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

Introduction: The aim of this study was to assess the effect of surface treatment with erbium: yttrium-aluminum-garnet (Er:YAG) and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers on shear bond strength of composite resin to recently bleached dentin.Methods: In this study, 40 extracted human premolars were selected. The teeth were cut 4 mm apical to the cusp tip and were randomly divided into four groups (n = 10 in each group) for shear bond strength testing. For bleaching, 35% hydrogen peroxide (H2o2) gel (Opalescence Endo, Ultradent, South Jordan, UT, USA) was applied to dentin surfaces of all specimens for 10 days. Before etching and bonding, in Er,Cr:YSGG and Er:YAG laser groups, dentin surfaces were irradiated with Er,Cr:YSGG and Er:YAG lasers, respectively. In Er,Cr:YSGG group, Er:YAG group and control group, composite restoration was performed immediately after bleaching while in common procedure group, composite restoration was performed after seven days. The teeth were then subjected to shear bond strength testing machine. The data were statistically analyzed using analysis of variance (ANOVA) and Tukey test.Results: The mean and standard deviation (SD) of shear bond strength was 4.3 ± 1.4 MPa for control group, 6.7 ± 2.0 Mpa for Er,Cr:YSGG group, 14.4 ± 3.7 Mpa for Er:YAG group and 19.4 ± 2.6 Mpa for common procedure group.Conclusion: The shear strength of composite to Er:YAG laser-treated bleached dentin was significantly higher than control group while significantly lower than common procedure

In Vitro Comparison of Diagnostic Accuracy of DIAGNOdent and Digital Radiography for Detection of Secondary Proximal Caries Adjacent to Composite Restorations

Introduction: Early detection of secondary proximal caries is critical for the preservation of tooth vitality. This study sought to assess and compare the diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations.Methods: Sixty extracted molars including 30 teeth with carious lesions and 30 sound teeth were randomly selected. Class II cavities were prepared in all teeth and carious dentin was intentionally left in the gingival floor of cavities in 30 carious teeth. All cavities were restored with composite resin. The teeth were mounted in wax blocks (three teeth per block) and examined for caries using (DIAGNOdent kaVo Dental, Biberach, Germany). Digital radiographs using DIGORA photostimulable phosphor (PSP) plates (Soredex Corporation, Helsinki, Finland) were obtained from all teeth using the parallel technique and were evaluated by 4 observers. Repeated measure analysis of variance (ANOVA) was applied to calculate sensitivity and specificity values of the two diagnostic techniques. Receiver operating characteristic (ROC) curve was plotted for DIAGNOdent results and based on that, the cutoff points were determined.Results: The sensitivity and specificity values at the cut-off point of 10.5 were 0.622 ± 0.038 and 0.822 ± 0.077 for DIAGNOdent and 0.591 ± 0.093 and 0.891 ± 0.083 for digital radiography, respectively. The area under the ROC curve was 0.7 for DIAGNOdent. Weighted kappa revealed moderate to almost perfect intra-observer agreement (0.46-0.99). Intraclass correlation coefficient (ICC) for DIAGNOdent was calculated to be 0.88.Conclusion: No statistically significant difference was noted in diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations. Thus, DIAGNOdent may be used as an adjunct diagnostic tool for detection of secondary proximal caries beneath composite restorations

Microshear Bond Strength of a Self-adhesive Composite to Erbium Laser-Treated Primary Enamel

