Vivian Colucci

Water flow on erbium:yttrium-aluminum-garnet laser irradiation: effects on dental tissues

Since lasers were introduced in dentistry, there has been considerable advancement in technology. Several wavelengths have been investigated as substitutes for high-speed air turbine. Owing to its high absorbability in water and hydroxyapatite, the erbium:yttrium–aluminum–garnet (Er:YAG) laser has been of great interest among dental practitioners and scientists. In spite of its great potential for hard tissue ablation, Er:YAG laser effectiveness and safety is directly related to an adequate setting of the working patterns. It is assumed that the ablation rate is influenced by certain conditions, such as water content of the target tissue, and laser parameters. It has been shown that Er:YAG irradiation with water coolant attenuates temperature rise and, hence, minimizes the risk of thermally induced pulp injury. It also increases ablation efficiency and enhances adhesion to the lased dental tissue. The aim of this review was to obtain insights into the ablation process and to discuss the effects of water flow on dental tissue ablation using Er:YAG laser.

Microhardness and SEM after CO2 laser irradiation or fluoride treatment in human and bovine enamel

Background: It remains uncertain as to whether or not CO2 laser is able to hinder demineralization of enamel. The possibility to use bovine instead of human teeth on anticariogenic studies with laser has not yet been determined. Purpose: To compare the ability of CO2 laser and fluoride to inhibit caries‐like lesions in human enamel and to test whether a similar pattern of response would hold for bovine enamel. Study Design: Ninety‐six enamel slabs (2 × 2 × 4 mm) (48 from bovine and 48 from human teeth) were randomly distributed according to surface treatment (n = 12): CO2 laser, 5% sodium fluoride varnish (FV), 1.23% acidulated phosphate fluoride (APF) gel, or no treatment (control). Specimens were subjected to a 14‐day in vitro cariogenic challenge. Microhardness (SMH) was measured at 30 μm from the surface. For ultrastructural analysis, additional 20 slabs of each substrate (n = 5) received the same treatment described earlier and were analyzed by SEM. Results: ANOVA and Tukey test ascertained that CO2 laser promoted the least mineral loss (SMH = 252a). Treatment with FV resulted in the second highest values (207b), which was followed by APF (172c). Untreated specimens performed the worst (154d). SEM showed no qualitative difference between human and bovine teeth. APF and control groups exhibited surfaces covered by the smear layer. A granulate precipitate were verified on FV group and fusion of enamel crystals were observed on lased‐specimens. Conclusions: CO2 laser may control caries progression more efficiently than fluoride sources and bovine teeth may be a suitable substitute for human teeth in studies of this nature. Microsc. Res. Tech. 73:1030–1035, 2010.

The influence of mouthrinses and simulated toothbrushing on the surface roughness of a nanofilled composite resin

The aim of this study was to determine the influence of mouthrinses on the surface roughness of a nanofilled composite resin after toothbrushing. One hundred nanofilled composite resin specimens were prepared and randomly distributed into two groups-brushed and non-brushed-and then assigned to five subgroups, according to the mouthrinse solutions (n = 10): Colgate Plax Fresh Mint, Oral B, Cepacol, Colgate Plax, and artificial saliva. Each sample was immersed in 20 mL of the mouthrinses for 1 minute, 5 days per week, twice a day, for a 3-week period. The control group used in the study was one in which the specimens were not subjected to brushing and remained only in artificial saliva. Toothbrushing was performed once a week for 1 minute, for 3 weeks. Surface roughness measurements (Ra) were performed after the immersion period and toothbrushing, by means of a profilometer. Data were analyzed by two-way ANOVA and Tukeys test. Analysis revealed that the association between toothbrushing and Colgate Plax Fresh Mint produced the lowest surface roughness (p < 0.05). All other groups tested (Oral B, Cepacol, Colgate Plax, artificial saliva) exhibited no statistically significant differences between surfaces, whether subjected to toothbrushing or not (p < 0.05). It was concluded that the surface roughness of the nanofilled composite resin tested can be influenced by the mouthrinse associated with toothbrushing.

Effect of Two Restorative Materials on Root Dentine Erosion

This study sought to evaluate the microhardness of root dentine adjacent to glass-ionomer and composite resin restorations after erosive challenge. A crossover study was performed in two phases of 4 consecutive days each. One hundred twelve bovine root dentine slabs were obtained, and standardized box-shaped cavities were prepared at center of each specimen. The prepared cavities were randomly restored with glass-ionomer cement or composite resin. The slabs were randomly assigned among 14 volunteers, which wore intraoral palatal device containing four restored root dentin slabs. Starting on the second day, half of the palatal acrylic devices were immersed extraorally in a lemonade-like carbonated soft drink for 90 s, four times daily for 3 days. After 3-day wash-out, dentine slabs restored with the alternative material were placed into palatal appliance and the volunteers started the second phase of this study. After erosive challenges, microhardness measurements were performed. Regardless of the restorative material employed, eroded specimens demonstrated lower microhardness value (p < 0.0001). At eroded condition examined in this study, dentine restored with glass-ionomer cement showed higher microhardness values (p < 0.0001). It may be concluded that the glass-ionomer cement decreases the progression of root dentine erosion at restoration margin.

In situ investigation of the effect of TiF4 and CO2 laser irradiation on the permeability of eroded enamel.

