Analysis of the interfacial micromorphology and bond strength of adhesive systems to Er:YAG laser-irradiated dentin

This study evaluated the effects of different parameters of dentin irradiation with erbium-doped yttrium aluminum garnet (Er:YAG) laser on bond strength to dentin and analyzed the ultramorphological characteristics of resin–laser-irradiated dentin interfaces using a transmission electron microscope (TEM). Dentin surfaces were abraded with SiC paper (600 grit) or Er:YAG laser-irradiated (120/4, 140/6, 180/4, or 200/6 mJ/Hz). Three adhesive systems were tested: Single Bond Plus (3M ESPE), Clearfil Protect Bond (Kuraray Med.), and Clearfil Tri-S Bond (Kuraray Med.). Treatments were performed over flat dentin surfaces of human third molars. Specimens were stored in distilled water for 1 week or 6 months and prepared for a microtensile bond strength test and interfacial ultrastructure for analysis. Microtensile bond strength data (n?=?5) were analyzed with three-way analysis of variance. Irradiation with Er:YAG laser did not reduce the bond strength values for self-etching adhesives even after 6 months of water storage. The hybrid layer formation was observed only when the adhesives were applied to non-irradiated dentin (control group). Nanoleakage occurred in all resin–dentin interfaces using Single Bond Plus for both periods. Nanoleakage pattern and bond strength of self-etching adhesives to dentin were less affected by Er:YAG laser irradiation and by the 6-month storage in water than was those of the etch-and-rinse adhesive. TEM analysis revealed no hybridization when dentin was laser-irradiated. Clinical significance: Minimally invasive caries removal has been proposed. Nevertheless, bonding mechanisms to lased dentin are not entirely described. Knowing the interaction between the treated dentin and bonding agents and its behavior over time is of utmost importance for new technologies. Regarding that, two-bottle self-etching adhesive system provided a more consistent evidence of its better behavior when bonding to lased substrate.     

The effect of Er:YAG laser irradiation on the bond stability of self-etch adhesives at different dentin depths

The aim of this study was to evaluate the effect of Er:YAG laser irradiation on the micro-shear bond strength of self-etch adhesives to the superficial dentin and the deep dentin before and after thermocycling. Superficial dentin and deep dentin surfaces were prepared by flattening of the occlusal surfaces of extracted human third molars. The deep or superficial dentin specimens were randomized into three groups according to the following surface treatments: group I (control group), group II (Er:YAG laser; 1.2 W), and group III (Er:YAG laser; 0.5 W). Clearfil SE Bond or Clearfil S³ Bond was applied to each group’s dentin surfaces. After construction of the composite blocks on the dentin surface, the micro-shear bond testing of each adhesive was performed at 24 h or after 15,000 thermal cycles. The data were analyzed using a univariate analysis of variance and Tukey’s test (p < 0.05). Laser irradiation in superficial dentin did not significantly affect bond strength after thermocycling (p > 0.05). However, deep-dentin specimens irradiated with laser showed significantly higher bond strengths than did control specimens after thermocycling (p < 0.05). Thermocycling led to significant deterioration in the bond strengths of all deep-dentin groups. The stable bond strength after thermocycling was measured for all of the superficial-dentin groups. No significant difference was found between the 0.5 and 1.2 W output power settings. In conclusion, the effect of laser irradiation on the bond strength of self-etch adhesives may be altered by the dentin depth. Regardless of the applied surface treatment, deep dentin showed significant bond degradation.     

Comparison of the effects of Er,Cr:YSGG laser and different cavity disinfection agents on microleakage of current adhesives

