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Ramirez I, Bertolini GR, Candemil AP, Sousa-Neto MD, Souza-Gabriel AE. Chemical and morphological analysis of dentin irradiated by different high-power lasers: a systematic review. Lasers Med Sci 2023; 38:255. [PMID: 37932490 DOI: 10.1007/s10103-023-03912-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/12/2023] [Indexed: 11/08/2023]
Abstract
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.
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Affiliation(s)
- Iago Ramirez
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Avenida do Café, s/n - USP's campus, Ribeirão Preto, SP, 14040-904, Brazil
| | - Gunther R Bertolini
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Avenida do Café, s/n - USP's campus, Ribeirão Preto, SP, 14040-904, Brazil
| | - Amanda P Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Avenida do Café, s/n - USP's campus, Ribeirão Preto, SP, 14040-904, Brazil
| | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Avenida do Café, s/n - USP's campus, Ribeirão Preto, SP, 14040-904, Brazil
| | - Aline E Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Avenida do Café, s/n - USP's campus, Ribeirão Preto, SP, 14040-904, Brazil.
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Santos RMC, Scatolin RS, de Souza Salvador SL, Souza-Gabriel AE, Corona SAM. Er:YAG laser in selective caries removal and dentin treatment with chitosan: a randomized clinical trial in primary molars. Lasers Med Sci 2023; 38:208. [PMID: 37697177 DOI: 10.1007/s10103-023-03869-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
This study evaluated the effect of chitosan on dentin treatment after selective removal of caries lesions with Er:YAG laser in reducing Streptococcus mutans, as well as its effect on the performed restorations. The sample consisted of children (aged 7 to 9 years) with active carious lesions and dentin cavitation located on the occlusal surface of deciduous molars. Eighty teeth were randomly distributed into 4 groups according to the caries removal method: Er:YAG laser (250 mJ/4 Hz) or bur and dentin surface treatment: 2.5% chitosan solution or distilled water. The bacterial load of caries-affected dentin was quantified by counting CFU/mg (n = 10). The teeth were restored and evaluated at 7 days, 6 months, and 12 months using modified USPHS criteria (n = 20). Microbiological data was analyzed by Mann-Whitney and clinical analyses were done using Kruskal-Wallis and Dunn test (α = 0.05). The results showed that the Er:YAG laser significantly reduced the amount of Streptococcus mutans (p = 0.0068). After dentin treatment with chitosan, there was a significant reduction in the amount of Streptococcus mutans for both removal methods (p = 0.0424). For the retention and secondary caries criteria, no significant differences were observed along the evaluated time (p > 0.05). The laser-treated group was rated "bravo" for discoloration (p = 0.0089) and marginal adaptation (p = 0.0003) after 6 and 12 months compared to baseline. The Er:YAG laser reduced the amount of Streptococcus mutans and the chitosan showed an additional antibacterial effect. After 1 year, the Er:YAG laser-prepared teeth, regardless of the dentin treatment, showed greater discoloration and marginal adaptation of the restorations.
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Affiliation(s)
- Rai Matheus Carvalho Santos
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Renata Siqueira Scatolin
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, Ribeirão Preto, São Paulo, S/N, 14040-904, Brazil
| | - Sérgio Luiz de Souza Salvador
- Department of Clinical Toxicology and Bromatology of the School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Aline Evangelista Souza-Gabriel
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, Ribeirão Preto, São Paulo, S/N, 14040-904, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, Ribeirão Preto, São Paulo, S/N, 14040-904, Brazil.
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Marković L, Ivanišević A, Matijević J, Chan RSM, Tsoi JKH, Šnjarić D, Gjorgievska E. Micro-CT analysis and leakage of bioceramic retrofillings after ultrasonic and Er:YAG laser cavity preparations: an in vitro study. Lasers Med Sci 2023; 38:145. [PMID: 37347307 DOI: 10.1007/s10103-023-03809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
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.
