Evaluation of Tooth Surface Irradiated With Erbium: Yttrium Aluminum Garnet and Carbon Dioxide Lasers by Atomic Force Microscopy

Influence of preventive remineralizing techniques on surface roughness and volume loss of dentin submitted to erosive and/or abrasive challenges

Background

The objective this study was to evaluate the influence of preventive remineralizing techniques on surface roughness and volume loss of dentin submitted to erosive and/or abrasive challenges.

Material and Methods

One hundred and eighty specimens of bovine root dentin were made; half of each was isolated (without treatment - WT) and half was subjected to the following remineralizing techniques: fluoride varnish (FV); Regenerate Boosting Serum® (RBS); Er,Cr:YSGG laser (L); fluoride varnish+laser (FV+L); Regenerate Boosting Serum®+laser (RBS+L). The specimens were submitted to erosive, abrasive and erosive followed by abrasive challenge. Erosion was carried out for 5 minutes, twice a day for 10 days. Abrasion was performed with an electric toothbrush and slurry solution for 60 seconds. The evaluation was performed by confocal laser scanning microscopy. Analysis of variance and Tukey tests were used for surface roughness; volume loss comparison was performed using the Kruskal-Wallis test and Dunn's post-hoc (p<0.05).

Results

There was no statistically significant difference in the surface roughness of the reference area in relation to the areas submitted to different types of treatment and challenges (p>0.05). Regarding volume loss, the untreated group submitted to erosive/abrasive challenges showed greater percentage of volume loss compared to the other groups (p<0.05).

Conclusions

It is concluded that preventive remineralizing techniques are effective in maintaining dentin volume after erosive/abrasive challenges. Key words:YSGG lasers, Dentin, Erosion, Tooth Abrasion.

Chemical and morphological analysis of dentin irradiated by different high-power lasers: a systematic review

PURPOSE

This systematic review provides an overview of the main chemical and morphological alterations generated on dentin by different high-power lasers' irradiation.

METHODS

The review was registered in PROSPERO (CRD42023394164) and PRISMA guidelines were followed. The search strategy was conducted on MEDLINE (PubMed), Embase (Elsevier), and Web of Science (Clarivate) databases. The eligibility criteria were established according to the PICOS strategy, focusing on in vitro and ex vivo studies that assessed the chemical and morphological changes in dentin using five high-power lasers: Nd:YAG (1064 nm), Er:YAG (2940 nm), Er, Cr:YSGG (2780 nm), diode (980 nm), and CO2 (10,600 nm). Publication range was from 2010 to 2022. Data was summarized in tables and risk of bias was assessed by QUIN tool.

RESULTS

The search resulted in 2255 matches and 57 studies composed the sample. The methods most used to assess the outcomes were scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and Raman. The studies presented "medium" and "low" risk of bias. The laser prevalently identified was the Er:YAG laser, associated with dentin ablation, absence of smear layer, and exposed tubules. The Nd:YAG laser generated vitreous surface and thermal damage, such as carbonization and cracks. The other lasers caused an irregular surface and no adverse thermal effects. Regarding the chemical structure, only the Er,Cr:YSGG laser caused collagen matrix reduction. The effects found were more intense with higher dosimetry.

CONCLUSION

Evidence available indicates that the irradiation of dentin with high-power lasers are related to morphological outcomes favorable to adhesive restorative procedures, with minimal changes in collagen matrix and mineral content. However, those observations should be carried carefully by clinicians and more clinical trials regarding the association of high-power laser irradiation and restorative procedure longevity are needed.

Effect of Er:YAG, Co2 lasers, papain, and bromelain enzymes dentin treatment on shear bond strength of composite resin

OBJECTIVE

Effective bond strength of composite resin restoration leads to its durability, so evaluation of dentin surface treatment with enzymes and laser for higher bond strength is an important factor.

