Sevcan Kurtulmus-Yilmaz

Clinical evaluation of Er,Cr:YSGG and GaAlAs laser therapy for treating dentine hypersensitivity: A randomized controlled clinical trial

OBJECTIVE The advent of dental lasers has raised another possible treatment option for dentine hypersensitivity (DH) and has become a research interest in the last decades. The aim of this randomized, controlled, double-blind, split mouth, clinical study was to evaluate and compare the desensitizing effects of erbium, chromium-doped:yttrium, scandium, gallium and garnet (Er,Cr:YSGG) to galium-aluminium-arsenide (GaAlAs) laser on DH. METHODS Fifty-one patients participated in this study for a total of 174 teeth. DH was assessed for all groups with a visual analog scale. For each patient, the teeth were randomized to three groups. In the diode laser group, sensitive teeth were irradiated with the GaAlAs laser at 8.5J/cm(2) energy density. In the Er,Cr:YSGG laser group, sensitive teeth were irradiated with Er,Cr:YSGG laser in the hard tissue mode using a none-contact probe at an energy level of 0.25W and repetition rate of 20Hz, 0% water and 10% air. In the control group no treatment was performed. Treatment time was 60s for GaAlAs laser and 30s for Er,Cr:YSGG laser. RESULTS When compared with the control group and baseline data, in both laser groups, laser irradiation provided a desensitizing effect immediately after treatment and this effect was maintained throughout the study (p<0.05). No significant differences between Er,Cr:YSGG and GaAlAs laser groups were found at any follow-up examination (p>0.05). CONCLUSION Based on these findings, it may be concluded that both Er,Cr:YSGG and GaAlAs lasers were effective in the treatment of DH following a single application.

Effectiveness of Er,Cr:YSGG laser on dentine hypersensitivity: a controlled clinical trial

AIM Attempts have been made to treat dentine hypersensitivity (DH) with lasers. However, there is limited knowledge on the effects of erbium, chromium-doped:yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser on DH. The aim of this study was to evaluate the efficacy of Er,Cr:YSGG laser on reduction in DH. METHODS Forty-two patients (146 teeth) were included. Teeth were assigned to an experimental group and irradiated with the Er,Cr:YSGG laser. In the control group same clinical instrument was used without laser emission. DH was assessed for both groups utilizing the visual analog scale. Plaque index (PI) scores were recorded immediately following treatment, at 1 week, 1 and 3 months. RESULTS The results showed that Er,Cr:YSGG laser irradiation had a significantly higher desensitizing effect compared with the placebo immediately after treatment (p<0.05). Intra-group comparisons revealed no statistically significant differences within the placebo group (p>0.05). For the test group, the differences between baseline and all time points following treatment were statistically significant (p<0.05). No significant differences were observed in PI between the test and control groups at any follow-up examination (p>0.05). CONCLUSION Within the limits of this study, it appears that Er,Cr:YSGG laser is effective in the treatment of DH compared with the placebo treatment.

Long-Term Effect of Diode Laser Irradiation Compared to Sodium Fluoride Varnish in the Treatment of Dentine Hypersensitivity in Periodontal Maintenance Patients: A Randomized Controlled Clinical Study

OBJECTIVE The aim of this clinical study was to evaluate and compare the desensitizing effects of a gallium?aluminum?arsenide (GaAlAs) laser and sodium fluoride (NaF) varnish on dentine hypersensitivity (DH) in periodontal maintenance patients. BACKGROUND DATA The use of lasers opens a new dimension in the treatment of DH. METHODS Forty-eight patients with 244 teeth affected by DH were included in the trial. To be included in the study, the subjects had to have 4 or more hypersensitive teeth at different quadrants. Selected teeth were randomly assigned to a GaAlAs laser group, placebo laser group, NaF varnish group, or a placebo NaF varnish group. Laser therapy was performed at 8.5?J/cm(2) energy density. In the placebo laser group, the same laser without laser emission was used. In the NaF varnish group, the varnish was painted at the cervical region of the teeth. In the placebo NaF varnish group, the same treatment procedures were performed with a saline solution. DH was assessed with a visual analog scale (VAS); immediately, at 1 week, and at 1, 3, and 6 months after treatments. Intra-group time-dependent data were analyzed by Friedmans test, and Wilcoxons rank sum test was used to evaluate the differences within groups. RESULTS GaAlAs laser and NaF varnish treatments resulted in a significant reduction in the VAS scores immediately after treatments that were maintained throughout the study when compared to the baseline and placebo treatments. In the NaF group, there was a significant increase in the VAS scores at 3 and 6 months compared to at 1 week and 1 month. The placebo treatments showed no significant changes in VAS scores throughout the study period. CONCLUSIONS Within the limits of the study, GaAlAs laser irradiation was effective in the treatment of DH, and it is a more comfortable and faster procedure than traditional DH treatment.

Comparison of the translucency of shaded zirconia all-ceramic systems.

