Effect of different surface treatments on roughness of IPS Empress 2 ceramic

The aim of this study was to evaluate the influence of different surface treatments (air abrasion, acid etching, laser irradiation) on the surface roughness of a lithium-disilicate-based core ceramic. A total of 40 discs of lithium disilicate-based core ceramic (IPS Empress 2; Ivoclar Vivadent, Schaan, Liechtenstein) were prepared (10 mm in diameter and 1 mm in thickness) according to the manufacturer’s instructions. Specimens were divided into four groups (n = 10), and the following treatments were applied: air abrasion with alumina particles (50 μm), acid etching with 5% hydrofluoric acid, Nd:YAG laser irradiation (1 mm distance, 100 mJ, 20 Hz, 2 W) and Er:YAG laser irradiation (1 mm distance, 500 mJ, 20 Hz, 10 W). Following determination of surface roughness (R_a) by profilometry, specimens were examined with atomic force microscopy. The data were analysed by one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). One-way ANOVA indicated that surface roughness following air abrasion was significantly different from the surface roughness following laser irradiation and acid etching (P < 0.001). The Tukey HSD test indicated that the air abrasion group had a significantly higher mean value of roughness (P < 0.05) than the other groups. No significant difference was found between the acid etching and laser irradiation (both Er:YAG and Nd:YAG) groups (P > 0.05). Air abrasion increased surface roughness of lithium disilicate-based core ceramic surfaces more effectively than acid-etching and laser irradiation.     

Long-term effects of a single application of a water-cooled pulsed Nd:YAG laser in supplement to scaling and root planing in patients with periodontal inflammation

The aim of this work was to investigate the long-term effects of a single application of a water-cooled pulsed neodymium yttrium aluminium garnet (Nd:YAG) laser, in combination with scaling and root planing (SRP) for the treatment of periodontal inflammation. Twenty-two patients were included in this split-mouth single blind randomized controlled clinical trial. The parameters of the air and water-cooled Nd:YAG laser were: 4 W, 80 mJ/pulse, 50 Hz and a pulse width of 350 μs. The “test side” was treated with a single application of Nd:YAG laser and SRP; while the “control side ” was treated with SRP alone. At baseline, and after a median follow-up time of 20 months (range 12–39), periodontal inflammatory parameters (plaque index [PI], gingival index [GI], probing pocket depth [PPD]), and marginal bone loss (on digital bite-wing radiographs) were measured. Gingival crevicular fluid (GCF) was collected from the teeth 35, 36, 45, and 46 at baseline and at follow-up. Pl (p < 0.01), GI (p < 0.01), and PPD (p < 0.001) were significantly lower on the test side compared to the control side at follow-up. Radiological results showed significantly less bone loss on the test side compared to the control side (p < 0.05). GCF volume was lower on the test side compared to the control side (p < 0.01). In conclusion, a single application of Nd:YAG laser in combination with SRP had a positive long-term effect on periodontal health compared to treatment by SRP alone.     

Comparative evaluation of the effects of Nd:YAG and Er:YAG laser in dentin hypersensitivity treatment

Dentin hypersensitivity (DH) is one of the most common complications that affect patients after periodontal therapy. So far, many investigators have successfully used different types of laser on DH treatment. The aim of this study was to evaluate the comparative effect of Nd:YAG laser and Er:YAG laser on human teeth desensitization. A group of nine patients with a total of 63 chronic hypersensitive teeth were selected. Each one of them should at least have three hypersensitive teeth. These teeth were randomly allocated into three groups. Group 1, Nd:YAG laser (1 W, 15 Hz, 60 s, two times); group 2, Er:YAG laser (100 mJ, 3 Hz, 60 s, two times); and group 3 serves as control group without any treatment. Assessment of pain was performed by a visual analysing scale (VAS) after stimulation of sensitive tooth by using the sharp tip of an explorer. This test was performed before treatment, immediately after that and at 1-, 3- and 6-month intervals after treatment by one blinded examiner. Analysis of VAS score between the three groups at the time of treatment did not show any significant difference (p = 0.506). However, by using repeated-measurement analysis of variance test, significant differences were seen in the three groups between before-treatment VAS score and after treatment (p < 0.0005). This statistically significant difference in the control group demonstrated a placebo effect. However, the effect of using Nd:YAG and Er:YAG lasers was stronger than this placebo effect, so that after removing the effect of the placebo, differences immediately after, 1, 3 and 6 months post treatment between all three groups still were statistically highly significant (p < 0.0005). Compared to the Er:YAG laser group, using Nd:YAG laser resulted in a significant reduction of VAS score at each follow-up examination (p < 0.0005). Although using Nd:YAG and Er:YAG laser in desensitization of hypersensitive teeth showed a placebo effect limited to a short time, results of this study demonstrated that both of these lasers have an acceptable therapeutic effect. The observed effects seemed to last for at least 6 months. It was concluded that Nd:YAG laser is more effective than Er:YAG laser in reduction of patients’ pain.     

