Scanning electron microscopic evaluation of resin-dentin interface after Er:YAG laser preparation

BACKGROUND AND OBJECTIVES: The aim of this study was to observe the morphological characteristics of dentin-resin interfaces when a composite resin was bonded to Er:YAG laser irradiated dentin. STUDY DESIGN/MATERIALS AND METHODS: Human dentin surfaces were divided into three equal areas. One third was prepared using a carbide bur and etched with phosphoric acid, the second third was conditioned using an Er:YAG laser, the third one was irradiated and etched. A hybrid composite resin was bonded on dentin surfaces using a single-component adhesive system. Longitudinal sections were exposed to 5 N HCl then to 1% NaOCl. The thickness of the hybrid layer and the dimensions of the resin tags were measured using scanning electron microscopy (SEM) pictures and an image analysis software. RESULTS: When acid etching was performed, a hybrid layer as well as the characteristic funnel-shaped resin tags were observed. When Er:YAG laser was used alone, no hybrid layer could be detected. The resin tags appeared thinner and exhibited a cylindrical shape. CONCLUSIONS: The acid pre-treatment of the irradiated surface allowed both the seal of the dentinal surface and the increase of the diameter of the resin tags.     

Scanning electron microscopic evaluation of enamel and dentin surfaces after Er:YAG laser preparation and laser conditioning

OBJECTIVE: The aim of this study was to observe and evaluate the micro-morphology of enamel and dentin surfaces after Er:YAG laser preparation and conditioning. BACKGROUND DATA: Information regarding micro-morphologic changes of tooth substance as a result of a change of Er:YAG laser parameters for cavity preparation is limited. METHODS: Human enamel and dentin surfaces were irradiated with an Er:YAG laser with the following parameters : (1) energy output: 200 mJ, 250 mJ, 300 mJ, 350 mJ, and 400 mJ; (2) repetition rate: 5 Hz and 10 Hz; (3) pulse duration: 100 mus/VSP (very short pulse); (4) 5 and 10 passes over the surface at a distance of 7 mm, speed: 4 mm/s using a non-contact delivery tip; (5) water cooling: 5 mL/min. The hand piece was fixed in a power driven x-y moving table. Subsequently, half of the samples were laser-conditioned at 100 mJ, 10 Hz, 250 mus/SP (short pulse) for enamel, and 80 mJ, 10 Hz, SP for dentin at a distance of 10 mm. Surface morphology and surface alterations were evaluated using scanning electron microscopy (SEM). RESULTS AND CONCLUSION: SEM evaluation showed the characteristics of Er:YAG-lased enamel and dentin surfaces: irregular enamel surfaces with typical keyhole shaped prisms and rods, and protrusion of dentinal tubules with a cuff-like appearance. Laser conditioning rounded off the sharp edges on the enamel irregularities and dentin surface structures. First signs of vitrification were seen at 250 mJ for enamel samples and 300 mJ for dentin samples. Increase of the pulse repetition rate from 5 Hz to 10 Hz did not result in changes of surface morphology. Laser conditioning did not result in additional vitrification.     

Temperature rise during Er:YAG cavity preparation of primary enamel

This study aimed to assess in vitro thermal alterations taking place during the Er:YAG laser cavity preparation of primary tooth enamel at different energies and pulse repetition rates. Forty healthy human primary molars were bisected in a mesio-distal direction, thus providing 80 fragments. Two small orifices were made on the dentin surface to which type K thermocouples were attached. The fragments were individually fixed with wax in a cylindrical Plexiglass? abutment and randomly assigned to eight groups, according to the laser parameters (n = 10): G1 – 250 mJ/ 3 Hz, G2 – 250 mJ/ 4 Hz, G3 – 250 mJ/ 6 Hz, G4 – 250 mJ/10 Hz, G5 – 250 mJ/ 15 Hz, G6 – 300 mJ/ 3 Hz, G7 – 300 mJ/ 4 Hz and G8 – 300 mJ/ 6 Hz. An area of 4 mm² was delimited. Cavities were done (2 mm long × 2 mm wide × 1 mm thick) using non-contact (12 mm) and focused mode. Temperature values were registered from the start of laser irradiation until the end of cavity preparation. Data were analyzed by one-way ANOVA and Tukey test (p ≤ 0.05). Groups G1, G2, G6, and G7 were statistically similar and furnished the lowest mean values of temperature rise. The set 250 mJ/10 and 15 Hz yielded the highest temperature values. The sets 250 and 300 mJ and 6 Hz provided temperatures with mean values below the acceptable critical value, suggesting that these parameters ablate the primary tooth enamel. Moreover, the temperature elevation was directly related to the increase in the employed pulse repetition rates. In addition, there was no direct correlation between temperature rise and energy density. Therefore, it is important to use a lower pulse frequency, such as 300 mJ and 6 Hz, during cavity preparation in pediatric patients.     

