Tomoo Anjo

Effects of dentin surface modifications treated with Er:YAG and Nd:YAG laser irradiation on fibroblast cell adhesion.

OBJECTIVE The purpose of this in vitro study was to evaluate the effect of surface modifications induced by erbium (Er):YAG and neodymium (Nd):YAG laser irradiation on cell adhesion by comparing it to that of conventional methods for surface preparation after root-end resection. BACKGROUND DATA Many studies have been seeking a favorable method to produce a resected root end with optimal conditions for cell response. However, little improvement has been achieved. This study evaluated the biocompatibilities of resected root surfaces after Er:YAG or Nd:YAG laser irradiation on initial cell adhesion. MATERIALS AND METHODS Dentin disks were divided into three groups. Group A was left untreated, Group B was treated with Er:YAG laser irradiation (60 mJ/pulse, 10 pps, 60 sec), and Group C with Nd:YAG laser irradiation (60 mJ/pulse, 10 pps, 60 sec). After laser irradiation, the dentin disks were incubated with NIH/3T3 fibroblasts cultured in Dulbeccos modified Eagles medium. A morphological analysis of the dentin surface and cell adhesion was observed under a scanning electron microscope. Surface roughness was measured using a confocal laser scanning microscope. The statistical analysis was undertaken using ANOVA at a level of significance of 5% (p<0.05). RESULTS Morphological analysis and roughness measurement showed that dentin surfaces treated with Er:YAG laser irradiation were rougher than those in Groups A and C. Group B (Er:YAG) exhibited the greatest number of attached cells among all groups after 12 and 24 h. CONCLUSIONS Morphological alteration induced by Er:YAG laser irradiation showed a favorable effect on the attachment of fibroblasts to dentin surfaces.

Application of optical coherence tomography to identify pulp exposure during access cavity preparation using an Er:YAG laser.

OBJECTIVE The study aimed to evaluate the ability of optical coherence tomography (OCT) to guide and identify pulp exposure using an erbium: yttrium-aluminum-garnet (Er:YAG) laser. BACKGROUND DATA The Er:YAG laser has been proven to be effective in ablating dental hard tissue and offers advantages, as there is none of the vibration and noise you get with conventional methods, but it has limitations in relation to the tactile feedback that would aid in identification of entry into the pulp chamber. Based on depth-resolved optical reflectivity, OCT technology has been developed to provide high-resolution, cross-sectional images of the internal structure of biological tissues. MATERIALS AND METHODS The pulp chambers of 20 human mandibular incisors were examined, and the average thickness of hard tissue covering the pulp chamber was assessed using micro-computed tomography (micro-CT) images. An Er:YAG laser was used to gradually penetrate the hard tissue over the pulp chamber under microscopic guidance. The preparation was constantly imaged using a swept-source OCT at 10 sec intervals until a pulp chamber exposure was identified using the technology. The pulp exposure was re-examined under the microscope and compared with micro-CT images for verification. RESULTS The pulp exposures of 20 incisors were all verified microscopically and with micro-CT images. The thickness of hard tissue penetrated by the laser ranged from 0.44 to 1.69 mm. CONCLUSIONS Swept-source OCT is a useful tool for identifying pulp exposure during access opening with the Er: YAG laser.