Effect of different surface treatments on tensile bond strength of silicone-based soft denture liner

Failure of the bond between the acrylic resin and resilient liner material is commonly encountered in clinical practice. The purpose of this study was to investigate the effect of different surface treatments (sandblasting, Er:YAG, Nd:YAG, and KTP lasers) on tensile bond strength of silicone-based soft denture liner. Polymethyl methacrylate test specimens were fabricated and each received one of eight surface treatments: untreated (control), sandblasted, Er:YAG laser irradiated, sandblasted + Er:YAG laser irradiated, Nd:YAG laser irradiated, sandblasted + Nd:YAG laser irradiated, KTP laser irradiated, and sandblasted + KTP laser irradiated. The resilient liner specimens (n = 15) were processed between two polymethyl methacrylate (PMMA) blocks. Bonding strength of the liners to PMMA were compared by tensile test with the use of a universal testing machine at a crosshead speed of 5 mm/min. Kruskal–Wallis and Wilcoxon tests were used to analyze the data (α = 0.05). Altering the polymethyl methacrylate surface by Er:YAG laser significantly increased the bond strengths in polymethyl methacrylate/silicone specimens, however, sandblasting before applying a lining material had a weakening effect on the bond. In addition, Nd:YAG and KTP lasers were found to be ineffective for increasing the strength of the bond.     

Micromorphology and adhesive performance of Er:YAG laser-treated dentin of primary teeth

This study evaluated (1) the micromorphology by scanning electron microscopy (SEM) and (2) the adhesive performance by microtensile bond strength (μTBS) of diamond bur-treated dentin compared to Er:YAG laser-treated dentin of human primary teeth. (1) For qualitative SEM evaluation, dentin of 18 second primary molars (n = 3/method) was treated with either diamond bur as a control (group 1a: 40 μm diamond bur only (clinical situation); group 1b: grinding + 40 μm diamond bur) or with Er:YAG laser (group 2a (clinical situation, manufacturer’s settings): 200 mJ/25 Hz (5 W) + 100 mJ/35 Hz (3.5 W) laser only; group 2b (experimental setting "high"): grinding + 400 mJ/20 Hz (8 W); group 2c (manufacturer’s setting "finishing"): grinding + 100 mJ/35 Hz (3.5 W); group 2d (experimental setting "low"): grinding + 50 mJ/35 Hz (1.75 W)). (2) For evaluation of adhesive performance, 64 second primary molars were divided into four groups and treated as described for group 1b and groups 2b/c/d (n = 16/method), and μTBS of Clearfil SE/Clearfil Majesty Esthetic to dentin was measured. The SEM micrographs were qualitatively analyzed. The μTBS values were compared with a Kruskal–Wallis test. The significance level was set at α = 0.05. SEM micrographs showed the typical micromorphologies with a smear layer for the diamond bur groups and open dentin tubules for all laser-treated groups. However, in group 2d, the laser beam had insufficiently irradiated the dentin area, rendering the underlying ground surface partly visible. There were no statistically significant differences between μTBS values of the four groups (p = 0.394). This suggests that Er:YAG laser treatment of dentin of primary molars provides bond strengths similar to those obtained following diamond bur treatment.     

