Microleakage of class V glass ionomer restorations after conventional and Er:YAG laser preparation

Laser-Aided Enamel Conditioning: A Comparison of Microleakage Under Brackets Following Different Aging Procedures

Objective:

To evaluate microleakage under the orthodontic adhesives applied following two version of erbium:yttrium aluminum garnet (Er:YAG) laser-aided enamel conditioning after thermal and thermomechanical simulators.

Materials and Methods:

A comparative analytical study based on metal braces bonded on the enamel of extracted teeth ( n = 160) etched with acid, Er:YAG laser and Er:YAG laser with an X-Runner handpiece, and self-etch adhesives. An arch wire was ligatured to samples which were embedded in acrylic blocks by two with periodontal ligaments. The specimens were subdivided into two groups: those aged with thermal cycling and thermomechanical aging procedures. The samples were immersed in basic fuchsin solution (0.5%) for 24 h. Buccolingual sections were performed on the mesial and distal wings of the braces. The color penetration at the gingival and occlusal margins of the adhesive-bracket and enamel-adhesive was evaluated under a stereomicroscope. The median and mean values of microleakage in both groups were evaluated with Kruskal–Wallis and Mann–Whitney U tests ( P < .05).

Results:

The highest microleakage was recorded in the gingival part of the samples aged with the thermomechanical aging procedure ( P = .001). The amount of microleakage generally increased in the samples subjected to thermomechanical loading, but the only significant difference was recorded in the gingival part in each four different conditioning methods.

Conclusion:

Microleakage of the phosphoric acid-etched groups was recorded with lower values for both aging methods. Thermomechanical aging should be included to microleakage studies due to increased microleakage on gingival side for all etching groups.

Effect of different parameters of Er:YAG laser irradiations on class V composite restorations: A scanning electron microscopy study

The purpose of this study was to compare different parameters of Er:YAG laser irradiations on the marginal microleakage of Class V resin composite restorations. A total of 45 extracted premolars were selected for the study. Class V cavities prepared on both buccal and lingual surfaces of teeth by Er:YAG laser or bur and divided into nine groups. The occlusal margins were in enamel and the cervical margins were in cementum. Group-1: bur preparation; Group-2: laser preparation (lp) (600 mJ/5 Hz); Group-3: lp (300 mJ/10 Hz); Group-4: lp (200 mJ/15 Hz); Group-5: lp (150 mJ/20 Hz); Group-6: lp (200 mJ/20 Hz); Group-7: lp (300 mJ/14 Hz); Group-8: lp (400 mJ/10 Hz); Group-9: lp (700 mJ/5 Hz). All teeth were stored in distilled water at 37°C for 24 h, then thermocycled 1,000 times (5-55°C). Five teeth from each group were chosen for the microleakage investigation and two teeth for the scanning electron microscope (SEM) evaluation. Teeth, which were prepared for the microleakage test were immersed in 0.5% methylene blue dye for 24 h. After immersing, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p < 0.05). More microleakage was observed in cervical regions compared to occlusal regions in all groups (p < 0.05) except for Group 6 (p > 0.05). No significant difference was observed among groups in terms of occlusal and cervical surfaces, separately (p > 0.05). It may be concluded that the cavities prepared by Er:YAG laser showed higher degree of microleakage than bur prepared at cervical regions. Different parameters of Er:YAG laser irradiations affected microleakage. SCANNING 38:434-441, 2016. © 2016 Wiley Periodicals, Inc.

The effects of cavity-filling techniques on microleakage in class II resin restorations prepared with Er:YAG laser and diamond bur: A scanning electron microscopy study

