Effect of HEMA on bonding of Er:YAG laser-irradiated bovine dentine and 4-META/MMA-TBB resin

Effect of viscosity of experimental universal adhesive on bond strength to dentin prepared with Er:YAG laser

The aim of this study was to clarify the effect of universal adhesive (UA) viscosity on the bond strength of resin composite to dentin prepared with Er:YAG laser. Four experimental UAs (SI-1, SI-2, SI-3, and SI-4) were developed by adding 1, 2, 3, and 4 wt/% nanosilica to BeautyBond Xtreme (Shofu), respectively. BeautyBond Xtreme was used as a control (SI-0). The viscosities of experimental UAs were measured using a B-type viscometer. After bovine mandibular anterior teeth were ground with #600 emery paper to obtain the flattened dentin surfaces, the dentin surfaces were cut thinly by irradiating the Er:YAG laser. Specimens were prepared using the respective UA and flowable resin composite and subjected to the microtensile bond strength (µTBS) test. The data from viscosity measurement and the μTBS test were statistically analyzed using the Kruskal-Wallis test. The mean values of viscosity significantly differed among the all experimental groups (p < 0.01). The μTBS of SI-1 and SI-2 was significantly higher than that of SI-0, SI-3, and SI-4 (p < 0.001). The μTBS of SI-0 was significantly lower than that of SI-4 (p < 0.001). The viscosities of the experimental universal adhesives significantly affected their bond strength to laser-cut dentin.

Comparison of tensile bond strengths of four one-bottle self-etching adhesive systems with Er:YAG laser-irradiated dentin

This study aimed to investigate the interaction of current one-bottle self-etching adhesives and Er:YAG laser with dentin using a tensile bond strength (TBS) test and scanning electron microscopy (SEM) in vitro. Two hundred and thirteen dentin discs were randomly distributed to the Control Group using bur cutting and to the Laser Group using an Er:YAG laser (200 mJ, VSP, 20 Hz). The following adhesives were investigated: one two-step total-etch adhesive [Prime & Bond NT (Dentsply)] and four one-step self-etch adhesives [G-Bond plus (GC), XENO V (Dentsply), iBond Self Etch (Heraeus) and Adper Easy One (3 M ESPE)]. Samples were restored with composite resin, and after 24-hour storage in distilled water, subjected to the TBS test. For morphological analysis, 12 dentin specimens were prepared for SEM. No significant differences were found between the control group and laser group (p = 0.899); dentin subjected to Prime & Bond NT, XENOV and Adper Easy One produced higher TBS. In conclusion, this study indicates that Er:YAG laser-prepared dentin can perform as well as bur on TBS, and some of the one-step one-bottle adhesives are comparable to the total-etch adhesives in TBS on dentin.

Effect of pretreatment on Er:YAG laser-irradiated dentin

Erbium:yttrium-aluminum-garnet (Er:YAG) laser preparation of tooth cavities for restoration is an increasingly popular method, but its compatibility with existing composite material bonding protocols has not been fully defined. This study evaluated the effect of laser and etchant pretreatments on the performance of one-bottle self-etch adhesives in Er:YAG laser-prepared dentin. Eight groups of 20 extracted teeth were established to investigate bonding in tested dentin disks. Various combinations of laser preparation (with/without), pretreatment (none/acid-etch/low-fluence Er:YAG irradiation), and self-etching adhesive (G-Bond Plus or Xeno V) were tested. Samples were then restored with composite resin and subjected to a tensile bond strength (TBS) test. We also performed scanning electron microscopy (SEM) on dentin disks from some of these groups before and after adhesive application to evaluate their microscopic morphological appearance. Statistical analysis (Dunnett T3 test coupled with the general linear model at 5% significance level) revealed that the laser preparation of dentin did not impact on TBS (p = 0.914), whereas pretreatment with either phosphoric acid (p < 0.0001) or low-fluence Er:YAG laser irradiation (p < 0.0001) significantly increased TBS, although there was no difference between them in their respective elevation of TBS. SEM analysis demonstrated that both acid and laser pretreatments reduced irregularities and produced a more homogeneous surface. Er:YAG laser preparation does not compromise the efficacy of one-step self-etch dentin adhesives, and pretreatment with phosphoric acid or low-fluence Er:YAG laser can significantly increase the TBS of adhesion to this irradiated dentin.

Micromorphology of resin-dentin interfaces using one-bottle etch&rinse and self-etching adhesive systems on laser-treated dentin surfaces: a confocal laser scanning microscope analysis

BACKGROUND AND OBJECTIVES

This study evaluated the hybrid layer (HL) morphology created by three adhesive systems (AS) on dentin surfaces treated with Er:YAG laser using two irradiation parameters.