Effects of Er:YAG laser treatments on surface roughness of base metal alloys

We investigated the effects of different Er:YAG laser treatments on the surface roughness of base metal alloys. A total of 36 specimens were prepared of two base metal alloys (Wiron 99, Bellabond plus). The surfaces of the specimens were standardized by gradual wet grinding with 320-, 600-, 800- and 1,000-grit silicon carbide paper for 10 s each on a grinding machine at 300 rpm. Specimens of each alloy were randomly divided into six groups (n = 6) comprising a control group (group C), a group sandblasted with Al₂O₃ powder at 60 psi for 10 s through a nozzle at a distance of 10 mm (group S), and four Er:YAG laser (Fotona AT) treatment groups. The laser treatment groups were as follows: 500 mJ, 10 Hz, 100 μs (group 500MSP); 500 mJ, 10 Hz, 300 μs (group 500SP); 400 mJ, 10 Hz, 100 μs (group 400MSP); and 400 mJ, 10 Hz, 300 μs (group 400SP). Surface roughness measurements (Ra) were performed using a profilometer. The data were analysed by two-way ANOVA, and mean values were compared using Tukey’s HSD test (α = 0.05). According to the two-way ANOVA results, the base metal alloys and interaction between base metal alloy and surface treatment were not statistically significant different (p > 0.05), the surface treatments were significantly different (p < 0.0001). For the two base metal alloy groups, no significant differences were observed among the control, 400MSP, and 400SP groups (p = 0.912), and these groups demonstrated the lowest Ra values. The highest Ra value was observed in group S (p < 0.05). Er:YAG laser treatment at 400 and 500 mJ/10 Hz is not an alternative method for surface roughening of base metal alloys.     

Effects of Nd:Yag laser irradiation on osteoblast cell cultures

The application of Nd:YAG lasers in endodontics has been explored by many investigators for different purposes. The aim of this in vitro study is to evaluate the effects of Nd:YAG laser on osteoblast cell cultures. A 1,064 nm Nd:YAG laser was used to irradiate human osteoblast-like cells (Saos-2) in noncontact mode for 10 s with different energy settings. The settings varied were pulse energy (20–120 mJ), pulse repetition rate (10–30 Hz), and power output (0.2–3.6 W). He–Ne, the aiming beam of Nd:YAG laser, was used in noncontact mode for 10 s. After 7-, 14-, and 21-day incubation period, cell viability and proliferation were evaluated with methylthiazoletetrazolium (MTT) colorometric method. The comparison of average MTT values gave no statistically significant difference between 20 mJ, 10 Hz, He–Ne, and control (p<0.05). The differences between all other groups were significant (p<0.05). Increase in the pulse energy, pulse repetition rate, and power output has a negative effect on the cell viability and proliferation.     

Esthetic treatment of gingival hyperpigmentation with Nd:YAG laser or scalpel technique: a 6-month RCT of patient and professional assessment

This double-masked, randomized controlled trial with a split-mouth design aimed to compare patient- and professional-centered outcomes using different therapeutic approaches—neodymium–yttrium aluminum garnet (Nd:YAG) laser or scalpel technique—for gingival depigmentation. Patients presenting bilateral melanin gingival hyperpigmentation and who requested cosmetic therapy were recruited. Contralateral quadrants were randomly assigned to receive Nd:YAG laser (settings: 6 W, 60 mJ/pulse, and 100 Hz) or scalpel technique. Patient morbidity experienced at intratherapy and during the first postoperative week was evaluated. In addition, after 6 months, the cosmetic results achieved for the different therapeutic approaches were evaluated by patients and professionals. The chair time of each technique was also calculated. Patient-oriented outcomes concerning intratherapy morbidity did not demonstrate any differences between groups (p?>?0.05), although a higher extent of discomfort/pain was experienced in the side treated by the scalpel technique compared to the Nd:YAG laser procedure during the first posttherapy week (p?<?0.05). Regarding to cosmetic outcomes, no differences between techniques were observed for patient and professionals (p?>?0.05). Significantly higher chair time was required for the scalpel technique than for the Nd:YAG laser therapy (p?<?0.05). The Nd:YAG laser or the scalpel technique may be successfully used for the treatment of melanin gingival hyperpigmentation. However, the use of the Nd:YAG laser has presented advantages in terms of less discomfort/pain during the posttherapy period and a reduction of treatment chair time.     