The purpose of this study was to investigate how two cavity-filling techniques affect microleakage in class II resin restorations prepared with Er:YAG laser and diamond bur. Standard MO and DO cavities were prepared in 20 extracted third molars, each randomly assigned to either Group-1 [Herculite XRV Ultra-bur-prepared cavity(bp)], Group-2 [Herculite XRV Ultra-laser-prepared cavity(lp)], Group-3 (SonicFill-(bp)], or Group-4 [SonicFill-(lp)]. For Groups 2 and 4, cavities were prepared by using an Er:YAG laser with a wavelength of 2.94 μm, output power of 200 mJ/pulse, and repetition rate of 20Hz. Teeth were restored with a one-step, self-etch adhesive material (OptiBond All-in-One), a nanohybrid composite (Herculite XRV Ultra), and a bulk-fill composite (SonicFill) according to the manufacturer's instructions. Five teeth from each group were chosen for microleakage investigation and two teeth for scanning electron microscope evaluation. Statistical analysis was performed by using Kruskal-Wallis test. Pair-wise comparisons were performed by Mann-Whitney U test with Bonferroni correction (p < 0.05). The statistical analysis of data revealed greater microleakage in cervical versus occlusal regions in all groups (P < 0.05). Group-2 yielded a higher degree of marginal leakage than Group-3 in terms of occlusal surfaces (p < 0.05). For cervical regions, a statistically significant difference was observed between Groups 2 and 3 as well as Groups 2 and 4 (p < 0.05). Group-3 exhibited significantly better marginal sealing than Group-1 in the cervical region (p < 0.05). The cavities prepared using an Er:YAG laser showed greater microleakage than those conventionally prepared using burs regardless of restorative material at both occlusal and cervical margins. SCANNING 38:389-395, 2016. © 2015 Wiley Periodicals, Inc.

The effect of an erbium, chromium: yttrium-scandium-gallium-garnet laser on the microleakage and bond strength of silorane and micro-hybrid composite restorations

Objective:

The aim of this in vitro study was to compare the microleakage and bond strength of Class V silorane-based and universal micro-hybrid composite restorations prepared either with diamond bur or with an erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser.

Materials and Methods:

A total of 160 molar teeth were used for microleakage assessment and shear bond strength (SBS) test. The specimens were prepared using either diamond bur or 3 W-, 4 W- and 5 W-20 Hz Er, Cr:YSGG laser irradiation. All specimens were subjected to thermocycling (500 times at 5 ± 2°C to 55 ± 2°C, dwell time 15 s and transfer time 10 s). Microleakage was assessed using a 0.5% basic-fuchsin solution. The bond strengths were determined using a microtensile tester at a crosshead speed of 0.5 mm/min. The Kruskal Wallis test was used for the analysis of microleakage and a one-way analysis of variance test was used to analyze the SBS (P < 0.05).

Results:

No statistically significant differences were found (P > 0.05) between Er, Cr:YSGG laser and bur preparation methods regarding microleakage and bond strength values.

Conclusion:

Irradiation with Er, Cr:YSGG laser was confirmed to be as effective as conventional methods for preparing cavities before adhesive restorations.

Shear Bond Strength of an Etch-and-rinse Adhesive to Er:YAG Laser- and/or Phosphoric Acid-treated Dentin

Background and aims. Er:YAG laser irradiation has been claimed to improve the adhesive properties of dentin; therefore, it has been proposed as an alternative to acid etching. The aim of this in vitro study was to investigate the shear bond strength of an etch-and-rinse adhesive system to dentin surfaces following Er:YAG laser and/or phosphoric acid etching. Materials and methods. The roots of 75 sound maxillary premolars were sectioned below the CEJ and the crowns were embedded in auto-polymerizing acrylic resin with the buccal surfaces facing up. The buccal surfaces were ground using a diamond bur and polished until the dentin was exposed; the samples were randomly divided into five groups (n=15) according to the surface treatment: (1) acid etching; (2) laser etching; (3) laser etching followed by acid etching; (4) acid etching followed by laser etching and (5) no acid etching and no laser etching (control group). Composite resin rods (Point 4, Kerr Co) were bonded to treated dentin surfaces with an etch-and-rise adhesive system (Optibond FL, Kerr Co) and light-cured.After storage for two weeks at 37°C and 100% humidity and then thermocycling, bond strength was measured with a Zwick Universal Testing Machine at a crosshead speed of 1 mm/min. Data was analyzed using parametric and non-parametric tests (P<0.05). Results. Mean shear bond strength for acid etching (20.1±1.8 MPa) and acid+laser (15.6±3.5 MPa) groups were significantly higher than those for laser+acid (15.6±3.5 MPa), laser etching (14.1±3.4 MPa) and control (8.1±2.1 MPa) groups. However, there were no significant differences between acid etching and acid+laser groups, and between laser+acid and laser groups. Conclusion. When the cavity is prepared by bur, it is not necessary to etch the dentin surface by Er:YAG laser following acid etching and acid etching after laser etching.

Collagen production in diabetic wounded fibroblasts in response to low-intensity laser irradiation at 660 nm

BACKGROUND

Collagen type I (Col-I) is a major component of the extracellular matrix and is important in wound healing processes. Several studies have shown that low-intensity laser irradiation (LILI) biostimulates Col-I synthesis both in vitro and in vivo. This study aimed to determine if LILI affects collagen production and related cellular responses in an in vitro diabetic wounded fibroblast model.

