Evaluation of Different Types of Lasers in Surface Conditioning of Porcelains: A Review Article

The Effect of Various Lasers on the Bond Strength Between Orthodontic Brackets and Dental Ceramics: A Systematic Review and Meta-Analysis

Background/objective: This systematic review and meta-analysis aimed to assess how laser conditioning affected brackets bonded to dental ceramics' shear bond strength (SBS). Materials and methods: The study was conducted by searching Pubmed/Medline, Scopus, Embase, Web of Science, the Cochrane Library, and Google Scholar up to September 14, 2022. In addition, the reference lists of the relevant articles were checked manually. Articles that compared SBS of laser-treated feldspathic, lithium disilicate, or zirconia surfaces with other standard techniques for bonding metal or ceramic orthodontic brackets were considered. Using a random-effects model, data pooling was carried out as the weighted mean difference (WMD). Results: This study initially contained 1717 reports, and following review, 32 articles were deemed suitable for our meta-analysis. The pooling results showed that the treatments with lasers such as "Er:YAG" [WMD = -1.12 MPa; 95% confidence interval (CI): -1.93 to -0.31], "Er:YAG + Silane" (WMD = -3.08 MPa; 95% CI: -4.77 to -1.40), and "Nd: YAG + Silane" (WMD = -2.58 MPa; 95% CI: -3.76 to -1.40) had statistically significant lower adhesion values compared with controls. Contrarily, "Ti:Sapphire femtosecond" demonstrated significantly higher bonding values (WMD = 0.94 MPa; 95% CI: 0.29-1.60). In contrast, other interventions obtained no statistically significant difference in SBS. Conclusions: Most of the laser groups showed results comparable with those of conventional approaches. Although more research is necessary for definitive conclusions, laser treatment may be an effective option for treating the surfaces of ceramic materials.

Ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced adhesion to resin-matrix cements used in dentistry: An integrative review

Surface modification of yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) using lasers for adhesion enhancement with resin-matrix cement has been increasingly explored. However, Y-TZP is chemically inert and non-reactive, demanding surface modification using alternative approaches to enhance its bond strength to resin-matrix cements. The main aim of this study was to conduct an integrative review on the influence of ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced bonding to resin-matrix cements. An electronic search was performed on web of science, SCOPUS, Pubmed/Medline, Google Scholar and EMBASE using a combination of the following search items: zirconia, 3Y-TZP, surface modification, laser surface treatment, AND laser, ultrashortpulse laser, bonding, adhesion, and resin cement. Articles published in the English language, up to January 2022, were included regarding the influence of surface patterning on bond strength of Y-TZP to resin-matrix cements. Out of the 12 studies selected for the present review 10 studies assessed femtosecond lasers while 2 studies assessed picosecond lasers. Ultrashort pulsed laser surface patterning successfully produced different surface morphological aspects without damaging the bulk properties of zirconia. Contrarily, defects such as micro-cracks occurs after surface modification using traditional methods such as grit-blasting or long-pulsed laser patterning. Ultrashort pulsed laser surface patterning increase bond strength of zirconia to resin-matrix cements and therefore such alternative physical method should be considered in dentistry. Also, surface defects were avoided using ultrashort pulsed laser surface patterning, which become the major advantage when compared with traditional physical methods or long pulse laser patterning.

Color Changes Associated with Sandblasting, Hydrofluoric Acid Etching, and Er:YAG Laser Irradiation of Milled Feldspathic Porcelain Laminate Veneers

OBJECTIVES

To evaluate color changes in milled feldspathic porcelain laminate veneers following hydrofluoric acid etching (HFA), sandblasting (SB), or Er:YAG laser irradiation (LI).

METHODS AND MATERIALS

Disc-shaped specimens (thickness=1 mm, diameter=8 mm) were milled from feldspathic porcelain blocks (n=40). Glazed specimens were randomly assigned to four subgroups (n=10 each) according to surface treatment: negative control, HFA, SB, and LI. A layer of translucent, light-cured resin cement (thickness=0.1 mm) was then applied following silanization. The color was characterized by the L*, a*, and b* uniform color space (CIE) using a reflection spectrophotometer. CIEDE2000 (ΔE00) was calculated to determine the color difference between each surface treatment and negative control groups. Data were statistically analyzed using analysis of variance (ANOVA), Kruskal-Wallis, and Dunn-Bonferroni post hoc tests.