The aim of this study was to compare the effect of the Er,Cr:YSGG laser and different cavity disinfection agents on microleakage of an etch-and-rinse and a self-etch adhesive. Class V preparations were completed on the buccal and lingual surfaces of 30 extracted noncarious human molars. The occlusal margin was placed on enamel and the gingival margin on dentin. Preparations were randomly divided into five experimental groups (n = 12); (1) 2% chlorhexidine gluconate (CHX), (2) propolis, (3) ozone, (4) Er,Cr:YSGG laser, and (5) control (no treatment). Each group was divided into two subgroups according to the adhesive system: etch-and-rinse (Adper Single Bond 2), and a self-etch adhesive (All-Bond SE). The preparations were bulk-filled with a resin composite (Arabesk). After storage in distilled water for 24 h the restored teeth were subjected to thermocycling (1,000 cycles; 5-55°C). All specimens were immersed in 0.5% basic fuchsin solution for 24 h and sectioned longitudinally through the centre of the restorations and examined under a stereomicroscope at ×25 magnification. The data were analysed using the Kruskal-Wallis and Mann-Whitney U-tests. No difference was observed between the groups either on enamel or dentin when the etch-and-rinse adhesive was used (p > 0.05). In the self-etch adhesive groups, a significant difference was found only between the laser group and the CHX group on enamel and between the propolis group and the control group on dentin (p < 0.05). Comparing the etch-and-rinse and self-etch adhesives within each group, no differences were found on dentin (p > 0.05). On enamel, a statistically significant difference was found only in the CHX group (p < 0.05). There were no differences in microleakage with the laser and the different cavity disinfectant applications when used with etch-and-rinse adhesive. In the self-etch group there were differences in microleakage depending on the disinfection agent used.     

Influence of the LED curing source and selective enamel etching on dentin bond strength of self-etch adhesives in class I composite restorations

The aim of this study was to evaluate the influence of the LED curing unit and selective enamel etching on dentin microtensile bond strength (μTBS) for self-etch adhesives in class I composite restorations. On 96 human molars, box-shaped class I cavities were made maintaining enamel margins. Self-etch adhesives (Clearfil SE - CSE and Clearfil S(3) - S3) were used to bond a microhybrid composite. Before adhesive application, half of the teeth were enamel acid-etched and the other half was not. Adhesives and composites were cured with the following light curing units (LCUs): one polywave (UltraLume 5 - UL) and two single-peak (FlashLite 1401 - FL and Radii Cal - RD) LEDs. The specimens were then submitted to thermomechanical aging and longitudinally sectioned to obtain bonded sticks (0.9 mm(2)) to be tested in tension at 0.5 mm/min. The failure mode was then recorded. The μTBS data were submitted to a three-way ANOVA and Tukey's (α?=?0.05). For S3, the selective enamel-etching provided lower μTBS values (20.7?±?2.7) compared to the non-etched specimens (26.7?±?2.2). UL yielded higher μTBS values (24.1?±?3.2) in comparison to the photoactivation approach with FL (18.8 ±3.9) and RD (19.9 ±1.8) for CSE. The two-step CSE was not influenced by the enamel etching (p?≥?0.05). Enamel acid etching in class I composite restorations affects the dentin μTBS of the one-step self-etch adhesive Clearfil S(3), with no alterations for Clearfil SE bond strength. The polywave LED promoted better bond strength for the two-step adhesive compared to the single-peak ones.     

Effects of erbium:yttrium–aluminum–garnet and neodymium:yttrium–aluminum–garnet laser hypersensitivity treatment parameters on the bond strength of self-etch adhesives

This in vitro study evaluated the shear bond strength (SBS) of two self-etch adhesives to coronal and root dentin treated with erbium:yttrium–aluminum–garnet (Er:YAG) or neodymium:yttrium–aluminum–garnet (Nd:YAG) lasers for dentin hypersensitivity. The coronal and root dentin surfaces of 60 extracted human cuspids were divided into three groups (n = 20): (1) control (without treatment); (2) treated with Er:YAG; (3) treated with Nd:YAG laser and a one-step (S3) or two-step self-etch adhesive (SE). A nano-composite was applied and SBS tests were performed. The mean SBS values were calculated, failure modes were determined, and data were subjected to statistical analysis (P = 0.05). Control/SE exhibited higher values than did control/S3 and Nd:YAG/S3 on coronal dentin (P < 0.05). No significant differences were observed between the SE and S3 groups in root dentin (P > 0.05). Comparisons of two dentin substrates did not show any difference except control/SE (P < 0.05). The failure modes were mainly adhesive. The SBSs of self-etch adhesives to Er:YAG or Nd:YAG laser-treated surfaces were comparable with control for both coronal and root dentin.     