MATERIALS AND METHODS

This study was performed on isolated human skin fibroblasts. Different cell models (normal and diabetic wounded) were used. Cells were irradiated with 5 J/cm(2) at a wavelength of 660 nm and incubated for 48 or 72 h. Nonirradiated cells (0 J/cm(2)) were used as controls. Cellular viability (Trypan blue exclusion test), morphology (bright-field microscopy), proliferation [VisionBlue™ quick cell proliferation assay and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay], and Col-I (enzyme-linked immunoabsorbent assay) were assessed.

RESULTS

Diabetic wounded cells irradiated with 5 J/cm(2) at 660 nm showed a significant increase in cell migration, viability, proliferation, and collagen content.

CONCLUSIONS

This study shows that LILI stimulates Col-I synthesis in diabetic wound healing in vitro at 660 nm.

Microleakage of Er:YAG laser and dental bur prepared cavities in primary teeth restored with different adhesive restorative materials

The purpose of this study was to evaluate and compare the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation and conventional dental bur cavity preparation on in vitro microleakage of class V cavities restored with different adhesive restorative materials and two types of self-etching adhesives in primary teeth. Standard class V cavities were prepared on 80 extracted primary, and the teeth were randomly divided into eight subgroups prepared either by dental bur or Er:YAG laser irradiation and then restored with self-cured glass ionomer (GI), resin-modified glass ionomer (RMGI), resin composite and Clearfil SE Bond (two-step self-etching adhesive), and resin composite and Clearfil S3 Bond (one-step self-etching adhesive). Restorations were finished and stored in distilled water at 37 °C for 24 h and then subjected to thermocycling. All the teeth were sealed with nail varnish, placed in a silver nitrate solution, and then vertically cut in a buccolingually direction. Subsequently, the specimens were evaluated for gingival and occlusal microleakage using a stereomicroscope. Data were analyzed using Kruskal-Wallis test followed by Mann-Whitney test. Wilcoxon test was used for comparing occlusal microleakage with gingival microleakage at p < 0.05. A higher degree of occlusal and gingival microleakage values for the teeth restored with GI or RMGI was obtained by both preparation methods compared with that of resin composites and the two self-etching primers. Er:YAG laser irradiation resulted in a significantly higher degree of microleakage only at the gingival margins for teeth restored with GI or RMGI, or composite and Clearfil S3 Bond compared with the bur preparation. The Er:YAG laser-prepared teeth restored with composite and Clearfil SE Bond demonstrated a better marginal seal on occlusal and gingival margins compared with that of bur-prepared cavities. The degree of microleakage in class V cavities was affected by the type of adhesive restorative materials, type of self-etching adhesive, cavity margin location, and tooth preparation method either by Er:YAG laser or dental bur.

In vitro evaluation of microleakage under orthodontic brackets using two different laser etching, self etching and acid etching methods

This study evaluated the microleakage of brackets bonded by four different enamel etching techniques. Forty freshly extracted human premolars were divided randomly into four equal groups and received the following treatment: group 1, acid etching; group 2, self-etching primer (SEP); group 3, erbium:yttrium-aluminum-garnet (Er:YAG) laser etching; and group 4, erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching. After photopolymerization, the teeth were kept in distilled water for 1 month and then subjected to 500 thermal cycles. Then, the specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned, and examined under a stereomicroscope. In addition, they were scored for marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces from the incisal and gingival margins. Statistical analyses consisted of the Kruskal-Wallis test and the Mann-Whitney U test with Bonferroni correction. Microleakage occurred between the adhesive-enamel and bracket-adhesive interfaces in all groups. For the adhesive-enamel surface, a significant difference was observed between group 1 and groups 2 (P = 0.011), 3 (P = 0.002), and 4 (P = 0.000) on the gingival side. Overall, significant differences were observed between group 1 and groups 3 (P = 0.003) and 4 (P = 0.000). In dental bonding procedures, acid etching was found to result in the least microleakage. Since etching with a laser decreases the risk of caries and is time-saving, it may serve as an alternative to acid etching.

Microleakage of class V cavities with different adhesive systems prepared by a diamond instrument and different parameters of Er:YAG laser irradiation

OBJECTIVE

The aim of this study was to evaluate the microleakage of composite resin restorations using two different dentine adhesive systems prepared with a diamond instrument and different parameters of Er:YAG laser irradiation.

