Carlos de Paula Eduardo

Stem Cell Proliferation Under Low Intensity Laser Irradiation: A Preliminary Study

Phototherapy with low intensity laser irradiation has shown to be effective in promoting the proliferation of different cells. The aim of this in vitro study was to evaluate the potential effect of laser phototherapy (660 nm) on human dental pulp stem cell (hDPSC) proliferation.

LASER PHOTOTHERAPY AS TOPICAL PROPHYLAXIS AGAINST HEAD AND NECK CANCER RADIOTHERAPY-INDUCED ORAL MUCOSITIS: COMPARISON BETWEEN LOW AND HIGH/LOW POWER LASERS

Oral mucositis is a dose‐limiting and painful side effect of radiotherapy (RT) and/or chemotherapy in cancer patients. The purpose of the present study was to analyze the effect of different protocols of laser phototherapy (LPT) on the grade of mucositis and degree of pain in patients under RT.

Laser phototherapy in the treatment of periodontal disease. A review

Many studies in the literature address the effect of low-power lasers in the management of pathologies related to periodontal tissues. Due to the lack of standardized information and the absence of a consensus, this review presents the current status of laser phototherapy (LPT) in periodontics and discusses its benefits and limits in the treatment of periodontal disease. The literature was searched for reviews and original research articles relating to LPT and periodontal disease. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. The literature search retrieved references on wound and bone healing, analgesia, hypersensitivity, inflammatory process and antimicrobial photodynamic therapy. Each topic is individually addressed in this review. The current literature suggests that LPT is effective in modulating different periodontal disease aspects in vitro, in animals, and in simple clinical models. Further development of this therapy is now dependent on new clinical trials with more complex study designs.

Nd:YAG laser in caries prevention: a clinical trial.

It is widely known that Nd:YAG can increase enamel resistance to demineralization; however, there are no studies that report the application of Nd:YAG associated with topical application of fluoride in vivo. The aim of this study was to evaluate the effects of the Nd:YAG laser, when associated with the topical application of acidulated phosphate fluoride (APF), for preventing enamel demineralization in vivo.

Improvement in quality of life of an oncological patient by laser phototherapy.

OBJECTIVE AND BACKGROUND DATA Common side effects of radiotherapy (RT) to the head and neck include oral mucositis, xerostomia, and severe pain. The aim of this study is to report improvement in the quality of life of an oncological patient by laser phototherapy (LPT). CLINICAL CASE AND LASER PHOTOTHERAPY PROTOCOL The patient, a 15-year-old girl diagnosed with mucoepidermoid carcinoma, underwent surgical excision of a tumor of the left palatomaxilla. After that, she was subjected to 35 sessions of RT (2 Gy/d). Clinical examination revealed the spread of severe ulcerations to the jugal mucosa, gums, lips, hard palate, and tongue (WHO mucositis score 3). She had difficulty in moving her tongue and she was unable to eat any solid food. Oral hygiene orientation and LPT were performed throughout all RT sessions. A continuous diode laser, 660 nm, 40 mW, 6 J/cm(2), 0.24 J per point in contact mode, with spot size of 0.04 cm(2) was used in the entire oral cavity. A high-power diode laser at 1 W, 10 sec per cm of mucositis, approximately 10 J/cm(2), was used in defocused mode only on ulcerative lesions. After the first laser irradiation session, decreases in pain and xerostomia were reported; however, a more significant improvement was seen after five sessions. At that point although the mucositis score was still 2, the patient reported that she was free of pain, and consequently a palatine plate could be made to rehabilitate the entire surgical area. Seventeen laser irradiation sessions were necessary to eliminate all oral mucositis lesions. CONCLUSION Normal oral function and consequent improvements in the quality of life of this oncologic patient were observed with LPT.