The effect of different surface treatments on roughnessand bond strength in low fusing ceramics

The aim of this study was to evaluate the influence of different surface treatments (air abrasion, acid etching, and laser irradiation) on the surface roughness and bond strength of a low fusing ceramic. Thirty-six discs of low fusing ceramic (Finesse, Ceramco) were prepared (10 mm in diameter and 2 mm in thickness) according to the manufacturer’s instructions. Specimens were divided into three groups (n = 12), and the following treatments were performed: Air abrasion with alumina particles (50 μm), acid etching with 5% HF and Nd:YAG laser irradiation (distance: 1 mm, 100 mJ, 20 Hz, 2 W, and 141.54 J/cm²). Following determination of surface roughness (R_a) by profilometry, specimens were examined with scanning electron microscopy (SEM). The luting cement (Clearfil Esthetic Cement) was bonded to the ceramic specimens using Teflon tubes. After 24 h of water storage, shear bond strength test was performed using a universal testing machine at a crosshead speed of 1 mm/min. The data were analyzed with two-way analysis of variance (ANOVA) and Tukey HSD tests (α = .05). Two-way ANOVA indicated that surface roughness was significantly affected by surface treatments (p < .001). Tukey honestly significant difference (HSD) indicated that the air abrasion group had a significantly higher mean value (p < .05) than the other groups. Shear bond strength was significantly affected by surface treatments (p < .001). Tukey HSD indicated that the air abrasion group had a significantly higher mean value (p < .05) than the other groups. No significant difference was found between the acid-etching and laser-irradiation groups (p > .05). The SEM image of the laser irradiation surface appeared to be relatively smooth as compared to the images of other the groups. Air abrasion of low-fusing porcelain surfaces was effective in improving the bond strength as compared to the acid-etching and laser-irradiation methods.     

Porcelain conditioning with Nd:YAG and Er:YAG laser for bracket bonding in orthodontics

In this study, shear bond strength (SBS) of metal orthodontic brackets to porcelain following conditioning by Er:YAG (erbium-doped yttrium aluminum garnet) and Nd:YAG (neodymium-doped yttrium aluminum garnet) laser in comparison to conventional methods was evaluated. One hundred glazed porcelain discs with an upper central shape were prepared and randomly assigned to five equal groups of 20. In the first group, samples were only deglazed and roughened by diamond burs. In the second group, after roughening and deglazing of porcelain samples, the samples were etched by 9.6% hydrofluoric acid for 4 min. Groups, 3, 4, and 5 were prepared by 0.8-W Nd:YAG laser, 2-W Er:YAG laser, 3-W Er:YAG laser for 10 s, respectively. Then, metal, mesh-based brackets were bonded to porcelain samples, and after being stored in distilled water for 24 h, debonding was carried out by a Zwick testing machine. ANOVA and Tukey tests were used to compare SBS in five groups. Mean SBS in groups 1 to 5 were 3.3 ± 1.6, 7.0 ± 2.1, 6.9 ± 2.7, 2.3 ± 1.1, and 3.7 ± 2.3 MPa, respectively. ANOVA test revealed a significant difference between five groups (p < 0.05). Although Tukey’s test showed SBS in groups 2 and 3 were significantly higher than the other groups, they did not differ with each other significantly (p > 0.05). The results revealed that SBS of 9.6% hydroflouric acid and Nd:YAG Laser was in an acceptable range for orthodontic treatment. Nd:YAG laser was shown to be an acceptable substitute for hydrofluoric acid while Er:YAG laser with the mentioned power and duration was not a suitable option.     