BACKGROUND DATA

Information on this topic with regard to preparing class V cavities with different parameters of Er:YAG laser irradiation and adhesive systems is scarce.

MATERIALS AND METHODS

Two hundred class V cavities were assigned to ten groups (n = 20 each): group 1: Er:YAG laser (5 Hz, 600 mJ) + phosphoric acid (PA) + Adper Single Bond 2 (ASB2); group 2: Er:YAG laser (10 Hz, 300 mJ) + PA + ASB2; group 3: Er:YAG laser (15 Hz, 200 mJ) + PA + ASB2; group 4: Er:YAG laser (20 Hz, 150 mJ) + PA + ASB2; group 5: diamond instrument + PA + ASB2; group 6: Er:YAG laser (5 Hz, 600 mJ) + Adper Prompt L-Pop (APLP); group 7: Er:YAG laser (10 Hz, 300 mJ) + APLP; group 8: Er:YAG laser (15 Hz, 200 mJ) + APLP; group 9: Er:YAG laser (20 Hz, 150 mJ) + APLP; and group 10: diamond instrument + APLP. Cavities were restored with a nanofill composite (Filtek Supreme XT Body). After thermocycling, the specimens were stained with 0.5% aqueous basic fuchsin dye and sectioned bucco-lingually. Dye penetration was then scored. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction. The Wilcoxon signed ranks test was used to compare occlusal and gingival scores.

RESULTS

Leakage was seen in all groups at both the occlusal and gingival margins. The Kruskal-Wallis test showed statistically significant differences among the 10 groups (p < 0.001). The gingival margins had more microleakage than the occlusal margins (p < 0.001). Pairwise analysis by the Mann-Whitney U test showed that statistically significant differences (p < 0.05) in microleakage were found between groups 3 and 5 (3 > 5), 5 and 7 (7 > 5), and 7 and 8 (7 > 8) at the gingival margin, and between groups 3 and 6 (6 > 3), 3 and 7 (7 > 3), 4 and 6 (6 > 4), and 4 and 7 (7 > 4) at the occlusal margin.

CONCLUSION

We concluded that for all groups, microleakage values were higher at the gingival margins. The use of the Er:YAG laser for cavity preparation with different parameters and different dentine adhesive systems influenced the marginal sealing of composite resin restorations.

Effect of dentin hardness on ablation rate with Er:YAG laser

OBJECTIVE

This study used artificially demineralized bovine dentin to ascertain the effect of hardness of demineralized dentin on ablation rate with the Er:YAG laser.

BACKGROUND DATA

Before restoration of carious teeth, it is necessary to ablate any infected dentin that cannot be remineralized due to softening by the invading caries. A correlation has been suggested between the ablation efficiency of the Er:YAG laser and the progression of caries in dentin. To the best of our knowledge, no studies have investigated the relationship between degree of demineralization by dentinal caries and ablation rate with the Er:YAG laser.

MATERIALS AND METHODS

Bovine mandibular anterior tooth roots were used as dentin samples. Each sample was soaked in a demineralizing solution (2 M lactic acid, pH 4.0) for 3 d to obtain demineralized dentin (DD) samples. Another group of samples were prepared without demineralization as a sound dentin (SD) group for comparison. After determining the Knoop hardness number (KHN) of each sample, the dentin surface was ablated with an Er:YAG laser. Tip output and pulse rate were set at 50 mJ and 20 pulses per second (pps), respectively, and the water spray was set at 3.5 mL/min. Ablation width, depth, and volume were measured following irradiation.

RESULTS

In the DD group, dentin hardness was 10.4 +/- 1.6 KHN at 100 microm from the surface. In the sound dentin group, Knoop hardness was 51.0 +/- 1.6 KHN cross-sectionally throughout. No differences were observed from the surface to a depth of 2000 microm. In the DD group, dentin ablation volume at the superficial demineralized layer was 2888 +/- 272 x 10(4) microm. In the SD group, dentin ablation volume was 1298 +/- 219 microm(3). The relationship between ablation volume and Knoop hardness was defined as Y = -40.699x + 3350, revealing a marked negative correlation.

CONCLUSION

The results demonstrate that the ablation volume for demineralized dentin was greater than that for sound dentin. The results suggest that the Er:YAG laser is capable of ablating infected dentin without damaging sound dentin by adjustment of tip output and pulse rate.