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Affiliation(s)
| | - Ana Ivanišević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Jurica Matijević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Rosalind Sin Man Chan
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, SAR, Hong Kong, People's Republic of China
| | - James Kit Hon Tsoi
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, SAR, Hong Kong, People's Republic of China
| | - Damir Šnjarić
- Department for Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Elizabeta Gjorgievska
- Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, University "Ss Cyril and Methodius" Skopje, Skopje, Republic of Macedonia
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Wei D, Nakamoto A, Hiraishi N, Nakane A, Abuna G, Otsuki M, Shimada Y. Effect of Er: YAG laser irradiation with additional low energy on resin-dentin bonding and morphology of bonded interface. J Mech Behav Biomed Mater 2023; 140:105692. [PMID: 36753849 DOI: 10.1016/j.jmbbm.2023.105692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To examine the micro tensile bond strength (μTBS) and the resin-dentin interface on a laser-irradiated dentin surface using two different irradiation methods, with or without additional low-energy irradiation. METHODS The flat bovine dentin surface was divided into three groups: i). control group (C group, no irradiation), ii) 80 mJ/pulse Er: YAG laser group (80 group), iii) 80 + 30 mJ/pulse Er: YAG laser group (80 + 30 group, with an additional 30 mJ/pulse). After the roughness of the dentin surface was recorded, Clearfil SE Bond 2 or Clearfil Universal Bond Quick (Kuraray Noritake Dental Inc., Tokyo, Japan) was applied. After the μTBS testing, the failure mode was observed. The bonded interface was assessed using Rhodamine-dye incorporated adhesives and observed by optical coherence tomography. RESULTS The dentin surface showed opened dentinal tubules without a smear layer after irradiation. For both adhesives, the μTBS was significantly higher in 80 + 30 group than in the 80 group (p < 0.05). In the 80 group, the thickness of the adhesive layer was not uniform, and the dentin surface was occasionally in direct contact with the composite resin. The failure mode images showed that most of the fractures in the 80 group were at the sub-surface of irradiated dentin. The adhesive layers of the 80 + 30 groups were homogeneous. CONCLUSIONS The dentin surface was rough and irregular by 80 mJ irradiation, which might result in an inadequate resin-dentin interface and the weak μTBS. The bonded integrity was mitigated by additional irradiation.
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Affiliation(s)
- Diantong Wei
- Department of Cariology and Operative Dentistry, Division of Oral Health Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan
| | - Ayako Nakamoto
- Department of Cariology and Operative Dentistry, Division of Oral Health Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan
| | - Noriko Hiraishi
- Department of Cariology and Operative Dentistry, Division of Oral Health Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan.
| | - Akira Nakane
- Department of Cariology and Operative Dentistry, Division of Oral Health Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan
| | - Gabriel Abuna
- Foundational Sciences Department East Carolina University, Greenville, NC, USA
| | - Masayuki Otsuki
- Department of Cariology and Operative Dentistry, Division of Oral Health Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan
| | - Yasushi Shimada
- Department of Cariology and Operative Dentistry, Division of Oral Health Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan
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Sun G, Chen X, Wei F, Bai T, Zhu S. Effects of Er: YAG, Er,Cr: YSGG, and Nd: YAG laser irradiation and adhesive systems on the immediate and long-term bond strength of dentin: a systematic review and meta-analysis. Lasers Med Sci 2023; 38:32. [PMID: 36595096 DOI: 10.1007/s10103-022-03699-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/23/2022] [Indexed: 01/04/2023]
Abstract
At present, lasers are increasingly used in the oral clinical field, and research and applications in dental hard tissue treatment are also increasing. The effect of laser etching dentin on the bonding strength of composite resin reported in the literature is still inconclusive. The purpose of this review was to evaluate whether laser etching can improve the immediate and long-term bonding strength of dentin and investigate the effect of different types of adhesives on the bonding strength of dentin. Two reviewers performed a literature search up from January 2012 to November 2021 in four databases: MEDLINE (PubMed), Web of Science, EMBASE, and the Cochrane Library. A total of 25 studies were included in the meta-analysis. The Cochrane Collaboration Bias Risk Assessment tool was used to evaluate the quality of the included literature, and an analysis was carried out using Review Manager Software version 5.3. The aging bond strength of dentin after erbium (Er): yttrium aluminum garnet (YAG) laser treatment was significantly lower than that of dentin in the bur group (P < 0.00001). At the same time, the bond strength of dentin immediately and aging after (Er), chromium-doped (Cr): yttrium scandium gallium garnet (YSGG) laser treatment was lower than that of dentin in the bur group (P < 0.05). There was no significant difference in the immediate and aging bonding strength among samples in the Er: YAG laser, Er, Cr: YSGG laser, and blank control groups (no laser or bur). The aging bond strength of samples after neodymium-doped (Nd): YAG laser treatment was higher than that of samples in the blank control group (P < 0.05); in addition, the performance of self-etching adhesive was slightly better than that of acid etching adhesive. Regardless of the applied surface treatment and the adhesive employed, dentin after aging showed significant bond degradation (P < 0.05). There was high heterogeneity of bond strength between different groups, and the small number of studies and the contradictory results may be the main reasons for this outcome.
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Affiliation(s)
- Guangdi Sun
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130012, Jilin, China
| | - Xue Chen
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130012, Jilin, China
| | - Fei Wei
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130012, Jilin, China
| | - Tingting Bai
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130012, Jilin, China
| | - Song Zhu
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130012, Jilin, China.
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, 1500 Qinghua Road, Chaoyang District, Changchun, 130012, Jilin, China.
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Effect of nanosecond- and microsecond-pulse Er,Cr:YSGG laser ablation on dentin shear bond strength of universal adhesives. Lasers Med Sci 2022; 37:3285-3290. [PMID: 35951123 DOI: 10.1007/s10103-022-03625-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
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.
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