Comparative In Vitro Study of the Bond Strength of Composite to Enamel and Dentine Obtained with Laser Irradiation or Acid-etch

. The shear bond strength of composite resin on enamel and dentine was compared after acid-etch or irradiation by Er:YAG and Nd:YAP lasers. Forty-eight extracted molars were selected. Dentine and enamel samples were prepared by buccal and lingual surface sectioning to expose a plane enamel or dentine surface. Samples (n=12) were randomly assigned to eight groups. In groups 1 and 5, enamel and dentine surfaces were etched with a 37% phosphoric acid solution. In groups 2 and 6, surfaces were irradiated by Er:YAG laser at an energy of 200 mJ and 4 Hz for enamel and 140 mJ and 4 Hz for dentine. In groups 3 and 7, irradiation was performed by Nd:YAP laser at 310 mJ and 10 Hz for enamel and 240 mJ and 10 Hz for dentine. Groups 4 and 8 served as controls. A cone of composite was bonded perpendicularly onto the prepared surfaces using the Scotch Bond Multipurpose adhesive system. Each sample was then stored in physiological serum at 37°C for one week and thermocycled. Shear bond strength was determined on a universal testing machine. Composite–enamel and composite–dentine interfaces were examined by scanning electron microscopy and microanalysis. Shear bond strength was greater on dentine and enamel after acid-etch than laser radiation. These treatments could be ranged in the following order: acid-etch, laser Er:YAG and laser Nd:YAP. Differences between groups were significant for enamel, whereas no significant differences were found for dentine between acid-etch and Er:YAG laser-irradiation (Kruskal–Wallis test). Thus, laser preparation did not improve bonding to enamel and dentine. Paper received 14 August 1998; accepted following revision 11 January 1999.     

Influence of laser irradiation on fiber post retention

The purpose of this in vitro study was to compare the bond strength between fiber post and laser-treated root canals. Forty single-rooted bovine teeth were endodontically treated and randomly divided into four groups of equal size according to the root canal treatment: group 1 conventional treatment (without laser irradiation); group 2 Nd:YAG laser (1.5 W, 10 Hz, 100 mJ); group 3 Er,Cr:YSGG laser (0.75 W, 20 Hz); and group 4 Nd:YAG + Er,Cr:YSGG lasers. The fiber posts were cemented with an adhesive system + resin cement, in accordance with the manufacturer’s instructions. A mini acrylic pipe was fixed on the coronal section of the post using a light-polymerized resin. Specimens were mounted on an acrylic pipe with a self-polymerized resin. Retention forces were determined using a universal testing machine (0.5 mm/min). Data were analyzed using one-way ANOVA and Tukey tests (p <0.05). The post retention force in group 2 was found to be lower than that in the other experimental groups. Fractures were observed at the interface between the dentin and the resin in all groups. High-intensity lasers can be used in conventional endodontic treatment; however, root canal surface irradiation using the Nd:YAG laser was shown to negatively affect the post retention force.     

Heat generation caused by ablation of restorative materials with an ultrashort pulse laser (USPL) system

Heat generation during the removal of dental restorative materials may lead to a temperature increase and cause painful sensations or damage dental tissues. The aim of this study was to assess heat generation in dental restoration materials following laser ablation using an ultrashort pulse laser (USPL) system. A total of 225 specimens of phosphate cement (PC), ceramic (CE), and composite (C) were used, evaluating a thickness of 1 to 5 mm each. Ablation was performed with an Nd:YVO₄ laser at 1,064 nm, a pulse length of 8 ps, and a repetition rate of 500 kHz with a power of 6 W. Employing a scanner system, rectangular cavities of 1.5-mm edge length were generated. A temperature sensor was placed at the back of the specimens to record the temperature during the ablation process. All measurements were made employing a heat-conductive paste without any additional cooling or spray. Heat generation during laser ablation depended on the thickness of the restoration material (p < 0.05) with the highest values in the composite group (p < 0.05), showing an increase of up to 17 K. A time delay for temperature increase during the ablation process depending on the material thickness was observed in the PC and C group (p < 0.05) with highest values for cement (p < 0.05). Employing the USPL system for removal of restorative materials, heat generation has to be considered. Especially during laser ablation next to pulpal tissues, painful sensations might occur.     