RESULTS

There were no significant differences in CIEL* and CIEb* coordinates between negative control and all surface treatment groups (p≥0.108). The SB group demonstrated significantly lower mean CIEa* (higher greenish hue) compared to other groups (p≤0.003). HFA exhibited significantly higher CIEa* (closer to red) when compared to LI (p=0.039). LI induced the smallest overall color change compared to negative control (ΔE00=1.43 [1.07]). However, the differences in ΔE00 values were not statistically significant (p=0.648).

CONCLUSIONS

The tested surface treatments did not affect the lightness or the yellowness of the 1-mm-thick milled feldspathic porcelain veneers. However, sandblasting resulted in a significant increase in the greenish hue. The Er:YAG laser resulted in the closest ΔE00 (1.43) to the 50:50% perceptibility threshold (ΔE00=1.2).

Is the Er:YAG laser affect the surface characteristics and bond strength of Y-TZP?

This study evaluated the surface characteristics and bond strength of Y-TZP treated with Er:YAG laser at different focal distances. 120 Y-TZP blocks were divided into five groups (n=24), according to the surface treatment: no treatment (C-); sandblasting with silica-coated aluminum oxide particles (C+); and Er:YAG laser application at focal distances of 1mm (Er:YAG-1), 4mm (Er:YAG-4), and 7mm (Er:YAG-7). Surface characteristics were analyzed using Vickers microhardness, confocal laser microscope, scanning electron microscopy (SEM), and X-ray diffractometer (XRD). For the bond strength test, 100 Y-TZP blocks were subdivided into two subgroups (n=10), according to the resin cement used: with (MDP+) or without 10-methacryloyloxydecyl dihydrogen phosphate (MDP-). The Vickers microhardness and surface roughness were analyzed by one-way ANOVA and bond strength by two-way ANOVA and Tukey's test for both (α=0.05). Vickers microhardness differences were not observed between the groups (p>0.05); C+ showed higher surface roughness values. SEM images showed micromorphological differences between the groups. The XRD data detected tetragonal crystals for C- and, for the other groups, tetragonal and monoclinic peaks. For bond strength, no statistically difference significance were observed among the cements with or without MDP (p>0.05) but showed significant difference between the surface treatments (C+ > C- = Er:YAG1 > Er:YAG4 = Er:YAG7) (p<0.05). Suggested that the Er:YAG laser cannot replace conventional treatment with aluminum oxide particles and the presence of MDP in the resin cement had no influence on the bond strength.

Effects of Novel versus Conventional Porcelain Surface Treatments on Shear Bond Strength of Orthodontic Brackets: A Systematic Review and Meta-Analysis

BACKGROUND

Despite the importance of identifying proper novel porcelain preparation techniques to improve bonding of orthodontic brackets to porcelain surfaces, and despite the highly controversial results on this subject, no systematic review or meta-analysis exists in this regard.

OBJECTIVE

To comparatively summarize the effects of all the available porcelain surface treatments on the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets (metal, ceramic, polycarbonate) bonded to feldspathic porcelain restorations. Search Methods. A search was conducted for articles published between January 1990 and February 2021 in PubMed, MeSH, Scopus, Web of Science, Cochrane, Google Scholar, and reference lists. Eligibility Criteria. English-language articles comparing SBS of feldspathic porcelain's surface preparation methods for metal/ceramic/polycarbonate orthodontic brackets were included. Articles comparing silanes/bonding agents/primers without assessing roughening techniques were excluded. Data Analysis. Studies were summarized and risk of bias assessed. Each treatment's SBS was compared with the 6 and 10 MPa recommended thresholds. Studies including comparator (HF [hydrofluoric acid] + silane + bonding) were candidates for meta-analysis. ARI scores were dichotomized. Fixed- and random-effects models were used and forest plots drawn. Egger regressions and/or funnel plots were used to assess publication biases.

