Mieke De Bruyne

Microleakage of four different restorative glass ionomer formulations in Class V cavities: Er:YAG laser versus conventional preparation

OBJECTIVE To investigate microleakage in class V cavities following restoration with conventional glass-ionomer cements (CGICs) or resin-modified glass-ionomer cements (RMGICs), following Er:YAG laser or conventional preparation. BACKGROUND DATA The sealing ability of GICs in Er:YAG-lased cavities has not been studied extensively. METHODS Three hundred and twenty class V cavities were assigned to four groups: those in groups A and B were prepared using an Er:YAG laser, and those in groups C and D were conventionally prepared. In groups B and D the surface was additionally conditioned with cavity conditioner. Each group was subdivided according to the GIC used: groups 1 (Fuji II), 2 (Fuji IX), 3 (Fuji II LC) and 4 (Fuji VIII). After thermocycling, the specimens were immersed in a 2% methylene blue solution, sectioned oro-facially, and analyzed for leakage. The effect of the conditioner was analyzed using a scanning electron microscope (SEM). RESULTS Significant differences between occlusal and gingival margins were found in all groups (p < 0.05) except B4, D3, and D4. Comparison of preparation methods (groups A-D) revealed significant differences at the occlusal margin in groups 1 and 3, but in all groups at the gingival margin (p < 0.05). Laser preparation without conditioning allowed more leakage (p < 0.05). Comparison of filling materials (groups 1-4) revealed significant differences in groups B and C at the occlusal margin, and in all groups at the gingival margin (p < 0.05). In these groups, laser-prepared cavities (with or without conditioning) restored with Fuji II LC and Fuji VIII showed the least leakage at both margins. CONCLUSION RMGICs allowed less microleakage than CGICs. Complete marginal sealing was not achieved and conditioning is recommended.

Investigation of Coronal Leakage of Root Fillings After Smear-Layer Removal with EDTA or Nd:YAG Lasing Through Capillary-Flow Porometry

OBJECTIVE This study investigates the effects of Nd:YAG laser irradiation combined with different irrigation protocols on the marginal seal of root fillings. BACKGROUND DATA Limited information exists regarding the effects of morphologic changes to root canal (RC) walls after Nd:YAG laser irradiation after smear-layer removal with EDTA on the sealing ability of root fillings. METHODS The 75 root-filled teeth (5 × 15 teeth) were analyzed for through-and-through leakage by using capillary flow porometry (CFP). The RC cleaning procedure determined the assignment to a group: (1) irrigation with NaOCl 2.5% and EDTA 17% or standard protocol (SP), (2) SP + Nd:YAG lasing (dried RC), (3) NaOCl 2.5% + Nd:YAG lasing (dried RC), (4) SP + Nd:YAG lasing (wet RC), or (5) NaOCl 2.5% + Nd:YAG lasing (wet RC). Groups 1r to 5r consisted of the same filled teeth with resected apices up to the most apical point of the preparation length. Resection was performed after the first CFP measurement. Roots were filled with cold lateral condensation. CFP was used to assess minimum, mean flow and maximum pore diameters after 48 h, and immediately after these measurements, including root resection. Statistics were performed by using nonparametric tests (p > 0.05). An additional three roots per group were submitted to SEM of the RC wall. RESULTS Through-and-through leakage was observed in all groups. Statistically significant differences were observed in maximum pore diameter: 1r > 3r, and 1r > 5r; in mean flow pore diameter: 1r > 2r, 2r < 4r (p < 0.05). Typical Nd:YAG glazing effects were observed when the smear layer was present and exposed to the laser fiber (i.e., in the groups without use of EDTA) or when the fiber tip made direct contact with a smear-layer free RC wall. CONCLUSIONS The reduction in through-and-through leakage is significantly higher with the Nd:YAG laser as smear-layer modifier than when smear layer is removed with an EDTA rinsing solution.

Insight in the Chemistry of Laser-Activated Dental Bleaching

The use of optical radiation for the activation of bleaching products has not yet been completely elucidated. Laser light is suggested to enhance the oxidizing effect of hydrogen peroxide. Different methods of enhancing hydrogen peroxide based bleaching are possible. They can be classified into six groups: alkaline pH environment, thermal enhancement and photothermal effect, photooxidation effect and direct photobleaching, photolysis effect and photodissociation, Fenton reaction and photocatalysis, and photodynamic effect.

