Effects of Erbium Family Laser on Shear Bond Strength of Composite to Dentin After Internal Bleaching

Shear bond strength of a composite resin restoration in primary teeth following cavity preparation using laser- an in-vitro study

To evaluate and compare the shear bond strength of composite resin restorations in primary teeth, following cavity preparation with both traditional dental burs and laser irradiation. One hundred primary molars extracted from the children visiting our department were collected and randomly divided into five groups (A-E) with 20 teeth in each group. In groups A, B, C, D, and E the teeth samples were etched with phosphoric acid, Er; YAG laser followed by acid etching, Er, Cr: YSGG laser followed by acid etching, Er; YAG laser etching only and Er, Cr: YSGG laser etching only, respectively. Following, all the samples were restored with composite resin and subjected to 500 cycles of thermocycling. The shear bond strength of the resin composite was analyzed. The type of fractures was also noted. Data obtained were subjected to statistical analysis. The mean value of shear bond strength of Group A, B, C, D, and E was 17.562 ± 0.810, 15.928 ± 0.415, 14.964 ± 0.566, 11.833 ± 0.533 and 11.187 ± 0.517, respectively. Adhesive failure was most commonly seen in all the groups. The phosphoric acid etching remains a highly effective technique for pre-treating dentin in composite resin restorations. The shear strength of composite resin to the dentin of laser-prepared cavity in primary teeth can be improved by the addition of acid etching.

Effect of erbium family laser etching on shear bond strength of enamel surfaces: A meta-analysis-PRISMA

BACKGROUND

Recently, laser etching has appealed to people's attention. It is meaningful to compare the effect of erbium-doped yttrium-aluminum-garnet (Er:YAG) and erbium-chromium; yttrium-scandium-gallium-garnet (Er,Cr:YSSG) laser etching parameters with acid etching on bond strength of enamel surfaces. As far as we know, there still remains no related meta-analysis. To evaluate the efficacy of Er:YAG and Er,Cr:YSSG lasers etching on shear bond strength (SBS) of brackets bonded to enamel. The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, conducted with literature search.

METHODS

Twelve relevant randomized controlled trials (RCTs) were included.

RESULTS

The pooled analysis of SBS showed that there were no significant differences between erbium family lasers and acid etching. In the mass, we noticed they did not achieve statistical significance in the lasers etching and acid etching. However, pooled analysis of 5 studies showed the SBS bonding to enamel was lower in Er,Cr:YAG laser group compared with acid group. As a whole, there were statistical significance between erbium lasers groups and acid etching group in adhesive remnant index (ARI) aspects, which less adhesives remained can reduce damage to enamel. With regard to the rate of teeth with ARI score ≤2, the results in Er:YAG laser etching group were obviously higher than acid etching group.

CONCLUSION

Our data indicated that erbium lasers may be considered bonding of brackets to enamel instead of acid etching bonding to enamel.

Effect of nanosecond- and microsecond-pulse Er,Cr:YSGG laser ablation on dentin shear bond strength of universal adhesives

OBJECTIVE

The study aimed to evaluate the bond strength of universal adhesives to dentin after Er,Cr:YSGG laser irradiation with nanosecond-domain and microsecond-domain pulses.

METHODS

Eighty extracted caries-free, sound human molars were divided into eight groups. The enamel was removed until the dentin occlusal flat dentin surface was exposed. Etch-and-rinse followed by adhesive was applied to group 1, and a self-etch adhesive was applied to group 2. Er,Cr:YSGG laser (3 mJ, 100 Hz, 100 ns), (3 mJ, 100 Hz, 150 μs), and (20 mJ, 100 Hz, 150 μs) were applied to groups 3-4, 5-6, and 7-8, respectively. The laser preparation was followed by self-etch adhesives or adhesives treatment. When the composite resin had been built up on the samples, the shear bond strength was tested, and the data were statistically analyzed using analysis of variance (ANOVA).