PURPOSE The purpose of this study was to evaluate and compare the translucency of shaded zirconia all-ceramic systems. MATERIALS AND METHODS Translucency of 3 different zirconia all-ceramic systems colored by different techniques was compared with a lithium disilicate glass-ceramic (IPS e.max Press). Square-shaped specimens with 0.5 mm thickness were fabricated from In-Ceram YZ, ICE Zirkon and Katana systems in A1, A2 and A3.5 shades according to Vitapan Classical shade tab (n=11). Specimens were then veneered and glazed with corresponding veneer ceramic recommended by each zirconia system manufacturer and the total thickness was set to 1.5 mm. Translucency measurements were performed with VITA Easyshade Compact spectrophotometer after each stage and translucency parameter was calculated. Data were statistically analyzed with repeated measures ANOVA and Tukey multiple comparison test. RESULTS The control group was significantly more translucent than the zirconia systems (P<.05). ICE Zirkon cores showed the least translucency; neither In-Ceram YZ nor Katana systems were superior to each other in terms of translucency. Translucency of all specimens was decreased after veneering, and the translucency rankings were changed. CONCLUSION Coloring technique did not have a significant effect on translucency of zirconia cores. Although zirconia systems were less translucent than lithium disilicate glass ceramic, they had partial translucency and there were translucency differences among the zirconia systems. Chroma affected the translucency of precolored zirconia cores.

Digital evaluation of the accuracy of impression techniques and materials in angulated implants

OBJECTIVES The aim of this study was to investigate the accuracy of 2 different impression techniques and 3 different impression materials in models simulating parallel and angulated implants. METHODS Three master models simulating partial edentulous mandible with 2 implants at the sites of second premolars (parallel) and second molars with different angulations (parallel, 10° or 20° angulated) were fabricated. Two different impression techniques [splinted direct (D), indirect (I)] and 3 different monophase impression materials [polyether (PE), vinyl polysiloxane (VPS), vinyl polyether silicone (VPES)] were used for each master model and a total of 180 impressions were made (n=10). Master model and casts were scanned by a modified laser scanner and data were transferred to VRMesh software. Master model and duplicate cast scans were digitally aligned observing the superposition of anatomic markers. Angular and coronal deviations between master and duplicated copings were calculated and data were statistically analyzed. RESULTS Mean angular and coronal deviations were in a range of 0.205-0.359° and 22.56-33.33μm, respectively. Statistical analysis revealed that the angulation of implant affected both coronal and angular deviations of the impression copings (P<0.05). According to statistical analyses, for parallel implants, the accuracy of impression materials and techniques were ranging as VPS-D=PE-D>VPS-I=PE-I>VPES-D>VPES-I from most accurate to the least. For 10° and 20° angulated implants the most accurate material and technique was VPS-D whereas the least accurate combination was VPES-I (P<0.05). CONCLUSION Angulation, impression technique and material were found to be effective on the accuracy of implant impressions. CLINICAL SIGNIFICANCE Clinicians may prefer VPS impression material and splinted direct technique for impressions of both parallel and up to 20° angulated implants.

Clinical Application of Stereolithographic Surgical Guide With a Handpiece Guidance Apparatus: A Case Report

The success of implant-supported restorations depends on the treatment planning and the transfer of planning through the surgical field. Recently, new computer-aided design and manufacturing (CAD/CAM) techniques, such as stereolithographic (SLA) rapid prototyping, have been developed to fabricate surgical guides to improve the precision of implant placement. The objective of the present case is to introduce a recently developed SLA surgical guide system into the rehabilitation of a 62-year-old male patient with mandibular edentulism. After obtaining a cone-beam computerized tomography (CBCT) scan of the mandible with a radiographic template, the images were transferred into a 3-dimensional (3D) image-based software for implant planning. The StentCad Beyond SLA surgical guide system, which is a combination of a currently used surgical template with pilot hollows and a surgical handpiece guidance apparatus, was designed to transfer a preoperatively defined implant position onto the surgical site without any drill-surgical guide contact. For the fabrication of this system, a surgical handpiece was scanned by a laser optical scanner and a mucosa-supported surgical guide was designed according to the patients 3D model, which was attained from the CBCT images. Four dental implants were inserted through the SLA surgical guide system by a torque-controlled surgical handpiece to the interforaminal region via a flapless surgical procedure. Implants were assessed 3 months after surgery, and an implant-retained mandibular overdenture was fabricated. The present case emphasizes that CAD/CAM SLA surgical guides, along with CBCT images and scanning data, may help clinicians plan and place dental implants.

Treatment of amalgam tattoo with an Er,Cr:YSGG laser

Amalgam tattoos are common, asymptomatic, pigmented oral lesions that clinically exist as isolated, blue, gray, or black macules on the gingival, buccal, and alveolar mucosae, the palate, and/or the tongue. In this case report, the successful use of an erbium, chromium-doped:yttrium, scandium, gallium, and garnet laser for the removal of an amalgam tattoo is explained. A 46-year-old man is presented with a half decade history of an amalgam tattoo on his left maxillary premolar-molar gingiva. Depigmentation procedure was performed under topical anesthesia with the use of an erbium, chromium-doped:yttrium, scandium, gallium, and garnet laser at 2 W in the soft tissue pulsed mode for 10 min. The pigmented tissue was completely removed. The de-epithelialization area healed completely on the 10th day after treatment. The period of healing was uneventful. The amalgam tattoo was completely removed with erbium, chromium-doped:yttrium, scandium, gallium, and garnet laser, and the treated area healed without any adverse effect.