Bond strength of resin cement to zirconia ceramic with different surface treatments

Zirconia-based ceramics offer strong restorations in dentistry, but the adhesive bond strength of resin cements to such ceramics is not optimal. This study evaluated the influence of surface treatments on the bond strength of resin cement to yttrium-stabilized tetragonal zirconia (Y-TZP) ceramic. Seventy-five plates of Y-TZP ceramic were randomly assigned to five groups (n?=?15) according to the surface treatments [airborne particle abrasion, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiation (Fidelis Plus 3, Fotona; 2 W, 200 mJ, 10 Hz, with two different pulse durations 180 or 320 μs), glaze applied, and then 9.5 % hydrofluoric acid gel conditioned, control]. One specimen from each group was randomly selected, and specimens were evaluated with x-ray diffraction and SEM analysis. The resin cement (Clearfil Esthetic Cement, Kuraray) was adhered onto the zirconia surfaces with its corresponding adhesive components. Shear bond strength of each sample was measured using a universal testing machine at a crosshead speed of 1 mm/min. Bond strengths were analyzed through one-way ANOVA/Tukey tests. Surface treatments significantly modified the topography of the Y-TZP ceramic. The Nd:YAG laser-irradiated specimens resulted in both increased surface roughness and bond strength of the resin cement. The highest surface roughness and bond strength values were achieved with short pulse duration. Nd:YAG laser irradiation increased both surface roughness of Y-TZP surfaces and bond strength of resin cement to the zirconia surface.     

Shear bond strength of self-etching adhesive systems to Er:YAG-laser-prepared dentin

This study was conducted to compare the shear bond strengths of composite resin bonded to Er:YAG laser or bur-prepared dentin surfaces using three self-etching adhesive systems. The occlusal surfaces of 120 human third molars were ground flat to expose dentin. The dentin was prepared using either a carbide bur or an Er:YAG laser at 350 mJ/pulse and 10 Hz (fluence, 44.5 J/cm²). Three different self-etching adhesive systems were applied: iBond™, Xeno III™ and Clearfil SE Bond™. Rods of composite resin were bonded to dentin surfaces and shear bond tests were carried out. Both dentin surfaces after debonding and resin rods were observed using a scanning electron microscope. When the Xeno III™ was used, no difference was observed on shear bond strength values when bur and Er:YAG laser were compared. When using iBond™ and Clearfil SE Bond™, bond strength values measured on Er:YAG-laser-prepared surfaces were lower than those observed on bur-prepared surfaces. The absence of smear layer formation during the preparation of the dentin by the Er:YAG laser did not improve the adhesion values of self-etching adhesive systems.     

Assessment of the penetration depth of dental adhesives through deproteinized acid-etched dentin using neodymium:yttrium-aluminum-garnet laser and sodium hypochlorite

The objective of this study was to assess the penetration depth of dental adhesive systems through acid-etched dentin, deproteinized by neodymium:yttrium–aluminum–garnet (Nd:YAG) laser or 10% sodium hypochlorite (NaOCl) solution, using fluorescent light microscopy. Sixty extracted human upper premolars were selected to be given standardized buccal and lingual class V cavities. The teeth were randomly divided into two groups, each one consisting of 30 teeth and each group subdivided into three subgroups, each having ten teeth (20 cavities): group 1, Excite bonding system, which was subdivided into group 1a, acid etch/Nd:YAG laser plus Excite bond, group 1b, acid etch/10%NaOCl plus Excite bond, and group 1c, acid etch plus Excite bond; group 2, Solobond Plus bonding system, which was subdivided into group 2a, acid etch/Nd:YAG laser plus Solobond Plus bond, group 2b, acid etch/10%NaOCl plus Solobond Plus bond, and group 2c, acid etch plus Solobond Plus bond. The teeth were prepared for fluorescent light microscopy (FLM) analysis, and the results showed that treatment of the acid-etched dentin with Nd:YAG laser had led to a significant increase in the penetration depth of the adhesive bonding system, and that the maximum penetration depth of the adhesive bonding system through acid-etched, Nd:YAG-lased dentin was significantly more than that of acid-etched, 10% NaOCl-treated dentin. The Solobond Plus bonding system showed maximum penetration depth, more than that of the Excite bonding system.     