Effects of Er:YAG laser and Nd:YAG laser treatment on the root canal dentin of human teeth: a SEM study

The objective of the study was to observe the morphological changes on root canal dentin after Er:YAG laser and Nd:YAG laser treatment. Twenty-one teeth biomechanically prepared were divided into three groups with seven teeth of each. Group A was unlased as a control. In group B, Er:YAG laser and in group C, Nd:YAG laser was applied to the root canal dentin. The roots were split longitudinally and examined using a scanning electron microscopy for the evaluation of debris, smear layer, and recrystallization. There was no statistically significant difference between the groups. This study indicates that laser beam is not effective in removing debris and smear layer.     

Scanning electron microscopy of microarterial anastomoses with the argon laser

A carotid end-to-end anastomosis was performed in 50 Wistar rats (mean weight 260 g) by means of a Coherent 900 argon laser. Laser pulses (average 19) of 300 mW power and 5 s exposure time were used, the beam being focused to form a spot of 150 m diameter. From day 0 to day 210, 13 specimens underwent scanning electron microscope examination. The results show that the laser impact produces a wall injury of 100 m in width with some coagulative necrosis of the media and adventitia. The line of anastomosis became re-endothelialized within four days, at which time collagen fusion was observed in the subendothelial layers. The longitudinal arrangement of the endothelial cells was restored by day 10. In the long term, a thick collagenous meshwork maintained the strength of the media, while normal endothelium covered the anastomosis. Complications such as disruption and aneurysm formation were attributed to technical problems.

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Résumé Anastomoses micro-artérielles au laser argon: étude en microscopie électronique à balayage. Les auteurs réalisent au laser Argon (Coherent 900) une anastomose carotidienne terminoterminale sur une série de 50 rats Wistar de poids moyen de 260 g. Les impacts laser (en moyenne 19) sont de 300 mW de puissance et d'une durée de 5 s chacun, avec un point de focalisation de 150 m de diamètre. On réalise sur 13 spécimens un examen en microscopie électronique à balayage. L'impact laser induit sur la paroi artérielle une lésion de 100 m de large avec une légère nécrose de coagulation de la media et de l'adventice. La ligne de suture est re-endothélialisée dès le quatrième jour, alors qu'une fusion du collagène est observée dans les couches sousendothéliales. L'arrangement longitudinal des cellules endothéliales est retrouvé dés le dixième jour. A long terme, un réseau collagénique serré assure la résistance de la media et un endothélium normal recouvre la ligne de soudure. Les complications tel que lâchage ou anéurysmes doivent être attribuées aux inconvénients techniques du début de l'expérimentation.

     

Scanning electron microscopy investigation of PMMA removal by laser irradiation (Er:YAG) in comparison with an ultrasonic system and curettage in hip joint revision arthroplasty

The cement often left in the femur socket during hip joint revision arthroplasty is usually removed by curettage. Another method for removing the cement is to use an ultrasonic system, and yet another alternative may be to use a laser system. The aim of these investigations was to determine the pulse rate and pulse energy of the Er:YAG laser for sufficient cement ablation. We also compared the results obtained using the laser with those obtained using an ultrasonic device or curettage by histological and scanning electron microscopy (SEM) investigation of the border zone between the polymethyl methacrylate (PMMA) and unfixed specimens of femoral bone. Therefore we prepared 30 unfixed human femur stems after hip joint replacement and prepared ten sagittal sections from each femur stem (in total 300 sections). Of these 300 specimens, 180 were treated with the Er:YAG laser, 60 with the ultrasonic system and 60 by curettage. The high pulse energy of 500 mJ and a pulse rate of 4 Hz provided the highest PMMA ablation rate, although the boundary surface between PMMA and femoral bone was not as fine-grained as found in samples treated at 15 Hz and 250 mJ. However, the treatment time for the same cement ablation rate with the latter settings was twice that at 4 Hz and 500 mJ. Compared to the boundary surfaces treated with the ultrasonic device or curettage, the laser-treated samples had a more distinct undifferentiated boundary surface between PMMA and femoral bone. After development of the Er:YAG-laser to provide higher pulse energies, it may in the future be an additional efficient method for the removal of PMMA in revision arthroplasty. The Er:YAG laser should be combined with an endoscopic and a rinsing suction system so that PMMA can be removed from the femoral shaft under direct vision.     

Microleakage of Er:YAG laser and dental bur prepared cavities in primary teeth restored with different adhesive restorative materials

