Laser Aided Ceramic Restoration Removal: A Comprehensive Review

Introduction: All-ceramic restorations are being widely used due to its various advantages. However, they have restricted durability and may have to be removed. The conventional procedure for removal is grinding the restoration with rotary instruments which are considered time-consuming and inconvenient. A newer advantageous method is the application of lasers for debonding ceramics from the tooth surface. The objective of this study is to provide a comprehensive literature review on laser-aided ceramic restorations debonding.Methods: We searched PubMed and Google Scholar databases. Seven articles from 2011 to 2018 were identified. Studies were assessed for the efficacy of laser application and the amount of pulpal temperature rise.Results: Studies selected were categorized according to variables including shear bond strength, debonding time and intrapulpal temperature. Oztoprak and Iseri investigated that erbium-doped yttrium, aluminum, and garnet (Er:YAG) laser application reduced shear bond strength of ceramic laminate veneers. The time of debonding took an average of 190 seconds in Rechmann’s study and 106 seconds in Morford’s study. One of the main issues while using the laser is thermal irritation of the pulp. A 5.5°C temperature increase may cause pulpal damage according to Zach and Cohen. Philips et al and Rechmann et al reported no intrapulpal harm due to temperature increase. Additionally, Phillips et al demonstrated that the laser setting affects both the debonding time and the temperature alterations and that a laser adjustment of 2.5 W/25 Hz would be the best safest group.Conclusion: Removal of ceramic crowns and veneers from tooth surfaces can be successfully done by Er:YAG laser application in a less time-consuming procedure and without any harm to the underlying dentin. However, a temperature rise in the pulp may occur which could be overcome by adequate air water cooling

Scanning Electron Microscope (SEM) Evaluation of Tooth Surface Irradiated by Different Parameters of Erbium: Yttrium Aluminium Garnet (Er:YAG) Laser

INTRODUCTION: The aim of this study was to investigate the Scanning Electron Microscope (SEM) analysis of tooth surface irradiated by different parameters of Er:YAG laser.METHODS: 15 caries-free extracted human third molars were used in this study. The teeth were put into 5 groups for laser irradiation as follows: Group 1 (power: 2.5 W, Energy: 250 mJ); Group 2(power: 3 W, Energy: 300 mJ); Group 3 (power: 3.5 W, Energy: 350 mJ); Group 4 (power: 4 W, Energy: 400 mJ); Group 5 (power: 4.5 W, Energy: 450 mJ). All samples were prepared by repetition rate of 10 Hz. Then,the samples were prepared for SEM examination.RESULTS: The SEM images showed cleaned ablated surface and exposed dentinal tubules, without production of smear layer.CONCLUSION: It can be concluded that Er:YAG laser can be an alternative technique for surface treatment and can be considered as safe as the conventional methods,like turbine and bur

Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods

Introduction: Today the prevalence of teeth decays has considerably decreased. Related organizations and institutions mention several reasons for it such as improvement of decay diagnostic equipment and tools which are even capable of detecting caries in their initial stages. This resulted in reduction of costs for patients and remarkable increase in teeth life span. There are many methods for decay diagnostic, like: visual and radiographic methods, devices with fluorescence such as Quantitative light-induced fluorescence (QLF), Vista proof, Laser fluorescence (LF or DIAGNOdent), Fluorescence Camera (FC) and Digital radiography. Although DIAGNOdent is considered a valuable device for decay diagnostic, there are concerns regarding its efficacy and accuracy. Considering the sensitivity of decay diagnosis and the exorbitant annual expenses supported by government and people for caries treatment, finding the best method for early caries detection is of the most importance. Numerous studies were performed to compare different diagnostic methods with conflicting results. The objective of this study is a comparative review of the efficiency of DIAGNOdent in comparison to visual methods and radiographic methods in the diagnostic of teeth occlusal surfaces.Methods: Search of PubMed, Google Scholar electronic resources was performed in order to find clinical trials in English in the period between 1998 and 2013. Full texts of only 35 articles were available.Conclusion: Considering the sensitivity and specificity reported in the different studies, it seems that DIAGNOdent is an appropriate modality for caries detection as a complementary method beside other methods and its use alone to obtain treatment plan is not enough

