, standardizing optimal photoactivation protocols, and conducting more clinical-oriented research.

Effect of photodynamic therapy on resin-dentin bonding interface using different illumination time

OBJECTIVES

The aim of the present study was to evaluate the effect of photodynamic therapy(PDT) on the resin-dentin bonding interface using different illumination time.

METHODS

Seventy completed, isolated molar teeth were collected for this study, sixty of them were used in microtensile bond strength tests. These teeth were initially divided randomly in two main groups(n=30) by the random number table method upon the type of using illumination or not respectively. Then these groups followed by dividing each category in five subgroups(n=6): group A, group B1,group B2, group B3, group B4, group a, group b1, group b2, group b3, group b4. After different treatment, the remaining teeth were made specimens which were observed the fracture modes and interfaces under a stereomicroscope and a scanning electron microscope(SEM). The dentin permeability of the specimens were evaluated by a laser scanning confocal microscope(LSCM). To detect significance difference between means of different groups analysis of variance(ANOVA) was performed followed by LSD-t tests.

RESULTS

There was a significant statistical difference in the microtensile bond strength of the different illumination time of PDT between four experimental groups and the control (P<0.05).

CONCLUSION

With the increase of the illumination time in PDT, the bonding strength between resin and dentin decreased gradually.

Effects of methylene blue and curcumin photosensitizers on the color stability of endodontically treated intraradicular dentin

BACKGROUND

Photodynamic therapy with photosensitizers can reduce the microbial load. However, few studies have evaluated the effects of photosensitizers on the color stability of endodontically treated intraradicular dentin. This in vitro study investigated the effects of methylene blue and curcumin photosensitizers used in photodynamic therapy on the color stability of intraradicular dentin.

METHODS

Sixty human incisors were divided into three experimental groups according to the photosensitizer solutions used and their concentrations: methylene blue (25 mg/L), curcumin (1000 mg/L), and curcumin (1500 mg/L). The color stability of endodontically treated intraradicular dentin was evaluated using a portable reflectance spectrophotometer before and after the samples been storage in 2 mL of the photosensitizer solutions during 5 min (n = 20). Color stability data were subjected to a normality test, and statistical analysis was performed using the one-way analysis of variance and Tukey least significant difference test (α = 0.05).

RESULTS

Samples treated with 25 mg/L methylene blue photosensitizer showed a higher level of color alteration than those stored in 1000 mg/L curcumin (p = .03322). However, there was no significant difference in the color alteration profiles between the samples treated with 25 mg/L methylene blue and 1500 mg/L curcumin (p = .36428). Furthermore, there was no difference in the color alteration profiles between the dentin samples immersed in 1000 mg/L and 1500 mg/L curcumin photosensitizer solutions (p = .45321).

CONCLUSIONS

Methylene blue and curcumin photosensitizers influenced the color stability of endodontically treated intraradicular dentin, and this color alteration exceeded the clinical acceptability threshold. Samples treated with 25 mg/L methylene blue showed the highest level of color alteration.

Photodynamic therapy and gaseous ozone versus conventional post space treatment methods on the push-out bond strength of fiber posts luting with different resin cements

BACKGROUND

The aim of this study was to compare the push-out bond strength of fiber posts by using two different resin cement after the treatments of post space with photodynamic therapy, gaseous ozone and conventional disinfection solution.

METHODS

The root canal treatments of one hundred maxillary incisors were performed. The roots were randomly distributed into 5 groups (n = 20). NaOCl of 2.5% + EDTA of 17% in group 1, CHX of 2% in group 2, toluidine blue + diode laser as the photodynamic therapy (PDT) in group 3 and ozone in group 4 were applied to the post spaces. Group 5 was washed with distilled water as control group. Each group was divided into two subgroups according to the adhesive types and the posts were bonded by using RelyX and LinkForce. The bond strength was calculated using the push-out test method. Resin tag formations were photographed with SEM. The push-out bond strength was analyzed by ANOVA and Tukey tests (p = .05).

RESULTS

The PDT group, which showed the highest PBS among the groups bonded with LinkForce at all levels, was significantly higher than Ozone and DW groups (p<.05). NaOCl and ozone treatments provided the highest PBS among the groups bonded with RelyX for all levels and this difference was significant according to the DW group (p < .05).

CONCLUSION

Post space treatments improved the bond strength of the fiber post ​​in both types of resin cement.

Effectiveness of photodynamic therapy on bonding strength and failure modes of fiber-posts in c-shaped treated root canals

AIM

The present study aimed to assess the push-out bond strength (PBS) and failure modes of fiber-posts after photodynamic therapy (PDT) and Erbium yttrium scandium gallium garnet (Er,Cr:YSGG) in c-shaped canals.