MATERIALS AND METHODS

Sixty human molar teeth were cut at a depth of 2 mm of occlusal part and divided into six groups (n = 10). G1: etched with 37% phosphoric, G2 and G3: 10% papain or bromelain enzymes were used on the dentinal surface, G4: 10% papain and bromelain enzyme mixture were used for. Then, the specimens were washed with distilled water. In G5 and G6: Er:YAG or Co2 lasers were used on the dentin surface. An adhesive system was applied and then nanohybrid composite was placed in teflon mold and light cured. Samples were subjected to a shear bond strength (SBS) test by universal testing machines. Statistical analysis was performed, using one-way analysis of variance and Tukey HSD tests (p < .05).

RESULTS

The mean SBS in G1 was significantly higher in comparison with the other groups (p < .0001). On the other hand, a comparison of mean SBS between groups 2, 3, 4, and 5 shows no significant differences (p = .221). The mean SBS in group 6 (Co2 laser) was significantly lower in comparison with the other groups (p < .0001).

CONCLUSION

Results showed that SBS of composite resin to dentin was not significantly affected, using either bromelain or papain 10% enzymes or erbium laser. Co2 laser had a negative effect on dentin and decreased the SBS. Phosphoric acid has the best result.

Comparison between Shear Bond Strength of Er:YAG and Er,Cr:YSGG Lasers-Assisted Dentinal Adhesion of Self-Adhering Resin Composite: An Ex Vivo Study

(1) Background: Bonding composite to tooth structure is still evolving with a substitute for phosphoric acid being the main challenge. Lately, a self-adhering composite (SAC) was developed, promising to simplify bonding to tooth structure. Unfortunately, retention especially to dentin, was not as good as the gold standard three steps bonding system. During the last 2 decades, lasers were used to enhance shear bond strength of composite to tooth structure. However, the literature provided limited information regarding laser efficiency in the immediate, as well as the long term, adhesion success of SACs to dentin. The purpose of our study was to define the optimal irradiation conditions to improve the adhesion of self-adhering flowable resin composite to dentin exposed to Er:YAG and Er,Cr:YSGG laser irradiation. (2) Methods: Seventy-two freshly extracted human third molars, prepared to have flat dentinal surfaces, were randomly divided into three groups (n = 24) including a control group (Group 1) in which dentin was left without laser irradiation. The other two groups (Group 2 and 3) received standardized irradiation at a speed of 1 mm/second with Er:YAG (60 mJ; SSP mode = 50 μs; 10 Hz; fluency of 9.4 J/cm²; beam diameter: 0.9 mm; air 6 mL/min; and water 4 mL/min), and Er,Cr:YSGG: 1.5 W; fluency of 17.8 J/cm²; turbo handpiece with MX5 short insert; 20 Hz under air/water spray (65% air, 55% water). Self-adhering flowable resin was applied to dentin in all groups. Half of the specimens were stored in water for 24 h while the other half underwent 3000 thermal cycles. Later, all specimens received a shear bond strength test. Fracture observation was done first under a stereomicroscope then by using a scanning electron microscope. (3) Results: The mean values of shear bond strength for both laser-treated dentin groups (Er:YAG laser: 13.10 ± 1.291, and Er,Cr:YSGG: 14.04 ± 5.233) were higher than in the control group 1 (8.355 ± 2.297) before thermocycling. After thermocycling, shear bond strength decreased in all groups as follows: 10.03 ± 1.503, 10.53 ± 2.631, and 02.75 ± 1.583 for Er:YAG, Er,Cr:YSGG, and nonirradiated dentin, respectively. Shear bond strength values showed a significant difference between the control group (Group 1) and both lasers groups (Group 2 and 3). Statistical analysis of stereomicroscope observation revealed no significant difference between laser irradiation and failure mode (p < 0.136). SEM observation of the dentin surface in both laser-irradiated groups showed opened tubules, absence of smear layer as well as an increase of resin infiltration into dentinal tubules. (4) Conclusion: Er:YAG and Er,Cr:YSGG lasers enhance self-adhering flowable resin shear bond strength values and improve its longevity by eliminating the smear layer, opening dentinal tubules and increasing resin infiltration into the microstructure.