STUDY DESIGN

Occlusal flat dentin surfaces of 36 human third molars were assigned into nine groups (n = 4) according to the following ASs: one bottle etch&rinse Single Bond Plus (3M ESPE), two-step Clearfil Protect Bond (Kuraray), and all-in-one S(3) Bond (Kuraray) self-etching, which were labeled with rhodamine B or fluorescein isothiocyanate-dextran and were applied to dentin surfaces that were irradiated with Er:YAG laser at either 120 (38.7 J/cm(2)) or 200 mJ/pulse (64.5 J/cm(2)), or were applied to untreated dentin surfaces (control group). The ASs were light-activated following MI and the bonded surfaces were restored with resin composite Z250 (3M ESPE). After 24 hours of storage in vegetable oil, the restored teeth were vertically, serially sectioned into 1-mm thick slabs, which had the adhesive interfaces analyzed with confocal laser microscope (CLSM-LSM 510 Meta). CLSM images were recorded in the fluorescent mode from three different regions along each bonded interface.

RESULTS

Non-uniform HL was created on laser-irradiated dentin surfaces regardless of laser irradiation protocol for all AS, while regular and uniform HL was observed in the control groups. "Stretch mark"-like red lines were found within the HL as a result of resin infiltration into dentin microfissures, which were predominantly observed in 200 mJ/pulse groups regardless of AS. Poor resin infiltration into peritubular dentin was observed in most regions of adhesive interfaces created by all ASs on laser-irradiated dentin, resulting in thin resin tags with neither funnel-shaped morphology nor lateral resin projections.

CONCLUSION

Laser irradiation of dentin surfaces at 120 or 200 mJ/pulse resulted in morphological changes in HL and resin tags for all ASs evaluated in the study.

A three-dimensional evaluation of microleakage of class V cavities prepared by the very short pulse mode of the erbium:yttrium-aluminium-garnet laser

The aim of this study was to evaluate microleakage along resin restoration in cavities prepared with an erbium:yttrium-aluminium-garnet (Er:YAG) laser, with and without acid etching, and to compare it with that in diamond-drilled cavities. Thirty intact molars were divided into three equal groups. In the teeth in group I, class V cavities were prepared with a diamond drill. Cavities in groups II and III were prepared with an Er:YAG laser (400 mJ/15 Hz for enamel and 250 mJ/10 Hz for dentine). The cavities in groups I and II were acid-etched and adhesive and flowable composite were applied to all cavities. The specimens were first immersed in dye for 24 h and then in 5% nitric acid for 72 h for softening. The fillings were extracted and photographed through a dissecting microscope. The leakage area was measured with specially designed software. The Kruskal-Wallis test showed that the best ranking was group II [mean range (m.r.) = 27.46], followed by group I (m.r. = 33.48) and, lastly, group III (m.r. = 45.15). The differences between groups I and III (P = 0.023) and between groups II and III were statistically significant (P = 0.080). The least microleakage was found in those cavities prepared by Er:YAG laser and subsequently acid-etched, whereas the most leakage was in the lased cavities that had not been etched; the traditional diamond-drilled acid-etched cavities produced medium leakage.

Effects of Er:YAG laser irradiation and manipulation treatments on dentin components, part 1: Fourier transform-Raman study

The effects of laser etching, decontamination, and storage treatments on dentin components were studied using Fourier transform (FT)-Raman spectroscopy. Thirty bovine incisors were prepared to expose the dentin surface and then divided in two main groups based upon the decontamination process and storage procedure: autoclaved (group A, n=15) or stored in thymol aqueous solution (group B, n=15). The surfaces of the dentin slices were schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control subgroup) or irradiated with erbium-doped yttrium-aluminum-garnet (Er:YAG) laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ, and total energy of 12 J). Samples were analyzed by FT-Raman spectroscopy; we collected three spectra for each area (before and after treatment). The integrated areas of five Raman peaks were calculated to yield average spectra. The areas of the peaks associated with phosphate content (P<0.001), type I collagen, and organic C-H bonds (P<0.05) were reduced significantly in group A (control). Analyses of samples irradiated with reduced laser energies did not show significant changes in the dentin components. These results suggest that thymol storage treatment is advised for in vitro study; furthermore, 12 J of Er:YAG laser energy does not affect dentin components.