Initial fibroblast attachment to Erbium:YAG laser-irradiated dentine

AIMS To evaluate the effects of Erbium (Er):YAG laser irradiation on the morphology of resected dentine surfaces, and to investigate fibroblast attachment to laser-irradiated dentine surfaces. METHODOLOGY Dentine blocks obtained from single-rooted human teeth were divided into the following groups after sterilization in an autoclave: (i) Laser group treated with Er:YAG laser irradiation (30 mJ per pulse, 10 pps, 60 s); (ii) L-MTAD group treated with laser irradiation as in (i) plus a mixture of doxycycline, tetracycline isomer and citric acid; (iii) RC-Prep group treated with EDTA gel or cream (RC-Prep) and (iv) Control group left untreated. After each treatment, the dentine blocks were incubated with NIH/3T3 fibroblasts cultured to subconfluency in Dulbeccos modified Eagles medium supplemented with 10% foetal bovine serum and antibiotics. The number of attached cells amongst the groups was analysed statistically at the 5% significance level. The dentine surface morphologies and cell attachments were evaluated by counting assays, histological observations and scanning electron microscopy (SEM). RESULTS The number of attached cells was significantly higher (P < 0.05) in the Laser group than in the RC-Prep and Control groups at 16 h. Dendritic cell extension of the fibroblasts was only observed in the Laser group at 8 h by SEM. In the histological analyses, significantly more attached cells were found on the dentine surfaces treated with laser irradiation. CONCLUSIONS Er:YAG laser irradiation induced morphological alterations in dentine surfaces, which may improve the attachment of fibroblasts to dentine.

Dentin strain induced by laser irradiation.

The purpose of this study was to investigate the strain and temperature change in dentin induced by laser irradiation of human root canals with or without water cooling. Twenty-eight palatal roots of extracted human maxillary first molars were used. The strain in dentin was measured using strain gauges fixed on the apical third of the buccal root surface. The temperature change of the root dentin was monitored using thermocouples embedded into dentin near the apex. The root canal was irradiated with Er:YAG or Nd:YAG laser at an output of 1 W (100 mJ, 10 pps) for 5 s. The tip of the irradiation fibre was located 2.0 mm from the root apex. With water cooling, the mean maximum strain induced by Er:YAG laser was significantly lower than that by Nd:YAG laser (P < 0.05). However, without water cooling, no significant difference between the two lasers (P > 0.05) was found. The results suggest that the strain induced by Er:YAG laser irradiation in dentin with water cooling may be minimal, but there still might be a risk of root micro-fracture if cooling is not sufficient.

The surface of root canal irradiated by Nd:YAG laser with TiO2

The aim of this study was to determine the appropriateness of Nd:YAG laser irradiation for root canal preparation. Tooth crowns were removed from single-rooted human teeth and a quartz optical fiber (diameter 400 μm) was inserted into the root canal orifice towards the apical foramen. The length of the fiber within the root canal was measured, and the irradiating length determined. Root canals were then filled with 3% TiO2 emulsion solution (a photosensitizer) and irradiated using a pulsed Nd:YAG laser at 600 mJ/pulse (pulse frequency; 5 or 10 pps). During laser irradiation, the fiber was moved coronally from the apical region towards the canal orifice at a rate of 1 mm/s. Contact microradiographs (CMR) were taken before and after laser irradiation. Each root was then halved longitudinally, and the root canal surface observed by scanning electron microscopy (SEM). The CMR images of the tooth revealed that the root canal was slightly enlarged as a result of treatment. Carbonization of the root canal dentin was not seen, but a smear layer and melted dentin were observed by SEM. Nd:YAG laser irradiation using TiO2 emulsion solution appears to be a useful tool for root canal preparation.

Removal of root canal obstructions using pulsed Nd:YAG laser

Abstract The aim of this study was to investigate the ability and efficiency of the Nd:YAG laser to remove root canal obstructions. Crowns were removed from extracted human teeth and the samples were divided into three groups. In both the dowel core and the gutta-percha removal groups, the root canal was obturated with gutta-percha and sealer. In the dowel core removal group, a dowel core was subsequently placed. In the file removal group, a K file was intentionally fractured in the root canal. Nd:YAG laser irradiation was performed under water irrigation to remove dowel cores, gutta-percha, and K files. The Nd:YAG laser was able to remove all dowel cores and gutta-percha. Fractured files were successfully removed in five out of eight cases. The irradiation time in the dowel core, gutta-percha and file removal groups was 670, 19 and 317 s, respectively. The rate of postoperative increase of the canal area in the dowel core, gutta-percha and file removal groups was 28%, 6% and 62%, respectively. Since the laser irradiation is able to reach the deep portion of the root canal, with minimal risk of root fracture, it could be a useful tool for the removal of root canal obstructions.