The purpose of this study was to evaluate and compare the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation and conventional dental bur cavity preparation on in vitro microleakage of class V cavities restored with different adhesive restorative materials and two types of self-etching adhesives in primary teeth. Standard class V cavities were prepared on 80 extracted primary, and the teeth were randomly divided into eight subgroups prepared either by dental bur or Er:YAG laser irradiation and then restored with self-cured glass ionomer (GI), resin-modified glass ionomer (RMGI), resin composite and Clearfil SE Bond (two-step self-etching adhesive), and resin composite and Clearfil S3 Bond (one-step self-etching adhesive). Restorations were finished and stored in distilled water at 37 °C for 24 h and then subjected to thermocycling. All the teeth were sealed with nail varnish, placed in a silver nitrate solution, and then vertically cut in a buccolingually direction. Subsequently, the specimens were evaluated for gingival and occlusal microleakage using a stereomicroscope. Data were analyzed using Kruskal–Wallis test followed by Mann–Whitney test. Wilcoxon test was used for comparing occlusal microleakage with gingival microleakage at p?<?0.05. A higher degree of occlusal and gingival microleakage values for the teeth restored with GI or RMGI was obtained by both preparation methods compared with that of resin composites and the two self-etching primers. Er:YAG laser irradiation resulted in a significantly higher degree of microleakage only at the gingival margins for teeth restored with GI or RMGI, or composite and Clearfil S3 Bond compared with the bur preparation. The Er:YAG laser-prepared teeth restored with composite and Clearfil SE Bond demonstrated a better marginal seal on occlusal and gingival margins compared with that of bur-prepared cavities. The degree of microleakage in class V cavities was affected by the type of adhesive restorative materials, type of self-etching adhesive, cavity margin location, and tooth preparation method either by Er:YAG laser or dental bur.     

Modulating the Er:YAG laser

BACKGROUND AND OBJECTIVES: In the past 2 years, there has been some controversy about the optimal laser system, or combination of systems, for cutaneous resurfacing. Initially, it seemed that the Er:YAG laser would have significant advantages over the CO(2) laser. In practice, some of those who jumped early onto the Er:YAG bandwagon have been unimpressed with the degree of skin tightening that can be achieved with this system. Also, the excessive bleeding induced by the Er:YAG lasers prevented deeper vaporization. During the past 18 months, three new "modulated" Er:YAG lasers have been produced that are said to be able to achieve CO(2) laser-like effects, while maintaining the Er:YAG laser advantages. The purpose of this article is to examine these new systems and to discuss their potential benefits, if any, over the "conventional" Er:YAG lasers, and the CO(2) lasers. STUDY DESIGN/MATERIALS AND METHODS: The author has collected data from his own experience and that of his colleagues in the department of dermatology at University of California at San Francisco. The author has used all three types of modulated Er:YAG laser on patients presenting for cosmetic laser resurfacing and the treatment of many benign conditions over an 18-month period. RESULTS: All three modulated forms of Er:YAG lasers have been demonstrated to provide better coagulation than the conventional Er:YAG lasers. The Derma-K and the Contour Er:YAG lasers were able to induce tissue contraction/desiccation similar to the CO(2) laser. The author and his colleagues have induced only two cases of permanent hypopigmentation in over 50 cases during the past 18 months while using the Er:YAG laser, significantly less than might be expected with the CO(2) lasers. CONCLUSIONS: If a laser surgeon is happy with the results obtained with a high-energy, short-pulse CO(2) laser, then there seems little reason to consider changing to an Er:YAG laser. The modulated Er:YAG lasers have definite advantages over the conventional Er:YAG lasers. They exhibit better control of hemostasis and can ablate tissue to a greater depth than the conventional Er:YAG lasers. The Er:YAG lasers might induce less permanent hypopigmentation than the CO(2) lasers.     

Cartilage shaping using the Er:YAG laser: preliminary report

Cartilage grafts have been widely used for reconstruction of congenital or acquired deformities. Reshaping and preserving the new shape of the cartilage grafts have been a problem. In this in vitro experimental study the authors studied the effect of the Er:YAG laser on cartilage reshaping in comparison with scalpel stripping and suture holding. The study consisted four groups (n = 9): group I, untouched cartilage; group II, the short edges of the cartilage were sutured to each other; group III, cartilage was incised using a scalpel; and group IV, Er:YAG laser stripping was applied to the cartilage. Changes in the shape of cartilage were evaluated at 15 minutes, and days 1, 4, and 10. The majority of cartilage in the scalpel-stripped group returned to the initial shape by day 10, whereas the laser-stripped cartilage showed progressive warping day by day, and almost all cartilage formed a circle by day 10. The Er:YAG laser enhanced cartilage warping by a mechanical effect of stripping and a thermal effect of laser radiation resulting in ultrastructural changes.     

Scanning electron microscopy study of the lung

The pulmonary parenchyma is characterized by a marked development of blood-tissue and gaz-tissue interfaces. Thus the study of the lung is easy by scanning electron microscopy. Numerous and various technics of sample preparation are described and discussed. They permit to carry out morphological and morphometrical studies of fine structures in the adult and foetal lung surface. The systematisation of the different parts of the pulmonary air tract (bronchi, bronchioli, alveolar ducts and alveoli) is analysed. The different epithelial cells are characterized by their apical differentiations and by their often specific localization. Bronchial (mucus), bronchiolar and alveolar (surfactant) secretions are studied after different fixations. The observation of the vascular network (arteries, veins and pulmonary capillaries) is performed after vascular injection of fixator liquid. The scanning electron microscope is also used to study the alveolar macrophage (in situ or in cell culture), the visceral surface of pleura, the pre and post-natal development of the lung parenchyma. The SEM is a complementary and modern method of lung observation. It gives a dynamic view of the fine structure of lung surfaces, which appears needful for the study of the local histophysiological processes.