Effect of dental surface treatment with Nd:YAG and Er:YAG lasers on bond strength of resin composite to recently bleached enamel

The aim of this work is to evaluate the effect of surface treatment with Er:YAG and Nd:YAG lasers on resin composite bond strength to recently bleached enamel. In this study, 120 bovine incisors were distributed into two groups: group C: without bleaching treatment; group B: bleached with 35% hydrogen peroxide. Each group was divided into three subgroups: subgroup N: without laser treatment; subgroup Nd: irradiation with Nd:YAG laser; subgroup Er: irradiation with Er:YAG laser. The adhesive system (Adper Single Bond 2) was then applied and composite buildups were constructed with Filtek Supreme composite. The teeth were sectioned to obtain enamel-resin sticks (1 × 1 mm) and submitted to microtensile bond testing. The data were statistically analyzed by the ANOVA and Tukey tests. The bond strength values in the bleached control group (5.57 MPa) presented a significant difference in comparison to the group bleached and irradiated with Er:YAG laser (13.18 MPa) or Nd:YAG (25.67 MPa). The non-bleached control group presented mean values of 30.92 MPa, with statistical difference of all the others groups. The use of Nd:YAG and Er:YAG lasers on bleached specimens was able to improve the bond strengths of them.     

Bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin irradiated with a novel CO<Subscript>2</Subscript> 9.3 μm short-pulsed laser for dental restorative procedures

The objective of this study was to evaluate the influence of CO₂ 9.3 μm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO₂ 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa).     

Effect of sandblasting,silica coating,and laser treatment on the microtensile bond strength of a dental zirconia ceramic to resin cements

The purpose of this in vitro study was to evaluate the effect of laser irradiation as well as other surface treatment methods on the microtensile bond strength of a dental zirconia ceramic to the two types of resin cements. Zirconia ceramic blocks (ICE Zirkon) were sintered according to the manufacturer’s instructions and duplicated in resin composites. The ceramic specimens were divided into four groups according to the following surface treatments: no surface treatment (control), sandblasting with alumina, silica coating plus silanization, and Nd:YAG laser irradiation. The specimens were divided equally and then bonded with Panavia F2.0 (self-etching resin cement) and Clearfil SA Luting (self-adhesive resin cement) to the composite blocks. The bonded ceramic-composite blocks were stored in distilled water at 37 °C for 72 h, cut to prepare bar-shaped specimens with a bonding area of approximately 1 mm², and thermocycled for 3000 cycles between 5 and 55 °C, and the microtensile bond strengths were measured using a universal testing machine. The data were analyzed by ANOVA and Tukey post hoc test. The results showed that the self-adhesive resin cement used in this study did not improve the microtensile bond strength when the zirconia surface was sandblasted by alumina. The use of the Nd:YAG laser did not enhance the bond strength between the zirconia and both types of resin cements. In addition, silica coating of the zirconia surfaces plus silane application significantly improved the bond strength regardless of the type of resin cement utilized.     

Bond strength to dentin of primary teeth irradiated with varying Er:YAG laser energies and SEM examination of the surface morphology

