Erbium: YAG Laser versus Ultrasonic in Preparation of Root-End Cavities

Micro-CT analysis and leakage of bioceramic retrofillings after ultrasonic and Er:YAG laser cavity preparations: an in vitro study

The purpose of the study was to determine the influence of preparation techniques on marginal adaptation and sealing of Biodentine™ and TotalFill® RRM bioceramic retrograde fillings. Fifty-two single-root teeth extracted for periodontal reasons were used. Root canals were instrumented using Reciproc Blue #25 and obturated using a single cone technique with an AH Plus® root canal sealer. Retrograde cavities were prepared with Piezomed device (Piezo), Er:YAG laser in short-pulse(SP) and quantum square pulse(QSP) modes and filled with Biodentine™ (BD) or TotalFill® RRM (TF). There were 6 groups (n=8): (1) Piezo BD, (2) Piezo TF, (3) SP BD, (4) SP TF, (5) QSP BD, and (6) QSP TF, and positive and negative controls (n=2). Micro-CT analysis was performed on two samples from each group. Percentage volumes of internal and external voids in apical 1.5 mm were determined. Rhodamine B dye leakage was done on six samples. The samples were cut longitudinally and examined under a stereomicroscope. Digital recordings were analyzed in ImageJ software. The deepest penetration of color in mm was recorded. The data were statistically analyzed using ANOVA and Duncan's test at the level of significance α=0.05. TotalFill® RRM performed significantly better than Biodentine™ in terms of sealing (p<0.05) and marginal adaptation, as evaluated by micro-CT. Sealing was significantly better in SP compared to QSP mode preparations (p<0.05). Differences between Piezomed and laser modes were not significantly different (p>0.05). Sealing was statistically significantly better with TotalFill® RRM compared to Biodentine™ and in Er:YAG SP preparations compared to Er:YAG QSP.

Sealing Ability of Bioactive Root-End Filling Materials in Retro Cavities Prepared with Er,Cr:YSGG Laser and Ultrasonic Techniques

The aim of this in vitro study was to compare the apical sealing ability of total fill bioceramic root repair material (BC-RRM) and mineral trioxide aggregate (MTA), regarding the retrograde preparation technique used: ultrasonic or erbium, chromium: yttrium, scandium, gallium, or garnet (Er,Cr:YSGG) laser. The study sample consisted of 48 human single-rooted teeth. After root-end resection, the samples were divided into two groups, according to the retrograde preparation technique used: Group 1: ultrasonic; Group 2: Er,Cr:YSGG laser. In each group, half of the retrograde cavities were filled with BC-RRM, and the other half were filled with MTA. The specimens were mounted in tubes and sterilized in plasma. The root canals were inoculated with Enterococcus faecalis, and the tubes were filled with fetal bovine serum, leaving the apical part of the root in the serum. After 30 days, the canals were sampled and cultured, and the colony forming units (CFUs) were counted with the additional polymerase chain reaction (PCR analysis). There was no significant difference between ultrasonic groups and the Er,Cr:YSGG-MTA group, regarding the number of CFUs (p > 0.05). The Er,Cr:YSGG-BC-RRM group showed the highest number of remaining viable bacteria (p < 0.001). Both filling materials filled in ultrasonic preparations presented similar sealing abilities. The BC-RRM showed more leakage when used in retro cavities prepared with the Er,Cr:YSGG laser.

The Effect of Root End Cavity Preparation Using Er,Cr:YSGG Laser, Ultrasonic Retrotip, and Bur on the Apical Microleakage of Retrograde Cavity Filled with MTA Plus

Aim:

The sealing ability of the retrograde material is greatly affected by the technique used for root end preparation. Advances in retrograde preparation techniques such as lasers has shown to provide an efficient outcome. The study was to evaluate and compare the effect of various techniques of retrograde cavity preparation on apical microleakage.