CO2 Laser (10.6 μm) Parameters for Caries Prevention in Dental Enamel

Although CO2 laser irradiation can decrease enamel demineralisation, it has still not been clarified which laser wavelength and which irradiation conditions represent the optimum parameters for application as preventive treatment. The aim of the present explorative study was to find low-fluence CO2 laser (λ = 10.6 μm) parameters resulting in a maximum caries-preventive effect with the least thermal damage. Different laser parameters were systematically evaluated in 3 steps. In the first experiment, 5 fluences of 0.1, 0.3, 0.4, 0.5 and 0.6 J/cm2, combined with high repetition rates and 10 μs pulse duration, were chosen for the experiments. In a second experiment, the influence of different pulse durations (5, 10, 20, 30 and 50 μs) on the demineralisation of dental enamel was assessed. Finally, 3 different irradiation times (2, 5 and 9 s) were tested in a third experiment. In total, 276 bovine enamel blocks were used for the experiments. An 8-day pH-cycling regime was performed after the laser treatment. Demineralisation was assessed by lesion depth measurements with a polarised light microscope, and morphological changes were assessed with a scanning electron microscope. Irradiation with 0.3 J/cm2, 5 μs, 226 Hz for 9 s (2,036 overlapping pulses) increased caries resistance by up to 81% compared to the control and was even significantly better than fluoride application (25%, p < 0.0001). Scanning electron microscopy examination did not reveal any obvious damage caused by the laser irradiation.

Comparative study of influence on tensile bond strength of a composite to dentin using Er:YAG laser, air abrasion, or air turbine for preparation of cavities.

OBJECTIVES The purpose of this study was to evaluate, in vitro, the tensile bond strength of the Single Bond (3M) adhesive system placed over dentin surfaces treated with air turbine, Er:YAG laser without contact and in focused or air abrasion. SUMMARY BACKGROUND DATA The use of dentin adhesives is a well-established clinical routine among the dentists. However, there have been few reports comparing the influence of the Er:YAG laser, air abrasion, and air turbine on the Single Bond tensile bond strength of adhesives systems to dentin fact that could influence which tools dentists select for use in cavity preparations. METHODS Twenty-three extracted retained human molars were used in this study. The coronal portion was divided in two parts and fixed in acrylic resin; the occlusal surface was abraded to a 2-mm width with a mechanic lathe until the dentin surface was completely exposed. The dental portions were divided into three groups of 15 each and treated with Er:YAG laser, air abrasion, or air turbine. A 3 mm hole in the center of each tooth was marked off using contact paper. Single Bond (3M) adhesive system was applied after acid phosphoric at 35% application for 15 sec over dentin surfaces. A resin composite cone was built into the delimited area to accomplish the tensile bond strength test on the EMIC universal test machine. The specimens were then evaluated by stereoscopy to determine the type of failures into the dentin-adhesive-resin composite surface. RESULTS The tensile test was performed using the universal testing machine EMIC DL-2000 at a cross-head speed of 0.5 mm/min. The average results were: air turbine (17.52 MPa), Er:YAG laser (16.65 MPa) and air abrasion (15.83 MPa). Statistical treatment by ANOVA and Tukeys test (p < 0.01) showed no significant differences between the groups tested. The tensile bond strength test to the dentin showed no significant difference among the three groups when the Single Bond was used after the 35% phosphoric-acid conditioning. The stereoscopy showed a predominant adhesive failure in all groups. CONCLUSION These results suggest that Single Bond tensile bond strength is the same as dentin prepared by Er:YAG laser, air abrasion, or air turbine.

Comparative Study of Dentine Permeability after Apicectomy and Surface Treatment with 9.6 µm TEA CO2 and Er:YAG Laser Irradiation