RESULTS

Thirty-two studies were included (140 groups of SBS, 82 groups of ARI). Bond strengths of 21 studies were meta-analyzed (64 comparisons in 14 meta-analyses). ARIs of 12 articles were meta-analyzed (28 comparisons in 8 meta-analyses). Certain protocols provided bond strengths poorer than HF + silane + bonding: "abrasion + bonding, diamond bur + bonding, HF + bonding, Nd:YAG laser (1 W) + silane + bonding, CO₂ laser (2 W/2 Hz) + silane + bonding, and phosphoric acid + silane + bonding." Abrasion + HF + silane + bonding might act almost better than HF + silane + bonding. Abrasion + silane + bonding yields controversial results, being slightly (marginally significantly) better than HF + silane + bonding. Some protocols had controversial results with their overall effects being close to HF + silane + bonding: "Cojet + silane + bonding, diamond bur + silane + bonding, Er:YAG laser (1.6 W/20 Hz) + silane + bonding." Few methods provided bond strengths similar to HF + silane + bonding without much controversy: "Nd:YAG laser (2 W) + silane + bonding" and "phosphoric acid + silane + bonding" (in ceramic brackets). ARIs were either similar to HF + silane + bonding or relatively skewed towards the "no resin on porcelain" end. The risk of bias was rather low. Limitations. All the found studies were in vitro and thus not easily translatable to clinical conditions. Many metasamples were small.

CONCLUSIONS

The preparation methods HF + silane + bonding, abrasion + HF + silane + bonding, Nd:YAG (2 W) + silane + bonding, and phosphoric acid + silane + bonding (in ceramic brackets) might provide stronger bonds.

Effect of Ti: Sapphire and Nd: YAG Lasers on Shear Bond Strength at the Zirconia - Veneering Ceramic Juncture

Introduction: This study was conducted to assess the impact of nanosecond and femtosecond lasers on shear bond strength at the zirconia - veneering ceramic juncture. Materials and Methods: The first 60 samples of partially sintered zirconia cylindrical discs measuring 7 mm diameter and 4 mm height were milled and sintered. Then they were randomly divided into three groups namely group C (control, n=10), group N (Nd: YAG laser, n=10), and group T (Ti: sapphire laser n=40) which was further divided based on the duration of laser irradiation, into 4 subgroups (n=10 each) which were 30 seconds, 1 minute, 2 minutes and 3 minutes. Surface treatment was done on sintered zirconia discs based on the group. Following the treatment, the discs were ultrasonically cleaned followed by liner application (IPS Emax Zirliner, Ivoclar-Vivadent) and veneer ceramic layering (IPS e.max Ceram, Ivoclar-Vivadent) of 1.5 mm height. Each sample underwent shear stress in the universal test machine on the mounting jig, and bond strength was evaluated. Data were assessed using ANOVA followed by Tukey’s post hoc multiple comparison analyses. Results: According to one-way ANOVA, there was a significant difference in shear bond strength between the groups. Tukey’s post hoc pair wise comparison test showed a significant difference (P value=0.001) in shear bond strength of all pairs except group C and group N. The results of repeated measures, ANOVA (related and dependent groups) and Tukey’s multiple pair wise comparison test showed that there was a significant difference (P value=0.001) in shear bond strength at 30 seconds and all other groups. Conclusion: Ti: sapphire laser irradiation for 30 seconds can be used as potential surface treatment to increase shear bond strength at the zirconia-veneering ceramic juncture.

Laser surface treatment on Yttria-stabilized zirconia dental implants: Influence on cell behavior

Yttria-stabilized zirconia (YSZ) is being proposed as an alternative material to Titanium for dental implants due to its aesthetic and biocompatibility properties. However, is it yet to define the optimal surface treatment to improve YSZ bioactivy. Texturization is a promising approach, but the biological role of patterned YSZ surfaces in cell cultures is yet to be determined. Thus, cellular behavior of osteoblasts and fibroblasts in contact with groove-texturized YSZ surfaces was investigated. YSZ discs were groove-textured by conventional milling and Nd:YAG laser. All samples including control were sandblasted and acid-etched. Human osteoblasts and fibroblasts were cultured on discs for 14 days. Morphology and cellular adhesion were observed. Cell viability, interleukin-1β, osteopontin, collagen type I prodution, alkaline phosphatase activity, and interleukin-8 were measured. YSZ texturization by conventional milling improved osteoblasts viability and differentiation when compared to laser texturization. Fibroblasts behavior did not seem to be influenced by the texturing technique. Compared to sandblasting and acid etching currently used as gold standard for zirconia dental implants no superiority of macrotexturization was found.