RESULTS

Groups prepared with nanosecond-pulse laser showed significantly higher bond strength values than the microsecond-pulse laser groups and self-etch mode group, and the SEM photographs also showed more dentinal tubules and no damage in the ablation area. The shear bond strength of long pulse laser ablated was comparable to that of self-etching system when it was combined with a self-etch adhesive at low energy, but higher energy laser degraded shear bond strength.

CONCLUSIONS

The pulse width of Er,Cr:YSGG laser affects the bond strength, nanosecond pulses of laser irradiation without water cooling can enhance bond strength, but microsecond pulses of laser cannot enhance bond strength.

Photon-Induced Photoacoustic Streaming Activation of the Postbleaching Antioxidant Application Rapidly Improves Bonding to Pulp Chamber Dentin

Objective: This study explored whether the erbium/yttrium/aluminum/garnet (Er:YAG) laser irradiated through the photon-induced photoacoustic streaming (PIPS) method would impact on the resin bonding to pulp chamber dentin when used to activate bleaching and/or postbleaching antioxidant treatment. Materials and methods: One hundred five dentin samples prepared from freshly extracted human incisors were randomly assigned to seven groups (n = 15): control (no bleaching/antioxidant); CB (conventional bleaching only); MB (modified bleaching only); CB-NI (conventional bleaching+antioxidant with needle irrigation); MB-NI (modified bleaching+antioxidant with needle irrigation); CB-PIPSI (conventional bleaching+antioxidant with PIPS-activated irrigation); and MB-PIPSI (modified bleaching+antioxidant with PIPS-activated irrigation). Bleaching (40% hydrogen peroxide) lasted for 20 min. Modified bleaching groups were irradiated with Er:YAG laser using the PIPS tip (2940 nm, 0.90 W, 30 Hz, 30 mJ/pulse, 50-μsec pulse duration) during the first 60 sec of the procedure. The antioxidant treatment with 10% sodium ascorbate lasted for 60 sec. PIPS-activated antioxidant groups were irradiated with Er:YAG laser using the PIPS tip (2940 nm, 0.30 W, 15 Hz, 20 mJ per pulse, 50-μsec pulse duration) throughout the procedure. After completing the composite restorations, all samples were subjected to 5000 thermocycling and the shear bond strength (SBS) test at a crosshead speed of 1 mm/min. SBS data were analyzed using the Kruskal-Wallis test with Bonferroni correction (α& 0.05). Results: No significant difference was detected among the control, CB-PIPSI, and MB-PIPSI (p > 0.05), which presented a significantly higher SBS compared with the other groups (p < 0.05). Conclusions: Irrespective of the application mode of the initial bleaching, PIPS-activated irrigation of the antioxidant improved SBS to bleached dentin to the level of the control in 1 min. Postbleaching antioxidant treatment combined with the PIPS method might be a promising approach to enable immediate resin restoration of bleached dentin.

Bleaching Stained Arrested Caries Lesions: In vivo Clinical Study

Objective  Conservative approaches to esthetically treat stained arrested caries lesions (s-ACLs) have not been explored in clinical studies. This study aims to investigate the efficacy of in-office dental bleaching agent, as a conservative approach, to esthetically treat s-ACLs.

Materials and Methods  Twelve patients ( n = 46) presented with s-ACLs were treated with 40% hydrogen peroxide (in-office bleaching protocol; 20 minutes × 3). Color values were measured using a spectrophotometer (CIE L*a*b*), aided with digital photography to assess visual color change clinically. Measurements were taken for each specimen at baseline and immediately after bleaching.

Statistical Analysis  The color change calculated before and after bleaching for each dental substrate was analyzed using paired t -test (α = 0.05).

Results  The bleached s-ACLs had a significant increase in L * values ( p < 0.001), and a significant decrease in both a * ( p = 0.001) and b * ( p = 0.007) values, indicating lighter color improvement (bleaching efficacy). The baseline mean of L *, a *, and b * values were 61.5, 2, and 15.4, respectively, and after bleaching were 67.7, 1.4, and 13.3, respectively, with a mean increase in ∆ E of >7.9, which resulted in a visible clinical stain improvement as orange/light brown stains were removed completely, while gray/black stains improved to a lesser extent.