Effects of Er:YAG laser irradiation and manipulation treatments on dentin components, part 2: energy-dispersive X-ray fluorescence spectrometry study

The effects of laser etching, decontamination, and storage treatments on dentin components were studied by energy-dispersive X-ray fluorescence spectrometry (EDXRF). Thirty bovine incisors were prepared to expose the dentin surface and then divided into two main groups based upon the decontamination process and storage procedure: autoclaved (group A, n=15) or stored in aqueous thymol solution (group B, n=15). The surfaces of the dentin slices were schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control subgroup) or irradiated with erbium-doped yttrium-aluminum-garnet (Er:YAG) laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ). Samples were analyzed by micro-EDXRF, yielding three spectra for each area (before and after treatment). Surface mappings covering an area of 80x60 points with steps of 20 mum were also performed on selected specimens. The amount of Ca and P in group A specimens decreased significantly (P<0.05) after the acid etching and the CaP ratio increased (P<0.001). Er:YAG laser-etching using lower laser energies did not produce significant changes in dentin components. The mapping data support the hypothesis that acid etching on dentin produced a more chemically homogeneous surface and thus a more favorable surface for the diffusion of adhesive monomers.

Combined FT-Raman and SEM Studies of the Effects of Er:YAG Laser Irradiation on Dentin

OBJECTIVE

This study evaluated the molecular and morphological changes on dentin elements after Er:YAG laser irradiation.

BACKGROUND DATA

Spectroscopy studies reporting the effects of Er:YAG laser irradiation as an alternative to acid etching are needed to better understand the laser's effects.

METHODS

The occlusal one-third of the crown of six human third molars was removed. The dentin surface was schematically divided into areas corresponding to four surface treatment groups: control (group C): 37% phosphoric acid etching; group I: Er:YAG laser 80 mJ; group II: Er:YAG laser 120 mJ; and group III: Er:YAG laser 180 mJ. The analysis was performed by scanning electron microscopy (SEM) and Fourier transform Raman spectroscopy (FT-Raman) before and after the treatments. Raman data were submitted to ANOVA and Bonferroni tests.

RESULTS

The SEM photomicrographs revealed open dentin tubules in the control group. The molars from groups I, II, and III showed partially open dentin tubules. SEM images showed that the laser-irradiated dentin surface was not favorable to the diffusion of monomers. A significant reduction of the spectra relative intensity was observed in group III specimens.

CONCLUSIONS

Er:YAG laser irradiation with 180 mJ could produce chemical changes in proteins, phosphate, and carbonate in dentin.

Effect of a desensitizing agent containing glutaraldehyde and HEMA on bond strength to Er:YAG laser-irradiated dentine

OBJECTIVES

The aim of this study was to investigate whether a desensitizing agent (GLUMA Desensitizer) containing glutaraldehyde and HEMA improved the bond strength and bonding durability of a self-etching primer adhesive to Er:YAG-irradiated dentine.

METHOD

Dentine of 120 human molars was exposed by wet grinding on SiC paper for bond strength testing. Thirty specimens each were allocated to the following treatment groups: (1) control; (2) Er:YAG laser irradiation; (3) Er:YAG laser irradiation followed by application of GLUMA Desensitizer; (4) Er:YAG laser irradiation followed by application of GLUMA Desensitizer and 10s rinsing with water. Composite cylinders were bonded to the dentine surfaces with a self-etching priming adhesive system. Tensile bond strengths (TBS) of 10 specimens of each treatment group were measured after 24-h water storage, 6 months water storage and 12 months water storage, respectively, and the failure modes were analyzed. TBS data were statistically treated by two-way ANOVA and Fisher's PLSD test at a significance level of p<0.05.

RESULTS

TBSs for the GLUMA-non rinse and GLUMA-rinse groups were significantly higher than for the laser group at 24 h and 12 months. Specimens from the Er:YAG-irradiated dentine group had significantly lower bond strengths than the control group at each storage time. All control specimens showed cohesive fractures in resin close to the bonding interface whereas the Er:YAG laser-irradiated groups showed both dentine cohesive, resin cohesive and dentine-resin mixed failures.

CONCLUSION

Application of GLUMA Desensitizer to Er:YAG-irradiated dentine increases the bond strength and durability of the self-etching priming adhesive used.

Pathological study of pulp treated with chemicals after Er:YAG laser preparation

OBJECTIVE

The aim of this study was to clarify pulp reaction following cavity preparation with an Er:YAG laser and subsequent treatment with topically applied chemicals to achieve a high resin bond strength.

BACKGROUND DATA

The application of chemicals has been found to effectively remove or reform the denatured layer produced by Er:YAG laser irradiation and has been proposed as a new strategy for improving resin bond strength. However, very little is known about pulp reaction to chemical procedures.

METHODS

Class 5 dentin cavities were prepared with an Er:YAG laser in 128 teeth in nine adult dogs. The teeth were then coated with glutaraldehyde (GA group), or phosphoric acid and sodium hypochlorite (PA group) to reform or remove the denatured layer. All the cavities were then restored with composite resin. In the control group, no chemical application was carried out prior to restoration. The animals were sacrificed immediately after, and at 7 and 90 days following treatment. The treated teeth were then extracted for histopathological examination of the pulp.