Effect of Nd:YAG Laser with/without Graphite Coating on Bonding of Lithium Disilicate Glass-Ceramic to Human Dentin

This study evaluated the effect of different surface treatments on the tensile bond strength between lithium disilicate glass-ceramics, resin cement, and dentin. Fifty truncated cone-shape glass-ceramics were divided into five groups (n = 10): G1, control: 10% hydrofluoric acid (HF); G2, Nd:YAG laser + silane; G3, Sil + Nd:YAG laser; G4, graphite + Nd:YAG laser + Sil; and G5, graphite + Sil + Nd:YAG laser. Fifty human third-molars were cut to cylindrical shape and polished to standardize the bonding surfaces. The glass-ceramic specimens were bonded to dentin with a dual-cured resin cement and stored in distilled water for 24 h at 37ºC. Tensile testing was performed on a universal testing machine (10 Kgf load cell at 1 mm/min) until failure. The bond strength values (mean ± SD) in MPa were G1 (9.4 ± 2.3), G2 (9.7 ± 2.0), G3 (6.7 ± 1.9), G4 (4.6 ± 1.1), and G5 (1.2 ± 0.3). Nd:YAG laser and HF improve the bond strength between lithium disilicate glass-ceramics, resin cement, and dentin. The application of a graphite layer prior to Nd:YAG laser irradiation negatively affects this bonding and presented inferior results.

Effects of Diode and Nd:YAG Laser Irradiation on Friction Forces Between Two Types of Ceramic Brackets and Rhodium-Coated Archwires

Introduction: Ceramic brackets have gained increasing popularity among dental clinicians and orthodontic patients but friction is a major concern when using them. This study sought to assess the effects of diode and Nd:YAG (neodymium-doped yttrium aluminum garnet) laser irradiation on friction forces between two types of ceramic brackets and rhodium-coated esthetic archwires. Methods: Thirty polycrystalline and 30 poly-sapphire brackets were divided into 6 groups (n=10) as follows: (I) control polycrystalline brackets (no laser irradiation), (II) polycrystalline brackets subjected to diode laser irradiation, (III) polycrystalline brackets subjected to Nd:YAG laser irradiation, (IV) control poly-sapphire brackets (no laser irradiation), (V) poly-sapphire brackets subjected to diode laser irradiation, and (VI) poly-sapphire brackets subjected to Nd:YAG laser irradiation. The bracket slots were laser-irradiated on a custom-made table. Sixty 5-cm pieces of rhodium-coated archwires were used for the friction test in a universal testing machine at a speed of 10 mm/min. Ten brackets from the six groups underwent scanning electron microscopy (SEM), X-ray diffraction (XRD) and energy-dispersive X-ray spectroscopy (EDX). Results: The frictional resistance value of polycrystalline brackets was significantly higher than that of poly-sapphire brackets, irrespective of laser type (P <0.05). Irradiation of diode and Nd:YAG lasers, compared with the control group, had no significant effect on friction, irrespective of bracket type (P >0.05). Conclusion: It appears that diode and Nd:YAG laser irradiation cannot significantly decrease the friction. Future studies are warranted on different laser types with variable exposure.

Shear Bond Strength of the Metal Bracket to Zirconium Ceramic Restoration Treated by the Nd: YAG Laser and Other Methods: An In Vitro Microscopic Study

