The Effect of Diode and Er,Cr:YSGG Lasers on the Bond Strength of Fiber Posts

Influence of Laser Irradiation Settings, during Diode-Assisted Endodontics, on the Intraradicular Adhesion of Self-Etch and Self-Curing Luting Cement during Restoration-An Ex Vivo Study

Background: Diode-assisted endodontics is nowadays utilized for pulp space disinfection, but little is known on the bonding potential of this lased root dentin when the tooth is restored with an intracanal polymer post. Objectives: to investigate the influence of diode laser irradiation settings, in laser-assisted endodontics, on the intraradicular bonding of composite materials. Methods: Sixteen two-rooted, maxillary first premolars were collected, prepared up to F4 (Protaper Universal. Dentsply-Maillefer, Ballaigues, Switzerland), and randomly assigned in two groups: group A (chopped mode or short pulse), diode irradiated according to protocol, pulse 25 ms, power 2.5 W, and group B (microchopped mode or ultrashort pulse), pulse 25 μs, peak power 12 W (both groups GentleRay. KaVo Dental, Biberach an der Riss, Germany). Buccal canals were irradiated, palatal ones served as controls. Canals were then obturated, post space was created in all canals, and quartz-fiber posts (ICE light Danville. Danville Materials, San Ramon, CA, USA) were cemented by self-etch self-curing cement (Max Cem Elite. Kerr, West Collins Orange, CA, USA) (Max Cem Elite. Kerr, Brea, CA, USA). A week later, teeth were sectioned horizontally in 1 mm increments. Push-out test was conducted in a Zwick testing machine (Zwick Roell, Ulm, Germany) at 1 mm/min speed, and the force required to dislodge the post from each specimen (F-max) was recorded. Weibull regression models were applied for statistical analyses. Results: Differences in F-max by group (control vs. chopped mode vs. microchopped mode) and height (meaning the apical-to-coronal position of each specimen along the root) were statistically significant (p < 0.05 in all cases). Conclusions: Short pulses (or chopped mode) had a profound positive effect on the quality of intraradicular bonding, while Ultrashort pulses (or microchopped mode) affected it negatively. In addition, apically positioned bonding proved weaker compared with more coronally located specimens.

Photodynamic Therapy (PDT) in Prosthodontics: Disinfection of Human Teeth Exposed to Streptococcus mutans and the Effect on the Adhesion of Full Ceramic Veneers, Crowns, and Inlays: An In Vitro Study

The use of PDT in prosthodontics as a disinfection protocol can eradicate bacteria from tooth surfaces by causing the death of the microorganisms to which the photosensitizer binds, absorbing the energy of laser light during irradiation. The aim of the study was to investigate the capacity of PDT to increase the bond strength of full ceramic restorations. In this study, 45 extracted human teeth were prepared for veneers, crowns, and inlays and contaminated with Streptococcus mutans. Tooth surfaces decontamination was performed using a diode laser and methylene blue as a photosensitizer. The disinfection effect and the impact on tensile bond strength were evaluated by scanning electron microscopy (SEM) and pull-out tests of the cemented ceramic prosthesis. Results show that the number of bacteria was reduced from colonized prepared tooth surfaces, and the bond strength was increased when PDT was used. In conclusion, the present study indicates that using PDT as a protocol before the final adhesive cementation of ceramic restorations could be a promising approach, with outstanding advantages over conventional methods.

Effect of calcium silicate-based endodontic sealer on the retention of fiber posts cemented at different time intervals

Objective

To evaluate the effect of BC HiFlow, a new calcium silicate-based endodontic sealer, compared with a resin epoxy-based sealer after 2 different times of cementation on the pull-out bond strength of glass-fiber–reinforced composite posts cemented with a self-adhesive resin cement (RelyX Unicem).