BACKGROUND AND OBJECTIVES: This study aimed to assess in vitro the influence of Er:YAG laser energy on the shear bond strength of a total-etch adhesive to lased dentin of primary teeth, and observe under SEM the morphological appearance of laser-ablated dentin surfaces. STUDY DESIGN/MATERIALS AND METHODS: For SBS, specimens were irradiated with the energies 60 mJ/2 Hz (G2), 80 mJ/2 Hz (G3), 100 mJ/2 Hz (G4). Control (G1) was not irradiated. Dentin surfaces were acid-etched, Single Bond adhesive (3 M) was applied, and resin cylinders were fabricated from Z250 resin (3 M). Bond strength was tested in shear (0.5 mm/min). For morphological analysis, specimens were irradiated using the same energies, either or not acid-etched, and observed by SEM. RESULTS AND CONCLUSIONS: SBS means, in MPa, were: G1-17.89(+/-4.75); G2-12.34(+/-4.85); G3-10.30(+/-3.67); G4-10.41(+/-4.20). Overall, Er:YAG laser irradiation of primary teeth dentin, prior to the adhesive protocol, adversely affected bond strength. Furthermore, it was noticed that even though there was no significant difference among the Er:YAG laser-treated groups, the increase of laser energy resulted in increasingly cratered surfaces, regardless of acid-etching association.     

The influence of the energy density and other clinical parameters on bond strength of Er:YAG-conditioned dentin compared to conventional dentin adhesion

The aim of this in vitro study was to optimise clinical parameters and the energy density of Er:YAG laser-conditioned dentin for class V fillings. Shear tests in three test series were conducted with 24 freshly extracted human third molars as samples for each series. For every sample, two orofacial and two approximal dentin surfaces were prepared. The study design included different laser energies, a thin vs a thick bond layer, the influence of adhesives as well as one-time- vs two-time treatment. The best results with Er:YAG-conditioned dentin were obtained with fluences just above the ablation threshold (5.3 J/cm²) in combination with a self-etch adhesive, a thin bond layer and when bond and composite were two-time cured. Dentin conditioned this way reached an averaged bond strength of 23.32 MPa (SD 5.3) and 24.37 MPa (SD 6.06) for two independent test surfaces while showing no statistical significance to conventional dentin adhesion and two-time treatment with averaged bond strength of 24.93 MPa (SD 11.51). Significant reduction of bond strength with Er:YAG-conditioned dentin was obtained when using either a thick bond layer, twice the laser energy (fluence 10.6 J/cm²) or with no dentin adhesive. The discussion showed clearly that in altered (sclerotic) dentin, e.g. for class V fillings of elderly patients, bond strengths in conventional dentin adhesion are constantly reduced due to the change of the responsibles, bond giving dentin structures, whereas for Er:YAG-conditioned dentin, the only way to get an optimal microretentive bond pattern is a laser fluence just above the ablation threshold of sclerotic dentin.     

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.     

Evaluation of microtensile bond strength of glass ionomer cements to dentin after conditioning with the Er,Cr:YSGG laser

OBJECTIVE: The purpose of this study was to evaluate the hypothesis that conditioning with Er,Cr:YSGG laser energy would affect bond strength of glass ionomers to dentin. METHODS: Forty extracted caries-free human premolars were selected and ground to expose occlusal dentin. Then the teeth were randomly divided into eight groups of five each and were conditioned in two ways: with and without laser conditioning, and were then restored using Fuji II, Vitremer, and Fuji II LC (with and without polyacrylic acid conditioning) glass ionomers. After immersion in water for 24 h, the teeth were vertically sectioned into 1 x 1-mm beams for microtensile bond strength (microTBS) evaluation. The beams were then subjected to tensile forces in a microtensile tester at a cross-head speed of 0.5 mm/min. Failure patterns were analyzed using a stereomicroscope and unbonded dentin surfaces were evaluated using scanning electron microscopy (SEM) as well. Data were analyzed using one-way ANOVA, Dunnet C, and t-test at the 95% level of confidence. RESULTS: In unlased dentin, bond strength of Fuji II LC after conditioning with polyacrylic acid (PAA) was significantly higher than that of Vitremer and Fuji II. In the laser-irradiated group, bond strength of Fuji II LC after PAA conditioning and Fuji II were significantly less than those of Vitremer and Fuji II LC without PAA conditioning. With laser irradiation, bond strength of Fuji II and Fuji II LC after PAA conditioning were significantly reduced, while bond strength of Vitremer and Fuji II LC without PAA conditioning were not affected. CONCLUSION: Laser irradiation with Er,Cr:YSGG energy at 1 W for conditioning does not improve bond strength of Fuji II LC and Vitremer to dentin, and even reduced bond strength of Fuji II and Fuji II LC after PAA conditioning.     