Shear bond strength of composite bonded to erbium:yttrium-aluminum-garnet laser-prepared dentin

The purpose of this study was to evaluate the dentin bond strength to resin composite following erbium:yttrium-aluminum-garnet (Er:YAG) laser preparation using different adhesive systems. Seventy dentin specimens prepared from human molar teeth were randomly assigned to seven groups of ten. The first five groups were prepared with an Er:YAG laser 2940 nm at the manufacturer’s recommended settings and (1) acid etched, and etch-and-rinse adhesive Excite was applied; (2) Excite was applied; (3) two-step self-etching adhesive AdheSE was applied; (4) laser etched (120 mJ/10 Hz), and Excite was applied; (5) laser etched, and AdheSE was applied. The last two groups were added as controls (prepared with a diamond bur): (6) acid etched, and Excite was applied; (7) AdheSE was applied. Nanohybrid composite cylinders 4 mm × 2 mm were bonded to the dentin surfaces. After the specimens had been stored in distilled water and had undergone thermocycling, the shear bond strength was tested and the data were analyzed statistically. The Duncan multiple comparison test showed that specimens prepared with a diamond bur and with acid and Excite applied showed the highest mean bond strength (13.01 ± 2.09 MPa), followed by those prepared with Er:YAG and with AdheSE applied (11.5 ± 3.59 MPa) and those prepared with a diamond bur and with AdheSE applied (10.75 ± 1.95 MPa), but there were no significant differences among them (P > 0.05). Er:YAG-prepared specimens, with acid, Excite (3.28 ± 0.95 MPa) and specimens that were laser etched and with AdheSE applied (3.37 ± 0.63 MPa) showed the lowest mean values for bond strength (P < 0.05). The results suggested that dentin surfaces prepared with Er:YAG laser may provide comparable composite resin bond strengths depending on the adhesives used.     

Microtensile bond strength of an etch-and-rinse adhesive to enamel and dentin after Er:YAG laser pretreatment with different pulse durations

The purpose of this study is to evaluate microtensile bond strength (μTBS) of an etch-and-rinse adhesive to enamel and dentin after treatment with Er:YAG laser using different pulse durations. Extracted human molars were flattened to obtain enamel or dentin surfaces. The enamel specimens (E) were divided into nine groups and the dentin (D) specimens were divided into seven groups according to the surface treatments (n = 6). E-C: acid was applied according to the manufacturer’s instructions and used as control, E-SSP: 120 mJ, 10 Hz, SSP (50 μs), E-SSP-A: 120 mJ,10 Hz, SSP+acid, E-VSP: 120 mJ, 10 Hz, VSP (100 μs), E-VSP-A: 120 mJ, 10 Hz, VSP+acid, E-SP: 120 mJ, 10 Hz, SP (150 μs), E-SP-A:120 mJ,10 Hz, SP+acid, E-LP:120 mJ,10 Hz, LP (300 μs), E-LP-A:120 mJ,10 Hz, LP+acid; D-C: acid was applied and used as control, D-SSP: 80 mJ, 10 Hz, SSP, D-SSP-A: 80 mJ, 10 Hz, SSP+acid, D-VSP: 80 mJ, 10 Hz, VSP, D-VSP-A: 80 mJ, 10 Hz, VSP+acid, D-SP: 80 mJ, 10 Hz, SP, D-SP-A: 80 mJ, 10 Hz, SP+acid. After application of etch-and-rinse adhesive, composite built-ups were created with a nanoceramic composite. Specimens were sectioned into serial 1-mm² sticks, and μTBS was measured in five sticks from each tooth randomly selected (n = 30). Failure modes were determined under a stereomicroscope. μTBS test data were analyzed by Welch-ANOVA followed by Dunnett's T3 tests and failure mode distributions were analyzed by Pearson Chi-square test (p = 0.05). μTBS was higher for enamel and dentin after additional acid etching than laser irradiation alone. E-SSP-A group exhibited the highest μTBS for enamel (p < 0.05). The D-SP-A group showed the highest value but the difference was not significant in comparison to D-C (p > 0.05). The μTBS of laser-irradiated but not acid-etched groups decreased when longer pulse durations were used. Laser treatment could enhance or impair the μTBS to enamel and dentin depending on the pulse duration used and additional acid application.     