Materials and Methods:

Forty-five single rooted teeth were decoronated. Biomechanical preparation was carried out up to size F2 ProTaper system and obturated. Glass–ionomer cement was used as an access restorative material. The apical root resection was done at 3 mm from the apex at angulation of 90° to the long axis of the root. The allocation of the samples was done into three groups of 15 each. Group A: Retrograde cavities prepared using conventional round bur; Group B: Retrograde cavities prepared using ultrasonic retro preparation diamond tip; and Group C: Retrograde cavities prepared using “Erbium, chromium: yttrium, scandium, gallium, garnet” (Er,Cr:YSGG). The retrograde cavities hence prepared were filled with MTA Plus. Nail varnish was used to coat the samples except at the apical end. Samples were immersed in methylene blue for 24h. Stereomicroscope was used for examination of the sectioned teeth. The data were analyzed using one-way analysis of variance (ANOVA) and post hoc Tukey test.

Results:

Results showed very highly significant difference between laser and bur (P value = 0.001).

Conclusion:

Retrograde preparation with Er,Cr:YSGG showed significantly less microleakage when compared to the use of ultrasonic retrotip and burs.

Evaluation of the Effect of Various Powers of the Diode Laser in Microcrack Formation in the Wall of the Dental Root Canal by Scanning Electron Microscope (SEM)

Background:

The laser is utilized for the removal of the smear layer, cleaning and disinfecting the dental canal. Recently, diode laser has been offered with a wavelength of (635-980nm) for cleaning and disinfecting the dental root canal.

Objective:

There is not adequate evidence for microcrack formation when using diode lasers with different powers. Therefore, the present study was conducted in order to analyze various powers of a diode laser in microcrack formation in dental root canals.

Methods:

In this experimental study, 100 mandibular incisor teeth that were extracted because of periodontal disease were selected. Using stereo-microscope, the presence of crack and fracture of the root was evaluated before and after canal instrumentation. Then, samples were randomly divided into 10 groups (10 samples in any group) based on different powers of laser and canal to be humid or dry under laser radiation. The laser was utilized for 10s puls within three iterated times. The samples were cross-sectioned after disinfection with a diode laser at 3 and 6mm length from the dental apex. Sections were observed under a scanning electron microscope and images were taken.

Results:

The frequency of microcracks is increased at the distance of (3-6mm) from the dental apex by an increase in laser power level from 2 to 4w (P<0.05). Similarly, results showed that the probability of microcrack formation under dry condition than the humid condition at the distance of 3mm from the dental apex might increase to 6.606 times and at the distance of 6mm from the dental apex increase to 4.978 times more.

Conclusion:

The optimal power of diode laser in the wavelength of (980nm) for cleaning and disinfecting of the root canal with the minimum damage on hard periodontium tissue is 1.5w.

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.

Influence of different laser-assisted retrograde cavity preparation techniques on bond strength of bioceramic-based material to root dentine

The purposes of the study were to evaluate the bond strength of bioceramic TotalFill root repair material (RRM) in retrograde cavities prepared using Er:YAG and Er,Cr:YSGG laser and steel bur, and to analyze failure modes. The root canals of 30 single-rooted teeth were endodontically treated, their root-ends were resected using a diamond bur, and the teeth were randomly divided into three groups (N = 10) according to the retrograde cavity preparation technique: (1) Er:YAG laser, (2) Er,Cr:YSGG laser, and (3) steel bur. All retrograde cavities were filled with the TotalFill RRM which was prepared according to the manufacturers' instructions. Push-out test was performed using universal testing machine, and failure mode was analyzed using a scanning electron microscope. The data were analyzed using one-way ANOVA, post hoc analysis with Bonferroni correction, and Fisher-Freeman-Halton exact test (p < 0.05). In the Er:YAG-, Er,Cr:YSGG-, and steel bur-prepared cavities, mean bond strengths (MPa) were 12.76, 8.44, and 6.01, respectively. The bond strength of the TotalFill RRM to dentin was significantly higher in the Er:YAG laser compared with the steel bur-prepared cavities (p = 0.004). The bond strength was not significantly different between the Er:YAG and Er,Cr:YSGG cavities (p = 0.074) and between the Er,Cr:YSGG and bur cavities (p = 0.648). In the cavities prepared by the Er,Cr:YSGG laser and bur, the failure mode of the TotalFill RRM was predominantly mixed, then adhesive and cohesive. In the Er:YAG laser-prepared cavities, the most common failure mode was adhesive, followed by mixed type and no cohesive failure. The bond strength of the TotalFill RRM to dentin was highest in the group of retrograde cavities prepared by the Er:YAG laser.