Effect of Er:YAG laser on bond strength to dentin of a self-etching primer and two single-bottle adhesive systems

BACKGROUND AND OBJECTIVES: To assess the effect of erbium:yttrium aluminium garnet (Er:YAG) laser on bond strength to dentin of a self-etching primer (Clearfil Liner Bond 2V, CL2V) and two single-bottle agents (Excite, EX; Gluma One Bond, GB). STUDY DESIGN/MATERIALS AND METHODS: Thirty human molars were selected, roots were removed and crowns were bisected, providing 60 halves. Specimens were included and ground to expose dentin. Bonding site was limited and samples were assigned to three groups: I, CL2V; II, EX; III, GB. Dentin was either conventionally treated or submitted to laser conditioning + conventional treatment. The adhesive protocol was performed, samples were stored for 24 hours and bond strength was tested to failure (0.5 mm/min). RESULTS: Statistical analysis showed a decrease in bond strength for lased subgroups and this drop was more evident for EX. CL2V provided the best overall results, regardless of the surface treatment. CONCLUSIONS: Er:YAG laser may adversely affect bond strength in higher or lesser degree, depending on the adhesive system used.     

Microleakage and scanning electron microscopy evaluation of all-in-one self-etch adhesives and their respective nanocomposites prepared by erbium:yttrium–aluminum–garnet laser and bur

The aim of this study was to evaluate the microleakage of all-in-one self-etch adhesives and their respective nanocomposites in class V cavities prepared by erbium:yttrium–aluminum–garnet (Er:YAG) laser and bur. Class V cavities were prepared on both buccal and lingual surfaces of 72 premolars by Er:YAG laser or bur and divided into six groups (n = 24). The occlusal margins were enamel and the cervical margins were cementum. The groups were as follows: group 1 Er:YAG laser preparation (E) + Xeno V (X) + CeramX (C); group 2 bur preparation (B) + X + C; group 3 E + AdheSE One (A) + Tetric EvoCeram (T); group 4 B + A + T; group 5 E + Clearfil S3 Bond (CSB) + Clearfil Majesty Esthetic (CME); group 6 B + CSB + CME. All teeth were stored in distilled water at 37°C for 24 h, then thermocycled 500 times (5–55°C). Ten teeth from each group were chosen for the microleakage investigation and two teeth for the scanning electron microscopy (SEM) evaluation. The teeth that were prepared for the microleakage test were immersed in 0.5% basic fuchsin dye for 24 h. After immersion, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed by Kruskal–Wallis and Mann–Whitney U tests (P < 0.05). Bur-prepared cavities presented less microleakage in all groups for enamel (P < 0.05); however, in cervical margins, there were no differences between laser-prepared and bur-prepared cavities in the Xeno V + CeramX and AdheSE One + Tetric EvoCeram groups (P > 0.05). SEM observations of restorative material–dentin interfaces seemed to correspond with those of the microleakage test. Microleakage at the cervical interfaces was greater than that at the occlusal interfaces. Er:YAG laser-prepared class V cavities yielded more microleakage in occlusal margins with all-in-one self-etch adhesives and the respective manufacturer’s nanocomposites.     

Effect of low fluency dentin conditioning on tensile bond strength of composite bonded to Er:YAG laser-prepared dentin: a preliminary study