Influence of different conditioning methods on the shear bond strength of novel light-curing nano-ionomer restorative to enamel and dentin

The purpose of this study was to investigate shear bond strength (SBS) between a light-curing nano-ionomer restorative and enamel or dentin after acid etching, after erbium:yttrium–aluminum–garnet (Er:YAG) laser etching, or after combined treatment. Forty third molars were selected, the crowns were sectioned, and 80 tooth slabs were obtained. The specimens were assigned to two groups, which were divided into four subgroups(n = 10). Group 1 [enamel (e)], treated with 37% phosphoric acid (A) + Ketac nano-primer (K); group 2 [dentin (d)], (A) + (K); group 3(e), Er:YAG laser etching (L) + (A) + (K); group 4(d), (L) + (A) + (K); group 5(e), (L) + (K); group 6(d), (L) + (K); group 7(e), (K); group 8(d), (K). The SBS of the specimens was measured with a universal test machine (1 mm/min). Data were analyzed by independent samples t-test, one-way analysis of variance (ANOVA) and a post-hoc Duncan test (p < 0.05). No difference was determined between groups 3 and 5 (p > 0.05). Group 7 exhibited higher SBS values than those of groups 3 and 5 (p < 0.05). Group 1 showed higher SBSs than those of groups 3, 5 and 7 (p < 0.05). There was no significant difference between groups 4 and 6 (p > 0.05). No difference was observed between groups 2 and 4 (p > 0.05). However, group 2 presented higher SBSs than did group 6 (p < 0.05). Group 8 exhibited the highest SBS values when compared with groups 2, 4 and 6 (p < 0.05). Er:YAG laser adversely affected the adhesion of the light-curing nano-ionomer restorative to both enamel and dentin.     

Strength of the bond between a silicone lining material and denture resin after Er:YAG laser treatments with different pulse durations and levels of energy

The purpose of this study was to investigate the tensile strength of the bond between a silicone lining material and heat-cured polymethyl methacrylate (PMMA) denture base resin after Er:YAG laser treatment with different pulse durations and energy levels. PMMA test specimens were fabricated and each received one of six surface treatments: no treatment (control), and five Er:YAG laser treatments comprising (1) 100 mJ, 1 W, long pulse duration, (2) 200 mJ, 2 W, long pulse duration, (3) 200 mJ, 2 W, very short pulse duration, (4) 300 mJ, 3 W, long pulse duration, and (5) 400 mJ, 4 W, long pulse duration. The resilient liner specimens (n = 15) were processed between two PMMA blocks. The tensile strengths of the bonds between the liners and PMMA were determined using a universal testing machine at a crosshead speed of 5 mm/min. The mode of failure was characterized as cohesive, adhesive, or mixed modes. One-way ANOVA and the post hoc Tukey-Kramer multiple comparisons test were used to analyze the data (α = 0.05). There was a statistically significantly difference in tensile bond strength between laser-treated and untreated specimens (P < 0.05). The 300-mJ, 3 W, long pulse duration laser treatment produced the highest mean tensile bond strength. In addition, the long pulse duration treatments resulted in greater bond strength than very short pulse duration treatment (P < 0.05). Laser irradiation produced significant surface texture changes of the denture base material and improved the adhesion between denture base and soft lining material. In addition, different pulse durations and energy levels were found to effectively increase the strength of the bond.     