Lasers in Apicoectomy: A Brief Review

Since the invention of laser, various applications for lasers in endodontics have been proposed, such as disinfection of the root canal system, canal shaping, pulp diagnosis, and apico-ectomy. One of the major applications of laser in endodontics is apicoectomy. The aim of this article is to review the benefits and drawbacks of laser applications in apicoectomy, including effect on apical seal, effect on dentin permeability, effect on postsurgery pain, effect on crack formation, effect on root-end morphology, effect on treatment outcome, and connective tissue response to laser-treated dentin.

Sealing ability of three root-end filling materials prepared using an erbium: Yttrium aluminium garnet laser and endosonic tip evaluated by confocal laser scanning microscopy

Aims:

(1) To compare the sealing ability of mineral trioxide aggregate (MTA), Biodentine, and Chitra-calcium phosphate cement (CPC) when used as root-end filling, evaluated under confocal laser scanning microscope using Rhodamine B dye. (2) To evaluate effect of ultrasonic retroprep tip and an erbium:yttrium aluminium garnet (Er:YAG) laser on the integrity of three different root-end filling materials.

Materials and Methods:

The root canals of 80 extracted teeth were instrumented and obturated with gutta-percha. The apical 3 mm of each tooth was resected and 3 mm root-end preparation was made using ultrasonic tip (n = 30) and Er:YAG laser (n = 30). MTA, Biodentine, and Chitra-CPC were used to restore 10 teeth each. The samples were coated with varnish and after drying, they were immersed in Rhodamine B dye for 24 h. The teeth were then rinsed, sectioned longitudinally, and observed under confocal laser scanning microscope.

Statistical Analysis Used:

Data were analyzed using one-way analysis of variance (ANOVA) and a post-hoc Tukey's test at P < 0.05 (R software version 3.1.0).

Results:

Comparison of microleakage showed maximum peak value of 0.45 mm for Biodentine, 0.85 mm for MTA, and 1.05 mm for Chitra-CPC. The amount of dye penetration was found to be lesser in root ends prepared using Er:YAG laser when compared with ultrasonics, the difference was found to be statistically significant (P < 0.05).

Conclusions:

Root-end cavities prepared with Er:YAG laser and restored with Biodentine showed superior sealing ability compared to those prepared with ultrasonics.

A comparison of Er, Cr: YSGG laser with ultrasonic preparation on the seal of retrograde cavities

BACKGROUND AND AIM

The aim of this in vitro study was to compare Er, Cr: YSGG laser with ultrasonic preparation on the seal of retrograde cavities.

MATERIALS AND METHODS

Twenty-eight maxillary anterior teeth were used in this study. After removing the crowns, the canals were prepared with the step-back technique and filled with guttapercha. Three millimeters below the apex; each root was cut with a fissure diamond bur. The root surfaces were then covered with nail polish and three millimeters deep retrograde class I cavities were prepared, using Er, Cr: YSGG laser (group L=12 roots) or ultrasonic retro-tip (group U=12 roots). Four roots were arranged for negative and positive control groups. Retrograde cavities were then filled with mineral trioxide aggregate (MTA) and teeth were placed in 2% methylene blue dye for 72 hours. The amount of dye penetration in sagittal sections of each tooth was measured with a stereomicroscope. An independent sample t-test was used for statistical analysis.

