SEM evaluation of the hybrid layer after cavity preparation with Er:YAG laser

Influence of Er:YAG laser irradiation settings on dentin-adhesive interfacial ultramorphology and dentin bond strength

This study evaluated the effects of Erbium-doped yttrium aluminium garnet (Er:YAG) laser settings and dentin bonding agents on ultramorphological characteristics of resin-laser-irradiated dentin interfaces and dentin bond strength (BS) of these adhesive systems. Additionally, dentin depth affected by Er:YAG laser irradiations was measured. The experiments were performed on occlusal dentin surfaces of third molars that were flattened with 600-grit SiC sandpaper. Treated-dentin with laser settings (250 mJ/4 Hz and 160 mJ/10 Hz) were the experimental groups, while SiC abraded dentin was the control. These three dentin treatments and three adhesives (two self-etchings and one etch-&-rinse adhesive) formed nine groups for the ultramorphology of laser-ablated dentin-adhesives interfacial analysis, using a transmission electron microscope (TEM). For BS (n = 8), the same nine groups were tested with addition of the two evaluation times (24 h after sample preparation or 1 year). The depths of Er:YAG laser effects into the dentin were measured using a TEM (n = 10). Ablated-dentin depth and BS data were analyzed by one- and three-way ANOVA, respectively, and Tukey's test (α = 0.05). Hybrid layer formation was only observed for controls, while for laser-treated dentin, adhesives were bonded to dentin with resin tags formation. Laser settings reduced the BS for all adhesives at 24 h, while at 1 year, etch-&-rinse adhesive presented the highest BS, regardless treatment (control or laser settings). Dentin depth affected by laser settings was similar. The laser irradiation altered the bonding mechanism of the adhesives to dentin and reduced the BS for self-etching adhesives. Etch-&-rinse adhesive yielded the highest BS at 1 year. Laser settings similarly affected the dentin in depth.

Evaluation of the clinical success of class I cavities prepared by an Er:YAG laser-5-year follow-up study

The purpose of this study was to evaluate, after 5 years, the clinical success of preparing class 1 composite resin restorations with an Er:YAG laser. Sixty-five teeth of 30 patients were included in the study, and an Er:YAG laser emitting at a wavelength of 2.94 μm was used for the class I cavity preparations with not more than one third of the mesiodistal width of the occlusal surfaces of each tooth. All cavities were restored with a light-cured composite resin, following a single bond application. After the baseline examination, restorations were reevaluated by the same experienced clinician after 5 years, using the modified Ryge criteria. At the end of 5 years, 41 of the 65 restorations were evaluated in 22 patients and scored. With respect to marginal discoloration, anatomic form, color match, and surface texture, significant differences were found between baselines tested after 5 years. Clinical evaluation of postoperative sensitivity showed that 90.2 % were rated as alpha. All restorations evaluated in this study demonstrated acceptable clinical performance within the evaluation period based on the alpha and bravo ratings for clinically satisfactory restorations. Further evaluations are necessary for a better clinical performance analysis.

Morphological and chemical comparative analysis of the human and bovine dentin-adhesive layer

Micro energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF) and scanning electron microscopy (SEM) were used to evaluate dentin treated with an etch and rinse adhesive (ER) and a self-etch adhesive (SE). Ten human molars (H) and ten bovine anterior teeth (B) were prepared (exposure of dentin and divided in the middle) and allocated into two different adhesion strategy groups per substrate (n=40). µ-EDXRF data and SEM images were obtained before and after treatment. Untreated dentin of both substrates did not differ in terms of Ca (p<0.1503), P (p<0.2986) or Ca/P ratio (p<0.1400). H-SE and B-SE specimens showed reduced P content (p<0.0001; p<0.0002), while H-ER and B-ER specimens showed reduced Ca and P content (p<0.0001; p<0.0001) when compared with untreated specimens. The Ca/P ratio was significantly higher in H-ER and B-ER specimens than in H-SE and B-SE specimens (p<0.0001; p<0.0080). Untreated dentin showed a homogeneous elemental distribution. However, after adhesive treatments, the surface of the dentin showed an irregular demineralization pattern. The resin tags and adhesive layer were shorter in bovine specimens than in human specimens due to morphological differences.

The influence of experimental silane primers on dentin bond strength and morphology: a laboratory and finite element analysis study

STATEMENT OF PROBLEM

The inconsistency of dentin bonding affects retention and microleakage.

PURPOSE

The purpose of this laboratory and finite element analysis study was to investigate the effects on the formation of a hybrid layer of an experimental silane coupling agent containing primer solutions composed of different percentages of hydroxyethyl methacrylate.

MATERIAL AND METHODS

A total of 125 sound human premolars were restored in vitro. Simple class I cavities were formed on each tooth, followed by the application of different compositions of experimental silane primers (0%, 5%, 25%, and 50% of hydroxyethyl methacrylate), bonding agents, and dental composite resins. Bond strength tests and scanning electron microscopy analyses were performed. The laboratory experimental results were validated with finite element analysis to determine the pattern of stress distribution. Simulations were conducted by placing the restorative composite resin in a premolar tooth by imitating simple class I cavities. The laboratory and finite element analysis data were significantly different from each other, as determined by 1-way ANOVA. A post hoc analysis was conducted on the bond strength data to further clarify the effects of silane primers.