Failure of apicectomies is generally attributed to dentine surface permeability as well as to the lack of an adequate marginal sealing of the retrofilling material, which allows the percolation of microorganisms and their products from the root canal system to the periodontal region, thus compromising periapical healing. The purpose of this study was to evaluate dentine and the marginal permeability after apicectomy and surface treatment with 9.6 micro m TEA CO(2) or Er:YAG 2.94 micro m laser irradiation. Sixty-five single rooted human endodontically treated teeth were divided into five experimental groups: group I (control), apicectomy with high speed bur; group II, similar procedure to that of group I, followed by dentinal surface treatment with 9.6 micro m CO(2) laser; group III, similar procedure to group I followed by dentinal surface treatment with Er:YAG laser 2.94 micro m; group IV, apicectomy and surface treatment with CO(2) 9.6 micro m laser; and group V, apicectomy and surface treatment with Er:YAG laser 2.94 micro m. The analysis of methylene blue dye infiltration through the dentinal surface and the retrofilling material demonstrated that the samples from the groups that were irradiated with the lasers showed significantly lower infiltration indexes than the ones from the control group. These results were compatible with the structural morphological changes evidenced through SEM analysis. Samples from groups II and IV (9.6 micro m CO(2)) showed clean smooth surfaces, fusion, and recrystallized dentine distributed homogeneously throughout the irradiated area sealing the dentinal tubules. Samples from groups III and V (Er:YAG 2.94 micro m) also presented clean surfaces, without smear layer, but roughly compatible to the ablationed dentine and without evidence of dentinal tubules. Through the conditions of this study, the Er:YAG 2.94 micro m and the 9.6 micro m CO(2) laser used for root canal resection and dentine surface treatment showed a reduction of permeability to methylene blue dye.

The use of Er:YAG, Nd:YAG and Ga-Al-As lasers in periapical surgery: a 3-year clinical study.

OBJECTIVES In an attempt to increase the successful rate of endodontic surgical procedures this study proposes the use of an association of three lasers in apicectomy: Er:YAG laser, (wavelength 2.94 microm pulse mode), Nd:YAG laser (wavelength 1.064 microm, pulse mode), and Ga-Al-As laser, (wavelength of 790 nm, continuous wave). BACKGROUND DATA Previous studies have shown the low success rate of apicectomy by conventional methods due to the presence of remaining bacteria in the surgical site. METHODS The Er:YAG laser was used to perform osteotomy and root resection without vibration, discomfort, less contamination of the surgical site, and no smear-layer on the dentine surface. The Nd:YAG laser irradiation through a fiber performed sealing of the dentinal tubules and bacterial reduction of the cavity bone. In addition, the improvement of healing and better post-operative achieved with the Ga-Al-As laser encourages the use of those lasers in periapical surgeries. RESULTS Three years follow-up examination of the clinical case showed radiographically significant decrease of the radiolucent periapical area and no clinical signs and symptoms. CONCLUSION The outcome of this clinical case indicates that the use of those lasers could be considered an alternative, suitable, and useful method to perform an apicectomy.

Effects of ultramorphological changes on adhesion to lased dentin-Scanning electron microscopy and transmission electron microscopy analysis.

Dentin irradiation with erbium lasers has been reported to alter the composite resin bond to this treated surface. There is still a lack of studies reporting the effect of erbium lasers on dentin organic content and elucidating how laser treatment could interfere in the quality of the resin–dentin interface. This study aimed to evaluate the effect of erbium laser irradiation on dentin morphology and microtensile bond strength (μTBS) of an adhesive to dentin. Seventy‐two dentin disks were divided into nine groups (n = 8): G1‐Control (600‐grit SiC paper); Er:YAG groups: G2‐ 250 mJ/4 Hz; G3‐ 200 mJ/4 Hz; G4‐ 180 mJ/10 Hz; G5‐ 160 mJ/10 Hz; Er,Cr:YSGG groups: G6‐ 2 W/20 Hz; G7‐ 2.5 W/20 Hz; G8‐ 3 W/20 Hz; G9‐ 4 W/20 Hz. Specimens were processed for cross‐sectional analysis by scanning electron microscopy (SEM) (n = 3), transmission electron microscopy (TEM) (n = 2), and adhesive interface (n = 3). Forty‐five dentin samples (n = 5) were restored and submitted to μTBS testing. ANOVA (α = 5%) revealed that G1 presented the highest μTBS values and irradiated groups did not differ from each other. TEM micrographs showed a superficial layer of denatured collagen fibrils. For SEM micrographs, it was possible to verify the laser effects extending to dentin subsurface presenting a rough aspect. Cross‐sectional dentin micrographs of this hybridized surface revealed a pattern of modified tags with ringlike structures around it. This in vitro study showed that erbium laser irradiation interacts with the dental hard tissue resulting in a specific morphological pattern of dentin and collagen fibrils that negatively affected the bond strength to composite resin. Microsc. Res. Tech., 2011.