RESULTS

Cavities prepared with the Er, Cr: YSGG laser (1.61 + 0.81) showed significantly less micro-leakage than those prepared with the ultrasound (2.55+ 1.84) (P value =0.02).

CONCLUSIONS

Under the conditions of this research, the use of Er, Cr: YSGG laser for retrograde cavity preparation causes significantly less apical leakage and may increase the success rate of endodontic surgeries.

The Effect of Thickness on the Sealing Ability of CEM Cement as a Root-end Filling Material

Background and aims. Different materials have been used for root-end filling during surgical endodontic treatment. The aim of this in vitro study was to evaluate the dye penetration in different thicknesses of calcium enriched mixture (CEM) cement as root-end filling material. Materials and methods. Following root canal filling in 70 extracted human single-rooted premolar teeth, the apical 3 mm of their root-ends was resected; the root-end cavities with depths of 1, 2 and 3 mm were prepared by ultrasonic retrotips and filled with CEM cement. After setting of cement, the roots were immersed in 2% Rhodamine B and the dye leakage was measured under stereomicroscope (×16) using Image J software. The data were analyzed by one-way ANOVA and Bonferroni post hoc tests at 5% significance level. Results. The means and standard deviations of dye penetration in the 1, 2, and 3 mm groups were 3395.5±1893.4, 3410.4±1440.5, and 2581.6±1852.9 μm, respectively. The one-way ANOVA analysis indicated significant differences (P < 0.001); however, the Bonferroni post hoc test revealed that only the positive control group differed significantly from the experimental groups (P < 0.001). Conclusion. The findings demonstrated CEM cement to have an adequate root-end sealing ability in 3-mm thickness.

Effect of Er,Cr:YSGG laser irradiation on apical sealing ability of calcium silicatecontaining endodontic materials in root-end cavities

The aim of this research was to evaluate the apical sealing abilities of 60 root-end cavities filled with mineral trioxide aggregate (MTA) and iRoot BP cements after treated with either 17% EDTA solution or Er,Cr:YSGG laser irradiation. After the filling procedure, apical leakage quantity was measured at 4 weeks using a fluid filtration method. One root from each group was processed for scanning electron microscopy and energy dispersive X-ray spectroscopy analyses. Both EDTA/MTA and laser irradiation/MTA combinations showed significantly lower microleakage than EDTA/iRoot BP and laser irradiation/iRoot BP combinations (p<0.05). Between groups of the same filling material, there were no significant differences among specimens treated with EDTA or laser (p>0.05). Both MTA and iRoot-BP demonstrated tag-like structures within the dentinal tubules when used in conjunction with EDTA.

Evaluation of microleakage of root canal fillings irradiated with different output powers of erbium, chromium:yttrium-scandium-gallium-garnet laser

This study evaluated the root canal seal achieved by irradiation with an erbium, chromium:yttrium-scandium-gallium-garnet laser, and the optimal output power to remove debris and the smear layer were determined. One hundred mandibular premolar teeth were prepared and divided into four groups. Group 1 was not lased but was irrigated with 5 mL of 5.25% NaOCl and 5 mL of 17% ethylenediaminetetraacetic acid. Group 2 was irradiated at a panel setting of 1 W, group 3 at 2 W and group 4 at 2.5 W, with a 50% water level and 48% air-cooling level. Root canals were obturated by cold lateral compaction, and apical microleakage was measured using a fluid filtration model. The remaining debris and smear layer were evaluated via scanning electron microscopy. Statistically significant differences were detected between groups. Irradiation at 1 and 2 W using an erbium, chromium:yttrium-scandium-gallium-garnet laser produced a seal superior to that of the other treatments.