Introduction: Providing reliable bonding of the bracket base and the zirconia surface is required to apply orthodontic force. The purpose of this scientific experiment was to evaluate the efficacy of three different methods of surface preparation for Zirconia, including surface roughening, sandblasting and the Nd: YAG laser, in the shear bond strength (SBS) of the orthodontic brackets. Methods: Fifty-four discs of zirconia were divided into three groups of 18: A) Hydrofluoric acid etching, B) sandblasting, and C) Nd: irradiation using the power of 1.5 W for 10 seconds. After bonding the brackets, the samples were slowly thermo-cycled (1000 times) for 24 hours. The SBS test was performed by a universal testing machine at a head speed of 0.5 mm/min. The adhesive remnant index (ARI) was scored at a magnification of 10 in the stereo microscope. All data were collected and analyzed using the variance, Kruskal-Wallis, Tukey, Don, and Weibull tests (α = 0.05). Results: The HF acid etching group (6.11± 0.94 MPa) had the highest SBS, which was followed by the laser group (6 ± 0.61 MPa) and the sandblast group (3.1080 ± 0.82 MPa). There was a significant statistical difference between the laser and HF groups and the sandblast group (P < 0.05) and no significant difference between the HF group and the laser group (P = 0.03). Conclusion: Based on the obtained bond strength, the Nd: YAG laser with a power of 1.5 W could be a substitute treatment method for the HF acid-etching.

Oxide of lanthanoids can catalyse non-oxidative propane dehydrogenation: mechanistic concept and application potential of Eu2O3- or Gd2O3-based catalysts

This paper demonstrates the potential of Eu2O3 and Gd2O3 as catalysts for non-oxidative propane dehydrogenation to propene. They reveal a higher activity than the state-of-the-art bare ZrO2-based catalysts due to the higher intrinsic activity of Gdcus or Eucus in comparison with that of Zrcus (cus = coordinatively unsaturated).

Comparison of lithium disilicate-reinforced glass ceramic surface treatment with hydrofluoric acid, Nd:YAG, and CO2 lasers on shear bond strength of metal brackets

OBJECTIVES

To evaluate and compare the effects of different surface conditioning methods of lithium disilicate-reinforced ceramic on shear bond strength (SBS) of metallic brackets.

MATERIALS AND METHODS

Thirty-six lithium disilicate ceramic blocks mounted in acrylic resin blocks were assigned to 3 groups (n = 12): 9.6% hydrofluoric acid (HF); neodymium-doped yttrium aluminium garnet (Nd:YAG) laser; and carbon dioxide (CO₂) laser. The glass ceramic surfaces were primed with a silane, and the brackets were bonded using a light-cured composite resin. SBS test was carried out in a universal testing machine at 0.5 mm/min crosshead speed until the brackets were debonded. The remaining adhesive was evaluated under a stereomicroscope in terms of the adhesive remnant index (ARI). The surface hardness was determined with a 100-gr force using a microhardness tester. Glass ceramic surface changes were evaluated using the scanning electron microscope. One-way ANOVA and post hoc Tamhane tests were used to compare microhardness values, and Kruskal-Wallis and Mann-Whitney U tests were used to analyze SBS values and ARI.

RESULTS

The median and interquartile range of SBS values in 3 groups were 6.48 (1.56-15.18), 1.26 (0.83-1.67), and 0.99 MPa (0.70-2.10), respectively. Microhardness analysis revealed significant differences between the CO₂ laser and intact porcelain groups (P = 0.003), without significant differences between the other groups. Group 1 exhibited the highest ARI.

CONCLUSION

Neither CO₂ nor Nd:YAG lasers resulted in adequate surface changes for bonding of brackets on ceramics compared with the samples conditioned with HF. CO₂ laser decreased the microhardness of ceramics.

CLINICAL RELEVANCE

Surface conditioning with HF resulted in clinically acceptable SBS values.

Shear bond strength of a self-adhesive resin cement to dentin surface treated with Nd:YAG and femtosecond lasers

This study aims to evaluate the effect of Nd:YAG and femtosecond lasers irradiation on the shear bond strength (SBS) of a self-adhesive resin cement to the human dentin surface. One hundred extracted third molar teeth were randomly divided into 10 experimental groups according to dentin surface treatments; with and without the bonding agent, Nd:YAG 302 J/cm² and 440 J/cm², femtosecond 4 J/cm² and 7 J/cm², and control groups were prepared. After surface treatments, a self-adhesive resin cement was luted by using a bonding jig (Ultradent Products Inc.). The specimens were then subjected to shear test at a crosshead speed of 0.5 mm/min, and failure loads were recorded as megapascal (MPa). Two-way analysis of variance and Tukey HSD tests were performed (p ˂ 0.05). Representative specimens from each experimental subgroup were examined by means of SEM. The highest SBS values were obtained in Group 302 J/cm² Nd:YAG with bonding agent, and there is no statistical difference between Group 440 J/cm² Nd:YAG with bonding and Group 7 J/cm² femtosecond with bonding (p > 0.05). The lowest SBS values were observed in Group control without bonding agent. Nd:YAG and femtosecond laser treatments improved the adhesion between the dentin surface and the self-adhesive resin cement.