Several studies in the literature have previously shown that the bond strength of a composite bonded to dentin is almost equivalent as when dentin is prepared by either bur or Er:YAG laser. The aim of this preliminary study is to assess the hypothesis that dentin conditioning at low fluency by means of Er:YAG laser can improve the value of adhesion of composites resin to dentin. Sixty surfaces of caries-free human third molars extracted for orthodontic purposes were randomly divided into five groups of 12 teeth. The bur group was the control, prepared using bur, group L was prepared using Er:YAG 200 mJ, SSP (50 μs), 20 Hz, 15 seconds of sweeping, for groups L80, L100, L120, they were prepared first, with the same parameters of the group L 200, and then they received a conditioning, which is, respectively, 15 s of irradiations at: 80 mJ (SSP, 10 Hz), 100 mJ (SSP, 10 Hz), and 120 mJ (SSP, 10 Hz). All samples were restored in a single-component adhesive system: Xenon (DENTSPLY), and ceramX (DENTSPLY) as the resin composite. The specimens were submitted to tensile bond strength test using a universal testing machine. Data were submitted to statistical analysis using ANOVA coupled to a Tukey-Kramer test at the 95% level. The mean values in MPa were 33.3 for group B, 36.73 for group L 200, 41.7 for group L80, 37.9 for group L100, and 39.1 for group L120. Our results showed that dentin conditioning at a low fluency of 12.58 J/cm² per pulse, with 80 mJ output energy and 50-μs pulse duration can significantly improve tensile bond strength of a composite bonded to Er:YAG laser-prepared dentine.     

Selective targeting of protein, water, and mineral in dentin using UV and IR pulse lasers: the effect on the bond strength to composite restorative materials

BACKGROUND AND OBJECTIVES: Previous studies have shown that during the laser irradiation of dentin and bone, thermal damage can be minimized by using a highly absorbed laser wavelength, laser pulses shorter than the thermal relaxation time of the deposited laser energy at that wavelength, and the addition of a layer of water to the tissue surface before ablation. The objective of this study was to investigate the influence of laser pulse duration and wavelength with and without the added water layer on the bond strength of composite to laser prepared dentin surfaces. The specific hypothesis that was tested was that thermal damage to the collagen matrix in dentin compromises the bond strength to composite restorative materials. STUDY DESIGN/MATERIALS AND METHODS: Three laser systems were employed that were tuned to water, collagen, and mineral absorption with pulse durations less than the thermal relaxation time of the deposited energy. The surfaces of human dentin were irradiated by laser irradiation from free-running and Q-switched Er:YSGG lasers, pulsed CO(2) lasers operating at 9.6-microm, and a Q-switched Nd:YAG laser operating at 355-nm. A motion control system and a pressurized spray system incorporating a microprocessor controlled pulsed nozzle for water delivery, were used to ensure uniform treatment of the entire surface. Shear bond testing was used to evaluate the adhesive strength in order to access the suitability of laser treated surfaces for bonding. Bonded interfaces were examined by SEM. RESULTS: All the laser groups had significantly lower bond strengths than the positive acid etch control group. The highest bond strengths were for the short pulse (< 5-microsecond) Er:YSGG and CO(2) laser groups with water. Laser groups without water had significantly reduced bond strengths and thicker layers of thermally damaged dentin. CONCLUSIONS: Thermal damage to the collagen matrix profoundly influences the bond strength to composite restorations.     

Evaluation of the furcation area permeability of deciduous molars treated by neodymium:yttrium–aluminum–garnet laser or adhesive

The purpose of this in vitro study was to compare the effects of a self-etch adhesive system and neodymium:yttrium–aluminum–garnet (Nd:YAG) laser application on the dentinal permeability of the furcation area of primary molars. After endodontic access, 39 extracted human deciduous molars were divided into three groups: control group (CG), no treatment; adhesive group (AG), self-etching adhesive was applied to the furcation area; laser group (LG), specimens were irradiated with Nd:YAG laser. To evaluate dentin permeability of the furcation area, we immersed the specimens in 0.5 % methylene blue dye for 4 h. Then, they were longitudinally sectioned into two halves and photographed. The images were analyzed by two qualified evaluators using TpsDig software to calculate the percentage of the dye penetration area in comparison with the total furcation area. Additional analyses by scanning electron microscopy (SEM) were performed. The analysis of variance (ANOVA), complemented by Student’s t-test, showed that mean dye penetration in the LG was statistically significant lower than that in all the other groups (P < 0.05). The SEM analysis showed mostly dentinal tubules obliterated by smear layer in the CG; in the AG the smear layer was modified by the adhesive, and, in the LG, melted surfaces were observed. It can be concluded that the Nd:YAG laser was capable of reducing the dentinal permeability of the furcation area of deciduous molars.