Effect of Fibroblast Growth Factor 2 and Low-Level Laser Therapy on the Adhesion and Proliferation of Periodontal Ligament Stem Cells: Effect of FGF2 and LLLT on PDLSCs adhesion

Introduction: The adhesion ability of mesenchymal stem cells can significantly affect their viability and is considered a prerequisite for cell therapy. The current study sought to evaluate the effect of fibroblast growth factor 2 (FGF2) and low-level laser therapy (LLLT), either individually or in conjunction, on the adhesion and proliferation of periodontal ligament stem cells (PDLSCs) when applied on the first day of cell seeding.Methods: The experimental groups of this study comprised a control group and different combinations of adjunctive FGF2 (50 ng/mL) and LLLT with an 808 nm diode laser in one (LLLT1) or two sessions (LLLT-2) of irradiation. The proliferation and adhesion of cells were evaluated by using the methylthiazolyl tetrazolium (MTT) assay and 4′,6-diamidino-2-phenylindole (DAPI) staining. All experiments were done in triplicates on the first, third, and fifth days after cell seeding. Two-way ANOVA and post hoc Tukey tests were used to analyze the data of the MTT assay. P<0.05 was considered statistically significant.Results: One-day post-culture, only significant differences were found between the control group and the FGF2 (P=0.04) and FGF2+LLLT-2 application (P=0.04) groups. After three days post-cell culture, only a significantly higher proliferation rate was found in the control group than in the FGF2 group (P=0.01). After five days, the control group and LLLT-2 groups showed significantly higher amounts of proliferation compared to the other groups (P<0.05). DAPI staining qualitatively confirmed the results of the MTT assay.Conclusion: The LLLT can be applied to PDLSCs on the day of seeding without causing a notable decrease in their viability and adhesion. Conversely, the administration of FGF2 should be restricted on the seeding day and postponed to subsequent days as it may have adverse effects on their adhesion and proliferation

Local and Systemic Administration of Mesenchymal Stem Cells in Regeneration of Mandibular Defects: An Experimental Study

Introduction: Mesenchymal stem cells (MSCs) have been utilized as an aid in regeneration of bone defects however due to the poor homing ability via systemic injection, local administration, genetic manipulation has been used more. The present study aimed to compare the local and systemic application of MSCs in regeneration of bone defects. Materials and Methods: Sixty Wistar male rats were used in this study. Circular 5×5 mm bone defects were created in the angle of the mandible. Autogenous bone marrow mesenchymal stem cells (BMMSCs) were obtained and culture expanded. Green fluorescent positive (GFP+) transfection has been performed for the possible detection of the cells in the healed bone. The rats were randomly treated in four groups; 1. Beta tricalcium phosphate (β-TCP) scaffold seeded with MSC (β-TCP+MSC), 2. Intravenous MSC injection with β-TCP scaffold in the defect (MSC), 3. β-TCP without cell therapy (β-TCP) and 4. Control defects that left empty. The rats were euthanized after 8 weeks. New bone formation (BF) were investigated by hematoxylin and eosin staining. Results: Localized cell therapy (β-TCP+MSC group) showed the highest healing rate (BF= 54.05±2.39%) followed by MSC systemic injection (BF= 22.69±3.87%) (P≤0.05). Inflammatory cells infiltration was evident dominantly in systemic injection cell group. Immunohistchemical analysis showed existence of the MSCs around the defects. GFP+ cells were mainly detected in the defect in β-TCP+MSC group while few GFP+ cells were detected in the MSC systemic group. Conclusion: local application of the MSCs with synthetic scaffold showed better results than intravenous administration of MSCs in treatment of rat mandible bone defects.&nbsp