Methodology

Sixty human maxillary central incisors were decoronated, prepared and obturated with gutta-percha and sealer. Roots were distributed into 5 groups according to the sealer and time of post cementation: (1) AH Plus sealer with immediate post fixation, (2) BC HiFlow with immediate post fixation, (3) AH Plus and post fixation after 7 days, (4) BC HiFlow and post fixation after 7 days, and (5) fiber post fixation in canals obturated with gutta-percha only (no sealer). After 1 week of post cementation, the pull-out test was performed and the failure mode was examined under a digital microscope. Data were analyzed using ANOVA followed by Tukey's post hoc and t tests (p < .05).

Results

With immediate post cementation, AH Plus group showed significantly higher pull-out retentive strength than the BC HiFlow and control groups (p = .009 and p < .001, respectively). There was no significant difference between the groups when the posts were cemented 7 days after obturation (p = .726). The time of post cementation had a significant influence on the canals obturated with AH Plus (p = .003). The time did not significantly affect the canals obturated with BC HiFlow (p = .289). The prominent type of failure was mixed mode in all groups.

Conclusion

BC HiFlow sealer did not affect the pull-out bond strength of glass-fiber–reinforced composite posts cemented with a self-adhesive resin cement immediately after or 7 days after obturation. For immediate post cementation, AH Plus increased the pull-out bond in comparison to BC HiFlow.

Effect of temperature and activation techniques of irrigating solutions on push-out bond strength of fiber post

AIM:

This study evaluated the effect of preheated irrigants (EDTA, QMix), then use of various activation techniques such as ultrasonic system and laser on push-out bond strength (POBS) of fiber posts to root dentin.

Methodology:

One hundred and twenty extracted human teeth were decoronated below the cementoenamel junction. All the root canals were instrumented, irrigated using sodium hypochlorite and normal saline, dried with paper points, and filled with gutta-percha and AH Plus sealer. Post spaces were prepared. The irrigating solutions QMix and EDTA were heated to 60°C. Normal QMix and EDTA served as control. The irrigants were activated with Laser and Ultrasonic system. Then, the fiber posts were cemented, roots were sliced to thickness of 2 mm and mounted for measurement of POBS.

Results:

Preheated irrigants group showed maximum POBS as compared to Normal irrigants. QMix group showed better results as compared to EDTA. Irrigants when activated with laser and ultrasonics showed comparable results.

Conclusion:

Within the limitations of the study, it can be concluded that preheated irrigants(QMix, EDTA) increase the POBS of fiber post to root dentin. Both laser and ultrasonic are equally effective for increasing the POBS.

Fracture Resistance of Three Post Types in the Restoration of Anterior Primary Teeth

Background:

Extensive restorative treatments of anterior primary teeth are challenging in pediatric dentistry.

Objective:

This study aimed to compare the fracture resistance of three post types for restoring the anterior primary teeth.

Methods:

This in-vitro study was carried out on 90 extracted maxillary anterior primary teeth with intact roots. They were randomly allocated into six groups to be restored with conventional composite resin post, X-tra fill composite resin post, Tetric N Ceram composite resin post, prefabricated glass fiber post with conventional composite build-up, prefabricated glass fiber post with X-tra fill composite build-up, and prefabricated glass fiber post with Tetric N Ceram composite build up. The samples were polished and placed in acrylic resin blocks with 1 mm of part of cervical root being out, thermocycled (×5000) and tested for fracture resistance. Intra-class correlation test, Kruskal-Wallis test and one-way ANOVA were used for statistical analyses (α=0.05).

Results:

The mean fracture resistance was significantly different among the six groups. It was the highest in prefabricated glass fiber post with conventional composite build-up (418.64 N), prefabricated glass fiber post with X-tra fill composite build-up (403.63 N) and prefabricated glass fiber post with Tetric N Ceram composite build up (361.63 N); and the lowest in Tetric N Ceram group (280.65 N). The groups were significantly different concerning the fracture strength and fracture state.

Conclusion:

Since the anterior teeth restored with prefabricated glass fiber posts were far more fracture resistant, and prefabricated glass fiber posts can be promisingly used for the restoration of anterior primary teeth.