The impact of laser scanning on zirconia coating and shear bond strength using veneer ceramic material

Laser scanning is one of the methods that can be used for surface treatments of zirconia. Application of the laser to the surface of zirconia has diverse effects, depending on the type of laser. A carbon dioxide (CO₂) laser has high irradiation power and can alter the surface properties. This study investigated the surface coating of zirconia as a core material that subsequently coated with a veneering ceramic (v-c) material. This study compared laser scanning and conventional sintering processes. Various properties including surface topography, interface evaluation, phase transformation, elemental compositions, failure mode patterns, and contact angle were examined through X-ray diffractometry (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) analyses. Results were confirmed that the bond strength between the v-c and the substrate recorded through laser scanning was higher than that determined through conventional sintering.

Effects of MDP-based primers on shear bond strength between resin cement and zirconia

Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics are widely used for fixed dental prostheses and dental implants. Various primers have been introduced to enhance the bonding strength of zirconia crowns. The aim of current study was to analyze the effects of 10-methacryloyloxydecyl dihydrogen phosphate (MDP) primers on the shear bond strength between zirconia crowns and resin cement were assessed. The total sample size included 90 samples of Y-TZP ceramic surfaces. Samples in group I were abraded with aluminum oxide. Samples in groups II and III were abraded and primed with the zirconia and Z-PrimePlus MDP primers, respectively. Group IV samples did not undergo any treatment or application. Group V and VI samples did not undergo any abrasion but were primed with zirconia and Z-PrimePlus MDP primers, respectively. Prior to bonding of the resin cement, the primers were applied for 1 min and air-dried. Then, Clearfil SA luting self-adhesive resin cement was coated onto the zirconia crowns. The highest bond strength was achieved in group III, followed by group II, and group IV exhibited the lowest bond strength between Y-TZP ceramic and adhesive resin cement. Therefore, the application of MDP primers yielded greater bond strength between Y-TZP ceramics and adhesive resin cement, compared with the group without the use of primers.

Effects of different surface treatments on the shear bond strength of veneering ceramic materials to zirconia

PURPOSE

To evaluate and compare the effect of different materials and techniques on the shear bond strength of veneering ceramic materials to zirconia.

MATERIALS AND METHODS

136 sintered zirconia cubes were prepared and randomly divided into four study groups according to corresponding methods of surface treatment and materials: GLN (grinding followed by laser scanning using Noritake Cerabien ZR), SLN (sandblasting followed by laser scanning using Noritake Cerabien ZR), GLV (grinding followed by laser scanning using VITA VM 9), and SLV (sandblasting followed by laser scanning using VITA VM 9). Spraying technique was performed to coat the core. Profilometer, SEM, XRD, EDS, universal testing machine, and stereomicroscope were used to record surface roughness Ra, surface morphology, phase transformation, elemental compositions, shear bond strength SBS values, and failure types, respectively. Specimens were investigated in unaged (not immersed in artificial saliva) and aged (stored in artificial saliva for a month) conditions to evaluate SBS values.

RESULTS

Grinding and GLN as first and second surface treatments provided satisfactory Ra values in both conditions (1.05 ± 0.24 µm, 1.30 ± 0.21 µm) compared to sandblasting and other groups (P<.05). The group GLN showed the highest SBS values in both conditions (30.97 ± 3.12 MPa, 29.09 ± 4.17 MPa), while group SLV recorded the lowest (23.96 ± 3.60 MPa, 22.95 ± 3.68 Mpa) (P<.05). Sandblasting showed phase transformation from t-m. Mixed failure type was the commonest among all groups.

CONCLUSION

GLN showed to be a reliable method which provided satisfactory bond strength between the veneer ceramic and zirconia. This method might preserve the integrity of fixed dental crowns.