En face optical coherence tomography investigation of apical microleakage after laser-assisted endodontic treatment

The aim of our study was to evaluate the potential of en face optical coherence tomography (OCT) for the detection of apical microleakage after 980 nm and 1,064 nm laser-assisted endodontic treatment. Ninety, human, single-rooted teeth with one straight root canal and closed apices were used. All roots were prepared biomechanically to the working length at an apical size 30 and 0.06 taper. The teeth were divided into three equal groups of 30 samples each, according to the treatment to be applied to the root canal. Group I received 980 nm diode laser (3 W, 0.01 s on time, 0.01 s off time, 5 s per procedure, four procedures); group II received neodymium:yttrium–aluminum–garnet (Nd:YAG) laser (1.5 W, 15 Hz, 5 s per procedure, four procedures). In group III the root canals were approached conventionally only. In all groups the root canal filling was performed with AH Plus endodontic sealer and gutta-percha points. An en face OCT prototype was used for the investigation of apical microleakage. According to one-way analysis of variance (ANOVA) and en face OCT, the number of defects in the laser groups was significantly lower (P < 0.005) than in the control group. No statistical differences were noted between the laser groups (P = 0.049). En face OCT imaging proved that laser-assisted endodontic treatment improved the prognosis of root canal filling and led to a reduction in apical microleakage.     

Experimental Study of Different Laser Systems for PMMA Extraction Within the Scope of Revision Hip Arthroplasty

. Cement removal at revision hip arthroplasty forms a critical step for a successful operation. The removal of polymethymethacrylate (PMMA) with curet and chisel can cause major damage to the femoral shaft. The use of ultrasound or lithotripsy can cause perforation and microfractures to bone tissue. The goal of our study was to evaluate the application and practicability of different laser systems for cement removal. We examined and compared the effects of a diode laser (wavelength λ=800 nm), a Nd:YAG laser (λ=1064 nm), and an Er:YSSG laser (λ=2780 nm) on PMMA and the PMMA–bone interface. Whereas the Nd:YAG laser with a high ablation rate led to severe bone damage with extensive carbonisation, the Er:YSSG laser with a low ablation rate produced a defined cut at the PMMA–bone interface (max. depth 3.70 mm at 6.0 W laser power). Using the diode laser a defined high quality ablation of PMMA at the PMMA–bone interface was possible without any visible damage of adjacent tissue (max. depth 2.75 mm at 2.9 W laser power). However, sufficient ablation in an adequate operating time could not be realised with this power. The use of a laser tool for cement removal is insufficient. It only facilitated the manual removal of the remaining cement with chisel and curet. Paper received 5 November 1999; accepted after revision 27 April 2000.     

Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium–aluminum–garnet laser irradiation. A scanning electron microscopy study

The purpose of this study was to evaluate the effect of erbium:yttrium–aluminum–garnet (Er:YAG) laser (2.94 μm) irradiation on the removal of root surface smear layer of extracted human teeth and to compare its efficacy with that of citric acid, ethylenediamine tetra-acetic acid (EDTA), or a gel containing a mixture of tetracycline hydrochloride (HCl) and citric acid, using scanning electron microscopy (SEM). Thirty human dentin specimens were randomly divided into six groups: G1 (control group), irrigated with 10 ml of physiologic saline solution; G2, conditioned with 24% citric acid gel; G3, conditioned with 24% EDTA gel; G4, conditioned with a 50% citric acid and tetracycline gel; G5, irradiated with Er:YAG laser (47 mJ/10 Hz/5.8 J/cm²/pulse); G6, irradiated with Er:YAG laser (83 mJ/10 Hz/10.3 J/cm²/pulse). Electron micrographs were obtained and analyzed according to a rating system. Statistical analysis was conducted with Kruskal–Wallis and Mann–Whitney tests (P < 0.05). G1 was statistically different from all the other groups; no statistically significant differences were observed between the Er:YAG laser groups and those undergoing the other treatment modalities. When the two Er:YAG laser groups were compared, the fluency of G6 was statistically more effective in smear layer removal than the one used in G5 (Mann–Whitney test, P < 0.01). Root surfaces irradiated by Er:YAG laser had more irregular contours than those treated by chemical agents. It can be concluded that all treatment modalities were effective in smear layer removal. The results of our study suggest that the Er:YAG laser can be safely used to condition diseased root surfaces effectively. Furthermore, the effect of Er:YAG laser irradiation on root surfaces should be evaluated in vivo so that its potential to enhance the healing of periodontal tissues can be assessed.