Introduction: Advances have been made in the composition of flowable composites in recent years and self-adhering composites, which do not require a bonding agent, have recently been introduced to the market. This study aimed to assess the microshear bond strength (μSBS) of a self-adhering flowable composite (Vertise) to primary enamel treated with a graphite disc with silicon carbide particles (SIC) and laser irradiation, the result of which was compared to that of a conventional flowable composite (Premise).Methods: In this in vitro, experimental study, 72 samples of sound primary enamel were evaluated. A smooth enamel surface was obtained using a graphite disc. Next, the erbium chromium yttrium scandium gallium garnet (Er,Cr:YSGG) laser was used for enamel surface treatment in half of the samples (n = 36). All the samples were then randomly divided into 4 groups of (i) Premise flowable composite (PF) without laser (n = 18), (ii) Vertise flowable composite (VF) without laser (n = 18), (iii) PF with laser (n = 18), and (iv) VF with laser (n = 18). The teeth were then incubated at 37°C for 24 hours and were then subjected to thermocycling. The μSBS of samples was measured using a universal testing machine and reported in megapascal (MPa). Data were analyzed using SPSS via the two-way ANOVA and independent-samples t test at P < 0.05.Results: The mean μSBS of VF was significantly higher to the laser-treated samples (13.60 ± 5.47) compared with the non-treated samples (5.89 ± 2.42) (P < 0.001). However, no significant difference was noted in the μSBS of PF to the laser-treated (13.18 ± 3.45) and non-treated samples (16.06 ± 3.52) (P = 0.058).Conclusion: The μSBS of the conventional flowable composite is higher than that of the self-adhering flowable composite to the enamel of primary teeth. Enamel surface treatment with laser irradiation increases the μSBS of self-adhering flowable composites

Cavity Preparation by Laser in Primary Teeth: Effect of 2 Levels of Energy Output on the Shear Bond Strength of Composite Restoration to Dentin

Introduction: One of the main applications of laser in dentistry is the removal of dental caries and preparation of restorative cavities. The morphology and wettability of laser prepared surfaces are different from that of those prepared with conventional method which may affect the quality of the adhesive potential of bonding agents in these surfaces. This study aimed to assess the shear bond strength of a total-etch and self-etch adhesive system to primary tooth dentin prepared by two different energy densities of Er:YAG laser in comparison with surfaces prepared by bur.Methods: A total of 60 human primary second molars extracted for orthodontic purposes were selected and randomly divided into 3 main groups of equal (n = 20). Group A: Preparation of dentin surface by bur; group B: Preparation of dentin surface by laser with 300 mJ energy level; group C: Preparation of dentin surface by laser with 400 mJ energy level. In each of the main groups, the teeth were randomly assigned to 2 subgroups. Composite resin material was bonded with the total-etch adhesive system in subgroups A1, B1, and C1 and with the self-etch adhesive system in subgroups A2, B2, and C2. The samples were thermo-cycled, and composite restorations shear bond strength was measured in MPa. Data were analyzed using two-way analysis of variance (ANOVA), and P values less than 0.05 were considered statistically significant.Results: The highest and the lowest shear bond strength values were observed in group A2 (Preparation by bur- Composite resin material bonded by Clearfil SE Bond) and group C2 (Preparation by laser with 400 mJ energy level - Composite resin material bonded by Clearfil SE Bond), respectively. The results showed no statistically significant differences between the study subgroups (P > 0.05).Conclusion: It is concluded that in terms of shear bond strength to dentin, Single Bond and Clearfil SE Bond adhesive agents adequately perform in primary tooth dentin prepared by Er: YAG laser with energy levels of 300 and 400 mJ and frequency of 10 Hz

Evaluation of the Diode laser (810nm,980nm) on dentin tubule diameter following internal bleaching

Background: The aim of this study was to evaluate the effect of diode laser irradiation and bleaching materials on the dentinal tubule diameter after laser bleaching. Material and Methods: The dentin discs of 40 extracted third molar were used in this experiment. Each disc surface was divided into two halves by grooving. Half of samples were laser bleached at different wavelengths with two different concentrations of hydrogen peroxide. Other half of each disc with no laser bleaching remained as a negative control. Dentin discs were assigned randomly into four groups (n=10) with following hydrogen peroxide and diode laser wavelength specifications; Group 1 (30% - 810 nm), group 2 (30% - 980 nm), group 3 (46% - 810 nm) and group 4 (46% - 980 nm). All specimens were sent for scanning electron microscopic (SEM) analysis in order to measure tubular diameter in laser treated and control halves. Data were analyzed by ANOVA and Tukey test (p<0.05). Results: A significant reduction in dentin tubule diameter was observed in groups 1, 2 and 4. There was no significant difference between groups 1 and 2 and between groups 3 and 4 after bleaching. Conclusions: The SEM results showed that diode laser was able to reduce dentin tubule diameter and its effect on dentin was dependent on chemical action of bleaching material