Shaping of the Root Canal Using Er:YAG Laser Irradiation

OBJECTIVE The purpose of the present study was to investigate the degree of Er:YAG laser irradiation at the apical area in vitro. BACKGROUND DATA Since the laser was developed, advancement of laser treatment has been seen in various fields. However, few reports exist on shaping of the root canal using Er:YAG laser irradiation. METHODS Six single-rooted human teeth were used. The working length of root canals was set at 6.5 mm, and they were enlarged to apical file size #25. An Er:YAG laser and cone-shaped irradiation tips (R135T and R200T) were used. Laser irradiation conditions were 30 m J, 20 pps, and water flow of 5 mL/min. Samples were irradiated three times for 10 sec each using each tip. To evaluate the cutting degree of horizontal area of the root canal, the laser-irradiated surfaces were observed using microfocus X-ray computed tomographic photography before and after every irradiation. The samples were observed under a scanning electron microscope. Measurement of pixels in an area was performed by image-editing software (Adobe Photoshop 7.0). Statistical analysis was performed using StatView (version 5.0). One-way ANOVA and the Tukey-Kramer tests were used; p<0.05 indicated statistical significance. RESULTS When root canals were irradiated with R200T for 10 sec (p<0.05), a large amount of evaporation (0.12 ± 1.07 mm(2)) was acquired in their cut area compared with the other irradiation conditions. In scanning electron microscopic observation, there was no smear layer and the dentinal tubules were open. CONCLUSIONS When the distance between the tip and root dentin was adjacent, the shaping of root dentin by Er:YAG laser irradiation was definitely observed.

Application of Er:YAG laser to retrograde cavity preparation

Abstract The purpose of this study was to investigate the performance of Er:YAG laser when used with a tip curved at 100° in retrograde cavity preparation. Ten extracted single-rooted human teeth, prepared and obturated using the lateral condensation method, were resected 3 mm from the apex. Retrograde cavities were prepared using either an Er:YAG laser or an ultrasonic unit. There was no significant difference between the two methods with respect to working time and postoperative increase in the root canal area. In conclusion, retrograde cavity preparation performed with the Er:YAG laser is as effective as with the ultrasonic retro-tip.

Safety of laser use under the dental microscope

The aim of this study was to investigate the safety of laser use under the dental microscope. Nd:YAG, Er:YAG and diode lasers were used. The end of the tips was positioned at a distance of 5 cm from the objective lens of a dental microscope. Each eye protector was made into a flat disc, which was fixed on the lens of the microscope. The filters were placed in front of the objective lens or behind the eye lens. Transmitted energy through the microscope with or without the filters was measured. No transmitted laser energy was detected when using matched eye protectors. Mismatched eye protectors were not effective for shutting out laser energy, especially for Nd:YAG and diode lasers. None or very little laser energy was detected through the microscope even without any laser filter. Matched filters shut out all laser energy irrespective of their positions.

Autofluorescence of healthy and inflamed pulpal tissues: photodynamic diagnosis of pulpal tissue

Autofluorescence of healthy and inflamed human pulpal tissues was observed by confocal laser microscopy. In this preliminary study, photodynamic diagnosis (PDD) was applied to diagnose pulpal disease. The ability to accurately diagnose pulpal pathology prior to pulpectomy would be very beneficial. Clinically, however, we are unable to perform biopsy to detect pathological changes. Therefore, this study was performed using healthy, acutely and chronically inflamed human pulpal tissues to detect pathological changes in pulpal tissues. Following excision, pulpal tissues were rapidly frozen and standard cryosections were prepared. Autofluorescence of pulpal tissues was observed using a confocal laser microscope to examine whether there were any differences in autofluorescence intensities between healthy and inflamed pulpal tissues. Several combinations of excitation and detection wavelengths were tested to observe autofluorescence from pulpal tissues; the excitation wavelengths ranged from 488nm to 633nm, and the detection wavelengths were longer than 505 nm. Autofluorescence was detected in both healthy and inflamed groups. With this technique, it may be possible to diagnose pulpal pathology without biopsy, and might be applicable to photodynamic diagnosis (PDD) and photodynamic therapy (PDT) in root canal treatment.