Push-out bond strength of two root-end filling materials in root-end cavities prepared by Er,Cr:YSGG laser or ultrasonic technique

This study compared the push-out bond strength of mineral trioxide aggregate (MTA) and a new endodontic cement (NEC) as root-end filling materials in root-end cavities prepared by ultrasonic technique (US) or Er,Cr:YSGG laser (L). Eighty single-rooted extracted human teeth were endodontically treated, apicectomised and randomly divided into four following groups (n = 20): US/MTA, US/NEC, L/MTA and L/NEC. In US/MTA and US/NEC groups, root-end cavities were prepared with ultrasonic retrotip and filled with MTA and NEC, respectively. In L/MTA and L/NEC groups, root-end cavities were prepared using Er,Cr:YSGG laser and filled with MTA and NEC, respectively. Each root was cut apically to create a 2 mm-thick root slice for measurement of bond strength using a universal testing machine. Then, all slices were examined to determine the mode of bond failure. Data were analysed using two-way anova. Root-end filling materials showed significantly higher bond strength in root-end cavities prepared using ultrasonic technique (US/MTA and US/NEC) (P < 0.001). The bond strengths of MTA and NEC did not differ significantly. The failure modes were mainly adhesive for MTA, but cohesive for NEC. In conclusion, bond strengths of MTA and NEC to root-end cavities were comparable and higher in ultrasonically prepared cavities.

Management of Root Perforations Using MTA with or without Er:YAG Laser Irradiation: An In Vitro Study

The aim of this in vitro study is to compare the microleakage of a root perforation sealed with MTA (mineral trioxide aggregate) (group M) to that sealed with MTA following Er:YAG laser irradiation (group ML). Forty-two recently extracted human monoroot teeth were used. Two cavities were prepared on each root surface. Randomly, on each root, the exposed dentine of one cavity was irradiated prior to MTA filling using an Er:YAG laser with the following settings: 200 mJ/pulses under an air water spray, 10 Hz, pulse duration of 50 μsec, and 0.7 mm beam diameter. All cavities were then sealed with MTA. submitted to thermocycling and immersed in 2% methylene blue dye solution for 12 h. The penetration of methylene blue in the microleakage of cavity was observed and recorded. The mean value dye penetration in cavities sealed with MTA following Er:YAG laser irradiation (23.91 ± 14.63%) was lower than that of unlased cavities sealed only with MTA (25.17 ± 17.53%). No significant difference was noted. The use of an Er:YAG laser beam for dentinal conditioning prior to MTA filling of perforated roots did not decrease significantly the microleakage of MTA sealing when compared to the conventional use of MTA filling.

Shaping of the root canal using Er:YAG laser irradiation

OBJECTIVE

The purpose of the present study was to investigate the degree of Er:YAG laser irradiation at the apical area in vitro.

BACKGROUND DATA

Since the laser was developed, advancement of laser treatment has been seen in various fields. However, few reports exist on shaping of the root canal using Er:YAG laser irradiation.

METHODS

Six single-rooted human teeth were used. The working length of root canals was set at 6.5 mm, and they were enlarged to apical file size #25. An Er:YAG laser and cone-shaped irradiation tips (R135T and R200T) were used. Laser irradiation conditions were 30 m J, 20 pps, and water flow of 5 mL/min. Samples were irradiated three times for 10 sec each using each tip. To evaluate the cutting degree of horizontal area of the root canal, the laser-irradiated surfaces were observed using microfocus X-ray computed tomographic photography before and after every irradiation. The samples were observed under a scanning electron microscope. Measurement of pixels in an area was performed by image-editing software (Adobe Photoshop 7.0). Statistical analysis was performed using StatView (version 5.0). One-way ANOVA and the Tukey-Kramer tests were used; p<0.05 indicated statistical significance.

RESULTS

When root canals were irradiated with R200T for 10 sec (p<0.05), a large amount of evaporation (0.12 ± 1.07 mm(2)) was acquired in their cut area compared with the other irradiation conditions. In scanning electron microscopic observation, there was no smear layer and the dentinal tubules were open.