Effect of thermocycling and surface treatment on repair bond strength of composite

Repair of composite restorations is a conservative method that can increase the longevity and durability of restorations while preserving the tooth structure. Achieving a suitable bond between the old and new composite is difficult. To overcome this problem, some methods have been recommended to increase the repair bond strength of composite.This study aimed to assess the effect of aging by thermocycling (5,000 and 10,000 cycles) and mechanical surface treatments (Er,Cr:YSGG laser and bur) on repair shear bond strength of composite resin. Totally, 120 composite blocks measuring 6x4x4 mm were fabricated of Filtek Z250 composite and were randomly divided into three groups (n=40) based on initial aging protocol: (a) no aging: storage in distilled water at 37°C for 24 hours, (b) 5,000 thermal cycles, (c) 10,000 thermal cycles. Each group was then randomly divided into two subgroups (n=20) based on mechanical surface treatment (laser and bur). The laser and bur-prepared surfaces were silanized and Adper Single Bond 2 was then applied. The repair composite was bonded to surfaces. Half of the samples in each subgroup (n=10) were subjected to 5,000 thermal cycles to assess durability of bond. The remaining half were stored in distilled water at 37°C for 24 hours and all samples were then subjected to shear bond strength testing in a universal testing machine with a crosshead speed of 1mm/min. Data (in megapascals) were subjected to one-way ANOVA and Tukey?s test (P=0.05). Mode of failure was determined under a stereomicroscope. Bur preparation significantly improved the bond strength compared to laser (P<0.001). Aging by 10,000 thermal cycles significantly decreased the repair bond strength of composite (P<0.001). No significant difference was noted in this regard between distilled water and 5,000 thermal cycles groups (P=0.699). Primary bond strength and bond strength after 5,000 thermal cycles in the same subgroups were not significantly different either (P=0.342). Aging by 10,000 thermal cycles significantly decreases the repair bond strength of composite and surface preparation by bur provides a higher bond strength compared to laser

Effect of organic acids in dental biofilm on microhardness of a silorane-based composite

Objectives This study evaluated the effect of lactic acid and acetic acid on the microhardness of a silorane-based composite compared to two methacrylate-based composite resins. Materials and Methods Thirty disc-shaped specimens each were fabricated of Filtek P90, Filtek Z250 and Filtek Z350XT. After measuring of Vickers microhardness, they were randomly divided into 3 subgroups (n = 10) and immersed in lactic acid, acetic acid or distilled water. Microhardness was measured after 48 hr and 7 day of immersion. Data were analyzed using repeated measures ANOVA (p < 0.05). The surfaces of two additional specimens were evaluated using a scanning electron microscope (SEM) before and after immersion. Results All groups showed a reduction in microhardness after 7 day of immersion (p < 0.001). At baseline and 7 day, the microhardness of Z250 was the greatest, followed by Z350 and P90 (p < 0.001). At 48 hr, the microhardness values of Z250 and Z350 were greater than P90 (p < 0.001 for both), but those of Z250 and Z350 were not significantly different (p = 0.095). Also, the effect of storage media on microhardness was not significant at baseline, but significant at 48 hr and after 7 day (p = 0.001 and p < 0.001, respectively). Lactic acid had the greatest effect. Conclusions The microhardness of composites decreased after 7 day of immersion. The microhardness of P90 was lower than that of other composites. Lactic acid caused a greater reduction in microhardness compared to other solutions