RESULTS

Pathological evaluation of the pulp indicated a good condition in each group at each of the three observation time points. No bacterial growth was observed on the cavity walls or bacterial invasion into the dentinal tubules or pulp chambers in any of the groups at any of the observation periods.

CONCLUSION

Our findings suggest that the application of chemicals to remove or reform denatured layers is effective in obtaining better composite resin restoration with no pulp damage.

Effect of bonded restorations on the fracture resistance of root filled teeth

AIM

To evaluate the fracture resistance of root filled maxillary premolars restored with different techniques.

METHODOLOGY

One hundred and twenty single-rooted maxillary premolar teeth were divided randomly into six groups of 20 teeth and subjected to the following procedures: group 1: intact teeth. Group 2: endodontic access cavities prepared. Group 3: MOD cavities were prepared, root canals were filled and no restoration was placed. Group 4: teeth were prepared as group 3 and restored conventionally with amalgam. Group 5: teeth were prepared as group 3 and restored with amalgam using a bonding material. Group 6: teeth were prepared as group 3 and restored with composite resin using the same bonding material. Teeth were embedded in acrylic resin and the loads for fracture strength were applied vertically with a constant speed of 1 mm min(-1). Data were evaluated statistically with anova and Tukey's tests.

RESULTS

The mean force of fracture values were 1191.41, 599.86, 233.03, 494.72, 962.81 and 856.48 N for groups 1, 2, 3, 4, 5 and 6, respectively. The fracture resistance of group 5 was similar to group 1 (P > 0.05). The mean force at fracture of group 5 and group 6 was not significantly different. The fracture resistance of groups 5 and 6 was significantly higher than group 4 (P < 0.001).

CONCLUSIONS

The group, restored with conventional amalgam, had the weakest resistance to fracture when compared with the bonded restorations. No statistically significant differences were found between the bonded amalgam and composite resin groups.

Resin Bonding to Dentin Irradiated by High Repetition Rate Er:YAG Laser

OBJECTIVE

This study evaluated the influence of laser irradiation with a high pulse repetition rate on dentin bonding.

BACKGROUND DATA

Although resin bonding to erbium:yttrium-aluminium-garnet (Er:YAG) laserirradiated dentin has frequently been investigated, the effects of a high pulse repetition rate have not yet been sufficiently investigated.

METHODS

Four groups treated under different laser conditions were evaluated in this study: 100 mJ/pulse-10 pulses per second [pps], 50 mJ/pulse-20 pps, 33 mJ/pulse-30 pps, and the unlased condition as a control. The total energy used to irradiate each group was adjusted to 1.0 W. After bovine dentin specimens were irradiated by an Er:YAG laser, acid conditioners (10% citric acid/3% ferric chloride) were applied to the lased surface. Thereafter, a PMMA rod was bonded to the lased dentin using 4- META/MMA-TBB resin, and mini-dumbbell-shaped specimens were prepared. These specimens were then tested under tensile mode and fractured surfaces were observed under scanning electron microscopy (SEM).

RESULTS

The bond strength of the unlased control was significantly higher than those of the three lased groups. Among the three lased groups, irradiation with higher output energy and lower pulse repetition rate tended to affect the higher bond strength. Upon SEM observation of the fractured surface, the lased groups showed the mixture of failure in the hybrid layer in almost part. There was no significant difference among the three lased groups.

CONCLUSION

It can be concluded from the results of this study that a higher pulse repetition rate is not effective for resin bonding to laser-irradiated dentin.

Resin bonding to Er: YAG laser-irradiated dentin: combined effects of pre-treatments with citric acid and glutaraldehyde

The purpose of this study was to evaluate the combined effects of citric acid and glutaraldehyde (GA) on the resin bonding to Er: YAG laser-irradiated dentin. Bovine dentin was prepared with 180- to 600-grit SiC paper and then uniformly irradiated with an Er: YAG laser (laser-irradiated group) or immersed in water at 60 degrees C for 15 min (heated group). The samples were then acid-conditioned with 10% citric acid (10-0) or 10% citric acid/3% ferric chloride (10-3) for 15 s and treated with GA for 10 min before bonding to an acrylic rod with 4-META/MMA-TBB resin. These samples were trimmed to prepare miniaturized dumbbell-shaped specimens. After storage in water at 37C for 1 d, the tensile bond strength was measured, and the fractured surface was evaluated using a scanning electron microscope (SEM). In the laser-irradiated and heated groups, the 10-3+GA-treated specimen had higher bond strength than that of 10-0+GA. On the other hand, the tensile bond strength of 10-3 +GA in the non-irradiated group was lower that that of 10-0+GA. In conclusion, the combination of 10-3 and GA for bonding with 4-META/MMA-TBB resin was the most effective for Er: YAG laser-irradiated dentin and heated dentin, but it was not effective for the non-irradiated dentin.