METHODS

Sixty molars with c-shaped root configuration were studied. The endodontic prepared teeth specimen were equally randomized into four groups: i) photodynamic therapy (PDT); ii) Er,Cr:YSGG; iii) chlorhexidine and; iv) control group. Post root filling, 10 mm space was prepared for insertion of post in the root canals. The push-out bond strength was evaluated using Universal testing machine. Modes of failure were evaluated as adhesive, cohesive and admixed. Mean values were computed between groups using Kruskal-Wallis test followed by Bonferroni post hoc test. Comparison between two thirds of root sections were analyzed using Friedman test. P-value was set at 0.05 or less.

RESULTS

Specimens treated with PDT reported the highest mean PBS (8.56 ± 2.12 MPa), while the lowest PBS was observed in NaOCl group (6.92 ± 2.21 MPa). Thirteen failures were observed at the adhesive post interface, whereas 22 failures were found at the interface forming between the dentin surface and adhesive. Similarly, 9 failures were categorized as mixed. For PDT group, a sum of 3 failures and 4 failures were noted at the apical and cervical points.

CONCLUSION

The specimens treated with PDT showed the highest push out bond strength with least number of failures.in c-shaped root canals.

Influence of two photodynamic therapy sessions and different photosensitizers on the bond strength of glass-fiber posts in different regions of intraradicular dentin

BACKGROUND

Although photodynamic therapy associated with photosensitizers can promote microbial reduction, studies evaluating the consequences of two photodynamic therapy sessions associated with different photosensitizers on the bond strength of glass-fiber posts to endodontically treated intraradicular dentin are scarce. This in vitro study aimed to investigate the influence of two photodynamic therapy sessions using methylene blue or curcumin photosensitizers on the bond strength of glass-fiber posts to intraradicular dentin in different root thirds.

METHODS

Seventy-two teeth were divided into 9 experimental groups according to photosensitizer type, concentration and light-activation: Control - deionized water; Methylene blue 50 mg/L; Methylene blue 50 mg/L + laser; Methylene blue 100 mg/L; Methylene blue 100 mg/L + laser; Curcumin 500 mg/L; Curcumin 500 mg/L + LED; Curcumin 1000 mg/L; and Curcumin 1000 mg/L + LED. Push-out bond strength of the fiber posts to endodontically treated dentin was evaluated using a universal test machine (n = 8). Bond strength data underwent Kruskal-Wallis test, followed by Dunn test for comparison between treatments, and Friedman test for comparison between thirds (α = 0.05). Illustrative scanning electron microscopy images were obtained to qualify the failure mode.

RESULTS

Curcumin at higher concentration, activated or not by blue LED, decreased the bond strength values in the apical region when compared with the control group (P < 0.05). There was no difference between two photodynamic therapy sessions using methylene blue photosensitizer (activated or not) and the control group regardless of concentrations and root canal depth evaluated (P > 0.05). Regarding intraradicular depth, the different thirds showed no statistical difference on bond strength values (P > 0.05). All experimental groups presented predominance of mixed-type failure, excepting the methylene blue group at higher concentration activated by red laser, and the curcumin photosensitizer at both concentrations activated by blue LED.

CONCLUSIONS

Methylene blue at a 50 mg/L concentration can be applied in two PDT sessions, after biomechanical preparation and before glass-fiber post luting, as it presents no influence on root dentin bond strength in in vitro conditions.

Influence of a glycolic acid-based final irrigant for photosensitizer removal of photodynamic therapy on the microhardness and colour change of the dentin structure

INTRODUCTION

This study aimed to evaluate the influence of glycolic acid-based final irrigant for photosensitizer removal of photodynamic therapy on the microhardness and colour change of the dentin structure.

METHODS

Eighty extracted single-rooted human incisors were used. Sample preparation and root split resulted in 160 samples, 80 samples being used for microhardness and 80 samples for colour change evaluation. In the first, PDT protocol was performed and 80 samples were randomly divided into 4 groups (n = 20), according to the final irrigation protocol: distilled water (DW); 17 % ethylenediaminetetraacetic acid (EDTA); QMix; 17 % glycolic acid (GA). Microhardness was evaluated using the Vicker tester, before and after, PDT and final irrigation protocols, calculating the percentage of microhardness reduction. In the second evaluation, PDT and final irrigation protocols were performed in the same way. Colour change was evaluated using digital spectrophotometer before and after these protocols, calculating the ΔE colour change using the CIELAB system (L*a*b* values). Specific statistical analysis was performed for both evaluations (α = 5%).

RESULTS

The highest percentage of microhardness reduction was observed in 17 % EDTA, QMix and 17 % GA groups, with no significant difference among them (p > 0.05). Furthermore, none of these protocols was effective in photosensitizer removal, and all final irrigation protocols were statically similar to control group (p > 0.05).

CONCLUSIONS

GA promotes microhardness reduction and also contributes to the colourization of dentin structure during the photosensitizer removal process, followingPDT .