Conclusion  Significant color improvement was observed when the in-office bleaching protocol (40% hydrogen peroxide) was used in orange/brown s-ACLs. However, it showed lesser improvement in gray/black s-ACLs.

Optical changes of human dentin after non-vital bleaching and effect of Er,Cr:YSGG laser on micro-shear bond strength of a self-etch and an etch-and-rinse adhesive system

The aim was to evaluate the optical changes of bleached human dentin and the efficacy of Er,Cr:YSGG laser on micro-shear bond strength (μSBS) of two adhesive systems for immediate and delayed applications. Seventy-two human dentin specimens (1 mm) were obtained. Colour measurements of 30 specimens (control and bleaching groups) were made at baseline, after bleaching and a 7-day delay. Differences at colour (ΔE₀₀), translucency (ΔTP₀₀) and whiteness (ΔWI_D) were calculated by recorded data. Forty-two specimens were used to compare μSBS of a self-etch (Clearfil SE Bond [SE]) and an etch-and-rinse (Prime&Bond NT [PBNT]) adhesive to bleached dentin. Additional to a negative group, six groups were contemplated for each adhesive, considering the time of composite application (immediate, delayed) and whether additional surface treatment by laser (1 W, 2 W) or not. Colour and μSBS data were statistically analysed. For optical analysis, only ΔE₀₀ and ΔWI_D calculated for the difference between baseline and bleaching were found significantly different for control and bleaching groups. Whiteness of bleached specimens was remarkably decreased after a 7-day delay. Despite immediate applications of SE showing lower μSBS than negative control, delayed applications showed no significant differences except that of the 2 W laser etching. For PBNT, laser etching increased μSBS for both of the immediate and delayed applications, and no significant difference was observed from negative control. Related with the preferred adhesive system, Er,Cr:YSGG laser etching can be an alternative for optimal bond strength of immediate restorations, but the clinicians should always keep in mind that perceived colour and whiteness will change by the passing time which can affect the shade match.

Push-out bond strength of calcium-silicate cements following Er:YAG and diode laser irradiation of root dentin

This study aimed to compare the effects of diode and Er:YAG laser irradiation of root dentin on push-out bond strength of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cements. An in vitro experimental study was conducted on 90 dentin discs, cut out of freshly extracted human teeth. The discs were instrumented to obtain 1.3-mm lumen diameter. Then, they were randomly divided into six groups (n = 15). Groups 1 and 4 subjected to diode laser (Wiser, Doctor Smile, Italy) (980 nm, 1 W, continuous mode) for 10 s and filled with MTA and CEM cements. Groups 2 and 5 subjected to Er:YAG laser (Deka, Italy) (2940 nm, 1 W, 10 Hz, 230 μs) for 10 s and filled with MTA and CEM cements. Groups 3 and 6 (control groups) were filled with MTA and CEM cements without laser irradiation. After 7 days, push-out bond strength test was performed using a universal testing machine in order to evaluate the adhesion of the biomaterials to dentin. The samples were evaluated under a light microscope at × 40 magnification to determine the mode of fracture. Data were analyzed using two-way ANOVA. The highest push-out bond strength (8.76 ± 3.62 MPa) was noted in group 1 (diode/MTA), which was significantly higher than the other groups (P < 0.001). The lowest bond strength (2.61 ± 0.81) was noted in group 6 (control/CEM). Diode laser significantly increased the bond strength of both cements (P < 0.05), but Er:YAG laser irradiation only increased the bond strength of CEM and had no significant effect on MTA (P = 0.603). The bond strength of MTA control group was higher than that of CEM control group (P = 0.001). Push-out bond strength of endodontic cements can be affected by dentin conditioning with diode 980 nm and Er:YAG laser. Nine hundred eighty-nanometer diode laser irradiation is recommended to increase the bond strength of endodontic cements particularly the CEM cement to dentin.