CONCLUSIONS

When the distance between the tip and root dentin was adjacent, the shaping of root dentin by Er:YAG laser irradiation was definitely observed.

Temperature changes on the root surfaces of mandibular incisors after an 810-nm high-intensity intracanal diode laser irradiation

Temperature changes caused by laser irradiation can promote damage to the surrounding dental tissues. In this study, we evaluated the temperature changes of recently extracted human mandibular incisors during intracanal irradiation with an 810-nm diode laser at different settings. Fifty mandibular incisors were enlarged up to an apical size of ISO No. 40 file. After the final rinse with 17% ethylenediaminetetraacetic acid, 0.2% lauryl sodium sulfate biologic detergent, and sterile water, samples were irradiated with circular movements from apex to crown through five different settings of output power (1.5, 2.0, 2.5, 3.0, and 3.5 W) in continuous mode. The temperature changes were measured on both sides of the apical and middle root thirds using two thermopar devices. A temperature increase of 7 °C was considered acceptable as a safe threshold when applying the diode laser.

RESULTS

The results showed that only 3.5-W output power increased the outer surface temperature above the critical value.

CONCLUSION

The recommended output power can be stipulated as equal to or less than 3 W to avoid overheating during diode laser irradiation on thin dentin walls.

An in vitro evaluation of apicoectomies and retropreparations using different methods

OBJECTIVES

The aim of this study was to evaluate: 1) the apical root surface, gutta-percha interface, and preparation time of root-end resections made with burs, ultrasound, or laser; and 2) the thickness of surrounding dentin after laser or ultrasonic root-end cavity preparation.

STUDY DESIGN

1) Thirty root-filled teeth were resected as follows: Zekrya bur in group I, Chemical Vapor Deposition (CVD) ultrasonic tip (9.5107-8) in group II, and ErCr:YSGG (Waterlase) in group III. The preparation time was recorded. Replicas of the resected root-ends were examined under a scanning electron microscope (SEM). 2) Thirty root-filled teeth were submitted to apicectomies and root-end cavities were prepared by using: CVD (6.1107-6) ultrasonic retrotips (group IV), EMS (DT-060) ultrasonic retrotips (group V), and ErCr:YSGG laser tips (group VI). Replicas of the root apices were examined under a SEM.

RESULTS

There were no fissures or fractures on root-end surfaces. The bur produced the smoothest surface (P < .05). Group I had the lowest preparation time (P < .05). The best adaptation between the filling and the root canals walls was observed in group III, but it was not significantly different from group II (P < .05). No resected root-ends had cracks after preparation. Group VI showed the least minimum dentin thickness (P < .05).

CONCLUSIONS

The 3 methods evaluated did not cause any injury to the root-end surface, but they harmed the apical adaptation. Laser tips removed more dentin than ultrasonic retrotips and should be used with care to avoid overpreparation.

Apical sealing quality of in vitro apicectomy procedures after using both Er:YAG and Nd:YAG

The aim of this study was to evaluate the apical sealing of dentinal tubules after root-end surface cutting by using Er:YAG and Nd:YAG lasers. After root-canal instrumentation and filling, apices of 50 extracted maxillary canine human teeth were resected by Er:YAG with 400 mJ, 10 Hz, for 30 sec. The samples were randomly assigned to five groups (n = 10): (GI) treated without root-end cavity, but with Nd:YAG (1.0 W, 10 Hz, 20 sec) for dentinal tubules sealing; (GII) treated with root-end cavity without the use of Nd:YAG; (GIII) treated with root-end cavity and Nd:YAG application; (GIV) treated with root-end cavity made by Er:YAG with no focus and without Nd:YAG application; and (GV) treated without root-end cavity and without Nd:YAG application. The root-end cavities were performed by using Er:YAG at 300 mJ, 10 Hz, for 20 sec. Subsequently, all teeth were waterproofed and immersed in 2% methylene blue for 48 h in a vacuum environment. The samples were longitudinally sectioned, and microleakage was measured. ANOVA and the Fisher LSD test showed that GIV was less susceptible to microleakage than were the other groups (p < 0.05). Interestingly, the use of the Er:YAG with no focus showed superior dentinal tubule sealing in comparison with the other groups, even with or without root-end cavity and Nd:YAG application.