Laser Teeth Bleaching: Evaluation of Eventual Side Effects on Enamel and the Pulp and the Efficiency In Vitro and In Vivo

Light and heat increase the reactivity of hydrogen peroxide. There is no evidence that light activation (power bleaching with high-intensity light) results in a more effective bleaching with a longer lasting effect with high concentrated hydrogen peroxide bleaching gels. Laser light differs from conventional light as it requires a laser-target interaction. The interaction takes place in the first instance in the bleaching gel. The second interaction has to be induced in the tooth, more specifically in the dentine. There is evidence that interaction exists with the bleaching gel: photothermal, photocatalytical, and photochemical interactions are described. The reactivity of the gel is increased by adding photocatalyst of photosensitizers. Direct and effective photobleaching, that is, a direct interaction with the colour molecules in the dentine, however, is only possible with the argon (488 and 415 nm) and KTP laser (532 nm). A number of risks have been described such as heat generation. Nd:YAG and especially high power diode lasers present a risk with intrapulpal temperature elevation up to 22°C. Hypersensitivity is regularly encountered, being it of temporary occurrence except for a number of diode wavelengths and the Nd:YAG. The tooth surface remains intact after laser bleaching. At present, KTP laser is the most efficient dental bleaching wavelength.

Influence of different stool types on muscle activity and lumbar posture among dentists during a simulated dental screening task

Whereas in the past dental stools typically facilitated a 90° hip angle, a number of currently available alternative designs allow for a more extended hip posture. The present study investigated the influence of different stool types on muscle activity and lumbar posture. Twenty five participants completed a simulated dental procedure on a standard stool, a saddle and the Ghopec. The latter stool comprises a seat pan consisting of a horizontal rear part for the pelvis and an inclinable sloping down front part for the upper legs, with a vertically and horizontally adjustable back rest. Lumbar posture was most close to neutral on the Ghopec, whereas sitting on a standard/saddle stool resulted in more flexed/extended postures respectively. Sitting with a 90° angle (standard stool) resulted in higher activation of back muscles while sitting with a 125° angle (saddle and Ghopec) activated abdominal muscles more, although less in the presence of a backrest (Ghopec). To maintain neutral posture during dental screening, the Ghopec is considered the most suitable design for the tasks undertaken.

Debris Removal from the Mesial Root Canal System of Mandibular Molars with Laser-activated Irrigation

Introduction: The purpose of this study was to compare in vitro the canal and isthmus debridement of manual‐dynamic, passive ultrasonic, and laser‐activated irrigation with an Er:YAG laser in mesial roots of human mandibular molars. Methods: Fifty extracted mandibular molars with an isthmus were embedded in resin and sectioned axially 4 mm from the apex. The teeth were reassembled with guide pins and bolts, and the mesial canals were instrumented up to a ProTaper F2 rotary file (Dentsply Maillefer, Ballaigues, Switzerland). Teeth were randomly assigned to the following irrigant activation groups (n = 10): conventional needle irrigation (NI), manual‐dynamic irrigation with a ProTaper F2 gutta‐percha cone, ultrasonically activated irrigation using a size 20 Irrisafe (Satelec Acteon, Mérignac, France), and laser‐activated irrigation (LAI) with an Er:YAG laser and a conical 400‐&mgr;m fiber tip in the canal entrance or a 600‐&mgr;m tip over the canal entrance. Root cross‐sectional images were taken before and after final irrigation, and the area occupied by debris in the main canal and the isthmus was determined using image analysis software. Differences in debris before and after activation were statistically compared within and across groups. Results: Significant reductions in debris levels were observed in all groups, except for NI and manual‐dynamic irrigation (canal only). None of the methods rendered the canal systems debris free. In the canal, LAI with an Er:YAG laser and a 600‐&mgr;m tip over the canal entrance removed significantly more debris than NI. In the isthmus, LAI with an Er:YAG laser and a conical 400‐&mgr;m fiber tip in the canal entrance removed significantly more debris than NI. Conclusions: Within the limitations of this in vitro study, canal and isthmus cleanliness significantly improved after irrigant activation.