Cynthia Soares de Azevedo

Evaluation of caries-affected dentin with optical coherence tomography

The purpose of this study was to evaluate the degree of demineralization of artificially induced caries-affected human dentin by an in vitro microbiological method. The occlusal surfaces of 6 human molar teeth were abraded until a flat surface was obtained, and the enamel was removed to expose the occlusal dentin surface. These teeth were sectioned in 12 halves in the vestibular-lingual direction and divided into 3 groups according to the period length of the microbiological essay (n = 4): G1, 7 days; G2, 14 days; and G3, 21 days. The surfaces of all specimens were protected by an acid-resistant nail varnish, except for a window where the caries lesion was induced by a Streptoccocus mutans biofilm in a batch-culture model supplemented with 5% sucrose. The specimens were then analyzed by optical coherence tomography (OCT) with a super-luminescent light diode (Λ = 930 nm) with 6.0-µm lateral and longitudinal resolution (in the air). Qualitative and quantitative results (images and average dentin demineralization, respectively) were obtained. The mean demineralization depths were (µm) 235 ± 31.4, 279 ± 14, and 271 ± 8.3 in groups 1, 2, and 3, respectively. In addition, no significant change was observed in the lesion mean depth from 7 days of cariogenic challenge on. In conclusion, OCT was shown to be an efficient and non-invasive method to detect the depths of lesions caused by demineralization. Further, a seven-day demineralization time was considered sufficient for caries-affected dentin to be obtained.

Antimicrobial photodynamic therapy: A promise candidate for caries lesions treatment

BACKGROUND Antibacterial photodynamic therapy (aPDT) is a promising adjunctive therapy to the treatment of caries lesions, mainly in the minimally invasive approach to preserve dental tissue and favor its repair. Here we analyzed both the efficacy of aPDT in reducing the bacterial load in cariogenic biofilms and the indirect effect of noxious components produced by aPDT on the viability of dental pulp cells. METHODS The aPDT protocol was established using 0.025g/mL methylene blue (MB) and 5min pre-irradiation time. A continuous-wave diode laser (660nm, 0.04cm(2) spot size, 40mW, 60s, 60J/cm(2) and 2.4J) was used in punctual and distance modes to excite the MB. The protocol was first tested against Streptococcus mutans (U159) biofilms produced in 96-well microplates, and then evaluated on caries-like affected human dentin discs of three thicknesses. The number of colony forming units (CFU) was compared between groups. Discs were then assembled in metallic inserts to produce an artificial pulp chamber and allow investigation of the indirect effects of aPDT on dental pulp cells by the 3-(4,5-dimethylthiazol-2-yl)-diphenyltetrazolium bromide (MTT) assay. Data were analyzed using Students t test or one-way analysis of variance (ANOVA) followed by the Tukeys test at a significance level of 5%. RESULTS Bacterial load reduction was observed in biofilms produced both in the microplates (p<0.05) and on the caries-like affected dentin discs (81.01% or mean reduction of log21.010±0.1548; p=0.0029). The cell viability of aPDT and control group was similar (p>0.05). CONCLUSIONS aPDT may be considered a promise adjunctive therapy for deep carious lesions.

Er,Cr:YSGG Laser Dentine Conditioning Improves Adhesion of a Glass Ionomer Cement

OBJECTIVE The purpose of this study was to evaluate the bond strength (BS) of different surface treatments, including laser irradiation, between conventional glass ionomer cement (GIC) and dentine. METHODS Eighty-five human third molars were divided into five groups with one of the following treatments: G1- control group, had no treatment; G2, G3, and G4 were treated with Er,Cr:YSGG laser irradiation at 0.5 W, 20 Hz, 25 mJ, 9 J/cm(2) (G2); 1.0 W, 20 Hz, 50 mJ, 18 J/cm(2)(G3); and 1.5 W, 20 Hz, 75 mJ, 27 J/cm(2) (G4); and G5 was treated with GIC liquid, which contains polyacrylic acid. Scanning electron microscopy (SEM) evaluation (n=2) and micro-shear bond strength test (n=15) using the GIC bonded to dentine were performed after 24 h of water immersion. The data were analyzed by one way analysis of variance (ANOVA), according to irradiation protocol (p<0.001). RESULTS G2 specimens presented the highest BS results (in MPa) (10.50±0.84), followed by G1 (4.77±0.59) and G5 (4.26±1.02), which were statistically similar. G3 (3.32±0.39) and G4 (2.94±0.50) demonstrated the lowest BS values, and the difference between these groups was not statistically significant (p>0.001). SEM analysis of G1 revealed that the smear layer covered the entire dentine surface, whereas in G2, G3, and G4, irregular dentine was detected with open dentinal tubules and protruded peritubular dentine. Laser pulses could easily be distinguished in G2 but not in G3 and G4. G5 revealed a thin smear layer with dentinal tubule apertures clearly detectable. CONCLUSIONS Dentine treatment with an Er,Cr:YSGG laser irradiation at a power of 0.5 W increased the BS of conventional GIC.

A comparative leakage study on Er,Cr: YSGG laser- and bur- prepared Class V cavities restored with a low-shrinkage composite using different filling techniques

AIM: To evaluate the leakage on Er,Cr:YSGG laser- and bur- prepared Class V cavities restored with a silorane-based composite resin using different insertion techniques METHODS: 40 cavities were outlined according to: the type of instrument [Er,Cr:YSGG laser (3.0 W power, energy per pulse of 150 mJ, fluence of 53.57J/cm2, pulse duration of 140-200 ∝s, 20 Hz repetition rate and 55/65% air/water spray) or diamond bur]; and the type of filling technique (bulk increment or incremental). Four experimental groups were obtained (n=10): G1- diamond bur (DB) and incremental (I); G2- DB and bulk increment (BI); G3- Er,Cr:YSGG and I; and G4- Er,Cr:YSGG and BI. Specimens were restored with a silorane-based composite resin (Filtek P90, 3M/ESPE), subjected to 500 thermal cycles, sealed, infiltrated with 2% (w/v) methylene blue and sectioned in halves. Specimen analysis was scored based on a scale. Statistical analyses were done using the Kruskal-Wallis and Student Newman-Keuls tests (α=0.05). RESULTS: Statistically significant differences were observed between G2 and G4 (p=0.003) and between G1 and G2 (p=0.028). The filling technique did not influence the pattern of dye leakage in the cavity walls (p=0.151). CONCLUSIONS: Less leakage was observed when Er,Cr:YSGG cavities were restored with silorane-based composite resin, using the bulk increment technique. Nevertheless, cavities done using diamond bur have less leakage only when incrementally restored.

Laser Technology for Caries Removal

Laser technology has been in the scope of dentistry community since Stern & Sognnaes (1964) studied laser application on dental hard tissues. Lasers have become an attractive instrument for many dental procedures including soft tissues surgery (Sperandio et al., 2011), decontamination (Benedicenti et al., 2008; Koba et al., 1998) and for assuring antiinflammatory effects (Lang-Bicuto et al., 2008). In restorative dentistry, laser has been used successfully for cavity preparation (De Moor et al., 2010; Obeidi et al., 2009), caries prevention (Namoour et al., 2011; Rechmann et al., 2011; Zezell et al., 2009), caries decontamination (Namour et al., 2011) and caries removal (Neves et al., 2011; White et al., 1993). For that, high intensity lasers are indicated, which are able to promote controlled temperature rise in a small and specific area of dental hard tissue (Ana et al., 2007). Depending on the temperature rise and the interaction of laser irradiation with dental tissues, it is possible to produce specific micro structural and/or mechanical changes related to a correct clinical application.