Bactericidal effect of Nd:YAG and Er:YAG lasers in experimentally infected curved root canals

OBJECTIVE

The purpose of this study was to evaluate the bactericidal efficacy of Nd:YAG and Er:YAG laser in the experimentally infected curved root canals.

BACKGROUND DATA

Previous studies revealed that laser systems have a significant bactericidal effect in both human and bovine infected straight root canals.

MATERIALS AND METHODS

Sixty extracted single-rooted teeth with single root canals were selected and then instrumented with endodontic files to a size 60 (K-type file). The degree of root curvature was determined according to modified Schneider's method. Each of the specimens was incubated in a sterile centrifuge tube with 1 mL of the Enterococcus faecalis suspension at 37°C for 2 weeks under aerobic conditions. After laser irradiation at each of the two settings, 50 mJ, 10 pps (0.5 W) or 100 mJ, 10 pps (1.0 W), the number of E. faecalis in each root canal was examined.

RESULTS

In the straight root canals, the Er:YAG laser showed higher bactericidal effects by 6.4-10.8% than did the Nd:YAG laser. Conversely, the bactericidal effect of Er:YAG laser in the curved root canals was higher by 1.5-3.1% than was that with the Nd:YAG laser. The bactericidal effect of the Er:YAG laser in the curved root canal is significantly lower than that in the straight root canal (p < 0.05).

CONCLUSION

These results suggest that further development in the endodontic laser tip and technique is required to ensure its success in curved root canals sterilization.

Morphological assessment of dentine and cementum following apicectomy with Zekrya burs and Er:YAG laser associated with direct and indirect Nd:YAG laser irradiation

OBJECTIVES

This study aimed to assess the apical surface morphology of maxillary central incisors resected 3.0 mm from the tooth apex using Zekrya burs or Er:YAG laser, with or without subsequent direct Nd:YAG laser irradiation (apical and buccal surfaces) and indirect irradiation (palatal surface).

STUDY DESIGN

Forty maxillary central incisors were instrumented and obturated. The roots were divided into 4 groups according to the root resection method (Zekrya bur or Er:YAG laser - 1.8 W, 450 mJ, 4 Hz, 113 J/cm(2)) and further surface treatment (none or Nd:YAG laser - 2.0 W, 100 mJ, 20 Hz, 124 J/cm(2)). The teeth were prepared for SEM analysis. Scores ranging from 1 to 4 were attributed to cut quality and morphological changes. The data were analyzed by the Kruskal-Wallis test and by Dunn's test.

RESULTS

SEM images showed irregular surfaces on the apical portions resected with Zekrya burs, with smear layer and grooves in the resected dentine and slight gutta-percha displacement and plasticization. On the other hand, apicectomies carried out with Er:YAG laser showed morphological changes compatible with ablated dentine, with rough surfaces and craters. In spite of the presence of plasticized gutta-percha, with the presence of bubbles, an irregular adaptation of the filling material to the root walls was also observed. Direct Nd:YAG laser irradiation of the apical and buccal surfaces of the resected roots resulted in areas of resolidification and fusion in the dentine and cementum, with a vitrified aspect; indirect Nd:YAG laser irradiation of the palatal surfaces yielded a lower number of changes in the cementum, with irregular resolidification areas.

CONCLUSIONS

There were no differences in terms of cut quality between the use of burs and Er:YAG laser or between the 2 surfaces (apical and buccal) treated with Nd:YAG laser with direct irradiation. However, morphological changes were significantly less frequent on surfaces submitted to indirect irradiation (palatal) when compared with those directly irradiated.

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.