RESULTS

The strongest bond of hybrid layer (16.96 MPa) was found in the primer with 25% hydroxyethyl methacrylate, suggesting a barely visible hybrid layer barrier. The control specimens without the application of the primer and the primer specimens with no hydroxyethyl methacrylate exhibited the lowest strength values (8.30 MPa and 11.78 MPa) with intermittent and low visibility of the hybrid layer. These results were supported by finite element analysis that suggested an evenly distributed stress on the model with 25% hydroxyethyl methacrylate.

CONCLUSIONS

Different compositions of experimental silane primers affected the formation of the hybrid layer and its resulting bond strength.

Shear bond strength and ultrastructural interface analysis of different adhesive systems to Er:YAG laser-prepared dentin

The aim of this study was to evaluate the shear bond strength (SBS) of a microhybrid composite resin bonded with three different adhesive systems to Er:YAG laser- (EL) or bur-prepared dentin surfaces and to analyze the quality and ultrastructure of the adhesive-dentin interfaces by scanning electron microscopy (SEM). The specimens prepared for SBS test and SEM analysis were randomly assigned to eight groups (G1-G8): G1, EL (Fidelis PlusIII, Fotona) + Clearfil S3 Bond (C3S); G2, EL + AdperSE Plus (SE); G3, EL + laser etch + Adper Single Bond2 (SB2); G4, EL + acid etch + SB2; G5, EL + SB2 (no etching); G6, bur + acid etch + SB2; G7, bur + S3; G8, bur + SE. Laser was used in very short pulse mode at a setting of 200 mJ/20 Hz for dentin preparation and at 80 mJ/10 Hz for dentin etching. Bond strength test: 3.5 × 2.0 mm cylindrical molds were placed onto adhesives and filled with the composites. After 24 h in distilled water, SBS was tested at a crosshead speed of 0.5 mm/min. SEM analysis: The dentin-adhesive interfaces were evaluated for the ultrastructure of hybrid layer. Data of SBS (MPa) were statistically analyzed by ANOVA and Tukey HSD. ER:YAG laser-prepared dentin has demonstrated significantly more SBS (p < 0.01) for SE when compared to bur-prepared dentin. No significancies (p > 0.05) in SBS have been determined between the total-etch adhesive applied groups with regard to etching types. SEM analysis revealed that hybrid layers obtained in Er:YAG laser-irradiated dentin exhibited more irregular and non-homogeneous pattern than the conventionally prepared dentin. In conclusion, SE Bond demonstrated superior results in Er:YAG laser-ablated dentin compared to bur-prepared dentin.

Effects of ArF excimer laser irradiation of dentin on the tensile bonding strength to composite resin

OBJECTIVE

The purpose of the study was to evaluate the effects of argon fluoride (ArF) excimer laser irradiation on the tensile bonding strength (TBS) of dentin to composite resin.

BACKGROUND DATA

Dental lasers use a photothermal process, which potentially entails risk of tissue damage caused by heat affecting the bond strength of resins. The ArF excimer laser functions by a photochemical process in which the energy of photons directly cuts covalent bonds in molecules without generating heat.

METHODS

Twenty extracted human molars were sectioned perpendicularly to the tooth axis to expose a flat dentin surface. The surfaces were treated with various combinations of ArF excimer laser irradiation, primer treatment, and bonding treatment. After composite resin was built up on the treated dentin surface, specimens with a 1×1 mm bonding interface were prepared and subjected to TBS tests. Treated dentin surfaces were also observed using transmission electron microscopy (TEM).

RESULTS

Specimens that underwent laser irradiation followed by bonding treatment had a TBS that did not differ significantly from that of specimens that received conventional treatment, with or without priming. TEM observations showed sectioned and dispersed collagen matrix in the hybrid layer after laser irradiation, priming, and bonding, but no hybrid layer after laser irradiation and bonding at the treated dentin surface.

CONCLUSIONS

The TBS of conditioning with ArF excimer laser irradiation was identical to that with conventional treatment when bonding was used. The bonding mechanism with the ArF irradiation differed from that of conventional bonding depending upon dentin hybridization.

A three-dimensional evaluation of microleakage of class V cavities prepared by the very short pulse mode of the erbium:yttrium-aluminium-garnet laser

The aim of this study was to evaluate microleakage along resin restoration in cavities prepared with an erbium:yttrium-aluminium-garnet (Er:YAG) laser, with and without acid etching, and to compare it with that in diamond-drilled cavities. Thirty intact molars were divided into three equal groups. In the teeth in group I, class V cavities were prepared with a diamond drill. Cavities in groups II and III were prepared with an Er:YAG laser (400 mJ/15 Hz for enamel and 250 mJ/10 Hz for dentine). The cavities in groups I and II were acid-etched and adhesive and flowable composite were applied to all cavities. The specimens were first immersed in dye for 24 h and then in 5% nitric acid for 72 h for softening. The fillings were extracted and photographed through a dissecting microscope. The leakage area was measured with specially designed software. The Kruskal-Wallis test showed that the best ranking was group II [mean range (m.r.) = 27.46], followed by group I (m.r. = 33.48) and, lastly, group III (m.r. = 45.15). The differences between groups I and III (P = 0.023) and between groups II and III were statistically significant (P = 0.080). The least microleakage was found in those cavities prepared by Er:YAG laser and subsequently acid-etched, whereas the most leakage was in the lased cavities that had not been etched; the traditional diamond-drilled acid-etched cavities produced medium leakage.