Effect of alloy recasting on the color of opaque porcelain applied on different dental alloy systems

STATEMENT OF PROBLEM The effect of different proportions of recast dental alloys on the color of overlying opaque porcelain (OP) is unknown. PURPOSE The purpose of this study was to compare the color of OP applied on 2 different proportions (50% and 100%) of recast alloys with the color of commercially available shade tabs of OP. MATERIAL AND METHODS Six different metal alloy systems (2 base: Metalloy CC, Cr-Co [B-MCC]; Heraenium NA, Ni-Cr [B-HNA]; 3 noble: Cerapall 2, Pd-Au [N-CP2]; Triumph, Pd-Ag [N-T]; V-Deltaloy, Au-Pd [N-VD]; and 1 high-noble: V-Gnathos Plus, Au-Pt [HN-GP]) were selected for the fabrication of disk-shaped specimens (10 mm in diameter, 1 mm in thickness). Each alloy was divided into 2 subgroups: 50% new alloy with 50% recast alloy (n=3) and 100% recast alloy (n=3). OP (B1) was applied (0.1 mm) to all specimens. The color coordinates (L*, a*, b*) of each specimen and the corresponding commercially available OP shade tab (control) were measured with a spectroradiometer, and color differences between specimens and control group were calculated. Data were statistically analyzed (2-way ANOVA, Ryan-Einot-Gabriel-Welsch multiple range test, α=.05). RESULTS For each alloy, ΔL*(L(control)(-)L(recastalloy)) values for the 2 subgroups were not statistically different from each other. The Δa* and Δb* of different proportions of N-CP2, B-HNA, N-VD, and HN-GP were not statistically different within the alloys. However, the a* values of 100% recast N-T and B-MCC were significantly closer to the a* values of the control group, and the b* values of 50% recast B-MCC were significantly closer to the b* values of the control group (P<.05). Delta E(control-recast) alloy values for different proportions of alloys were not statistically different. However, color differences did not meet the criterion of clinical acceptability (ΔE=3.46). CONCLUSIONS According to the results of this study, the different proportions (50% and 100%) of recast alloys used have similar effects on the color of OP. Differences between the final color of OP on the recast alloys used and the color of OP shade guide tabs did not meet the criterion of clinical acceptability considered in this study.

The effect of home bleaching agents on the surface roughness of five different composite resins: A SEM evaluation.

The aim of this study was to investigate the effect of hydrogen peroxide (HP) and carbamide peroxide (CP) on the surface roughness of five different composite resins using profilometer and scanning electron microscope (SEM). Thirty-six specimens (1 mm thick, 10 mm in diameter) of five composite resins were fabricated. Each composite group was equally divided into three subgroups as control, CP and HP. In control group, specimens were stored in daily refreshed distilled water during the 14-day testing period. In other groups, 10% HP (Opalescence Treswhite) and 10% CP (Opalescence PF) were applied and surface roughness values (Ra) of each specimen were measured with a profilometer at the end of 14 days. Additionally, SEM analysis was performed to evaluate the surface deformations of composite resins. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Ra values of composite groups exposed to bleaching agents were statistically higher than control group (p < 0.05). There was no significant difference between Ra values after HP and CP application within each composite group while SEM micrographs showed higher surface alterations at HP group compared to CP. Among the composite resins tested, Ceram-X Mono revealed the lowest Ra values after CP and HP applications as seen at SEM images. Home bleaching agents increased the surface roughness of all composites. Except CP applied Ceram-X mono specimens, Ra values of all composite resins evaluated in this study exceeded the critical limit of 0.2 μm. Ceram-X mono was the least affected composite material after bleaching application. SCANNING 38:277-283, 2016.

A Comparative Study on the Mechanical Properties of a Polymer-Infiltrated Ceramic-Network Material Used for the Fabrication of Hybrid Abutment

Polymer-infiltrated ceramic-network (PICN) material is a new type of material used for the hybrid abutments of dental implants. This study aimed to compare flexural strength, bond strengths, and fracture-resistance values of PICN with lithium disilicate ceramic (LDS) and to evaluate the effect of thermocycling on the tested parameters. Twenty specimens were fabricated using computer-aided design and manufacturing (CAD-CAM) technology for each material according to three-point bending (n = 10), microshear bond strength (µSBS), and a fracture-resistance test (hybrid abutment, n = 10). All specimens of each test group were divided into two subgroups, thermocycled or nonthermocycled. Hybrid abutments were cemented on titanium insert bases and then fixed on implants to compare fracture resistance. Failure loads were recorded for each test and data were statistically analyzed. Thermocycling decreased bond strength to the resin luting agent and the fracture-resistance values of both materials (p < 0.001), whereas flexural-strength values were not affected. LDS ceramic showed significantly higher flexural strength, bond strength, and fracture-resistance values than PICN material (p < 0.001). Within the limitations of this study, LDS may be a preferable hybrid-abutment material to PICN in terms of mechanical and bonding properties.