Impact of photodynamic therapy on the push-out bond strength of fiber posts to root dentin: A systematic review and meta-analysis

BACKGROUND AND PURPOSE

This systematic review documents the up-to-date evidence on the efficacy of photodynamic therapy (PDT) on the push-out bond strength of fiber posts cemented to root dentin.

MATERIALS AND METHODS

The focused PICO question was: "What impact does PDT have on the push-out bond strength of fiber posts cemented to root dentin?" This systematic review followed the guidelines and recommendations reported in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines chart. An electronic search was performed in MEDLINE/PubMed, SCOPUS, Web of Science, and Embase from January 1980 up to and including January 2020. Heterogeneity was calculated for push-out bond strength by means of the Chi-square test and I² statistics. For meta-analyses, if the I² was higher than 50 %, a random effects model was used, otherwise a fixed effects model for I² ≤50 % was applied. A p-value <0.05 was set for significant heterogeneity. Forest plots were computed reporting standard mean differences (SMD) of outcomes and 95 % confidence intervals (CI).

RESULTS

In total, ten studies were included, all of wich demonstrated medium risk of bias. All studies tested the push-out bond strength by means of a universal testing machine with applying a load ranging between 0.5 and 1 mm/min speed. Of the 10 studies, nine (90 %) indicated that PDT had no effect on push-out bond strength of fiber posts to root dentin. Only one study indicated that PDT significantly improved the bond strength when compared with other control groups. The overall mean difference for push out bond strength showed no statistically significant difference between PDT and the control group (SMD = -1.11 [-3.25, 1.02], Z=-1.02, p = 0.305).

CONCLUSION

This systematic review concludes that PDT has no effect on improving the push-out bond strength of fiber posts to root dentin.

Effect of Photodynamic Therapy, Er,Cr:YSGG, and Nd:YAG Laser on the Push-Out Bond Strength of Fiber Post to Root Dentin

Objective: To evaluate the push-out bond strength and modes of failure of fiber post to root dentin by using photodynamic therapy (PDT), Er,Cr:YSGG, Nd:YAG laser, and conventional cleaning and shaping (CCS). Materials and methods: Eighty anterior teeth were sectioned in a horizontal manner being 2 mm incisal to the cementoenamel junction, and root canal was prepared for post space. After post space was made, fiber posts were placed inside the root canal system. The fiber posts were subjected to PDT, Er,Cr:YSGG laser, Nd:YAG laser, and conventional cleaning and shaping (CSS) with 20 specimens in each group. Cervical and apical sections were obtained from the specimens. For performing the push-out test, the universal testing machine was used. The formula used for calculating the push-out bond strength was σ = N/mm². Results: PDT group (8.16 ± 2.19 MPa) achieved the highest mean push-out bond strength, whereas Er,Cr:YSGG (7.24 ± 1.27 MPa) reported the lowest value in the specimens. Among the experimental groups, the ANOVA test expressed statistical difference (p = 0.481). In the cervical segments, the mean push-out bond strength was found to be higher in all of the experimental groups. For the cervical segments, the independent t-test results showed higher mean push-out bond strength values than the apical segments in PDT, Er,Cr:YSGG, Nd:YAG, and CSS groups, respectively (p < 0.05). Twenty failures were observed at the interface level between the adhesive and surface of dentin. Seven failures were found at the interface between mixed and the adhesive and post, respectively. Conclusions: Push-out bond strength to root canal dentin was not affected by PDT, Er,Cr:YSGG, and Nd:YAG laser compared with CCS. However, PDT produced the smallest number of failure modes and slightly higher push-out bond strength to root dentin. Laser treatment using PDT and Er,Cr:YSGG appeared to be clinically efficient showing acceptable push-out bond strength of fiber post with less number of failures at different regions of the root dentin.

Efficacy of phototherapy in the adhesive bonding of different dental posts to root dentin: A systematic review

BACKGROUND

The aim of the current systematic review was to evaluate the efficacy of phototherapy in the adhesive bonding of different dental posts to root dentin.

METHODS

The outline of this systematic review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Searches in both electronic and manual literature were performed in the main databases 'MEDLINE' and 'EMBASE' up to March 2019 using the following terms: (Phototherapy) AND (push out test) AND (bond strength) AND (post) OR (fibre) OR (metal) AND (smear layer).

RESULTS

Six in-vitro studies were included and processed for data extraction. All studies incorporated the use of fiber posts. The mean shear bond strength for test group ranged from 2.23 to 15.17 MPa while mean shear bond strength for control group ranged from 2.93 to 9.38 MPa. The wavelengths of diode lasers ranged from 660 to 2940 nm (nm). Power was reported in 5 studies ranging from 0.075 W to 3 W. All studies compared shear bond strength of phototherapy in the adhesive bonding of different dental posts to root dentin. In all the included studies, greater bond strength achieved by phototherapy compared to nonirradiated group.

CONCLUSION

Within the limits, this study shows that the dentin to post bond strength was significantly enhanced by phototherapy.