OBJECTIVE Interest in erosion and its role in tooth wear has increased considerably. Due to the limited contribution of patients in modifying their dietary habits, therapeutic resources aiming to reduce the progression of erosion-like lesions have been discussed. This study sought to evaluate the effect of TiF4 and CO2 laser in controlling the permeability of in situ eroded enamel. DESIGN Ten volunteers wore an intraoral palatal device containing two enamel slabs, treated with TiF4 gel and TiF4 gel + CO2 or placebo gel and placebo gel + CO2. After the washout period, volunteers were crossed over to the other treatment. During both phases, specimens were submitted to erosive challenges and then evaluated for permeability measured as the percentage of copper ion penetration over the total enamel thickness. RESULTS Two-way analysis of variance (ANOVA) revealed that there was a significant interaction between the factors under study (p = 0.0002). Tukeys test showed that TiF4 significantly reduced the enamel permeability of eroded enamel specimens, regardless of whether CO2 laser irradiation was performed. CONCLUSIONS It may be concluded that when the placebo gel was applied, CO2 laser was able to reduce enamel permeability; however, when TiF4 was applied, laser irradiation did not imply a reduction in permeability. TiF4 provided a lower permeability of eroded enamel, regardless of whether the CO2 laser was used.

Influence of laser irradiation on the push-out bond strength between a glass fiber post and root dentin

Statement of problem. A major issue related to the failure of endodontically treated teeth restored with an intraradicular post is gradual debonding of the glass fiber post, resin cement, and dentin. Purpose. The purpose of this in vitro study was to evaluate the influence of laser irradiation on the push‐out bond strength of glass fiber posts to radicular dentin. Material and methods. Thirty‐two mandibular bovine incisors were endodontically treated and divided into 4 groups according to the surface treatment of the post: silane control (GC); irradiation with Er:YAG (GYAG); irradiation with Er,Cr:YSGG (GCR); and 980‐nm diode laser (GDI) application. After surface treatment, the glass fiber posts were cemented with dual adhesive resin cement. To evaluate bond strength, the specimens were subjected to a push‐out test at a crosshead speed of 0.5 mm/min using a universal testing machine. Failure mode was analyzed using stereomicroscopy. The surface morphology was evaluated qualitatively after surface treatment by using confocal laser microscopy. The push‐out test data (MPa) were analyzed using a linear mixed effects model and the Bonferroni test (&agr;=.05). Results. At the cervical third, no significant differences were observed between the GC and GCR groups (P=1.00), and both of the groups exhibited higher bond strength. At the middle and apical thirds, the GCR group revealed higher bond strength, which was significantly different from that observed in all other groups (P<.05). No statistical differences were observed among the other tested protocols (GC, GYAG, and GDI groups; P=1.00). Adhesive failure was predominant in all groups. Conclusions. Irradiation with Er,Cr:YSGG improved the bond strength of the cement‐post‐dentin interfaces.

Surface roughness of composite resins subjected to hydrochloric acid.

The purpose of this study was to determine the influence of hydrochloric acid on surface roughness of composite resins subjected to brushing. Sixty samples measuring 2 mm thick x 6 mm diameter were prepared and used as experimental units. The study presented a 3x2 factorial design, in which the factors were composite resin (n=20), at 3 levels: microhybrid composite (Z100), nanofilled composite (FiltekTM Supreme), nanohybrid composite (Ice), and acid challenge (n=10) at 2 levels: absence and presence. Acid challenge was performed by immersion of specimens in hydrochloric acid (pH 1.2) for 1 min, 4 times per day for 7 days. The specimens not subjected to acid challenge were stored in 15 mL of artificial saliva at 37 oC. Afterwards, all specimens were submitted to abrasive challenge by a brushing cycle performed with a 200 g weight at a speed of 356 rpm, totaling 17.8 cycles. Surface roughness measurements (Ra) were performed and analyzed by ANOVA and Tukey test (p≤0.05). Surface roughness values were higher in the presence (1.07±0.24) as compared with the absence of hydrochloric acid (0.72±0.04). Surface roughness values were higher for microhybrid (1.01±0.27) compared with nanofilled (0.68 ±0.09) and nanohybrid (0.48±0.15) composites when the specimens were not subjects to acid challenge. In the presence of hydrochloric acid, microhybrid (1.26±0.28) and nanofilled (1.18±0,30) composites presents higher surface roughness values compared with nanohybrid (0.77±0.15). The hydrochloric acid affected the surface roughness of composite resin subjected to brushing.

Influence of Apical Enlargement in Cleaning of Curved Canals Using Negative Pressure System

This study aimed to evaluate, by scanning electron microscopy (SEM), the cleaning of canal walls with moderate curvature subjected to biomechanical preparation with different final diameters using apical negative pressure irrigation. Thirty-two mesiobuccal roots of molars were divided into 4 groups (n=8) according to the instruments final diameter: GI: 30.02, GII: 35.02, GIII: 40.02 and GIV: 45.02. Irrigating procedure was performed at each change of instrument with 1% NaOCl using the Endovac system. Final irrigation was conducted with 17% EDTA for 5 min. The SEM photomicrographs were evaluated under 35× and 1000× magnification, by three calibrated examiners, in a double-blind design. Data were submitted to Kruskal-Wallis and Dunns post hoc tests (α=0.05). Canals instrumented with 30.02 and 35.02 final diameters showed more debris, statistically different from the other groups (p<0.05). Comparing each root canal third, for the cervical and apical portions no statistically significant difference (p>0.05) was found among the four groups. Regarding the presence of smear layer, canals with 30.02 final diameter showed the highest scores, statistically different from the 45.02 group (p<0.05) and similar to the 35.02 and the 40.02 groups (p>0.05). Although none of the studied diameters completely removed debris and smear layer, it may be concluded that instrumentation with higher final diameters was more effective in cleaning the root canals with moderate curvature.

Sub ablative Er: YAG laser irradiation on surface roughness of eroded dental enamel.

This study evaluated the effects of Er:YAG laser irradiation applied at varying pulse repetition rate on the surface roughness of eroded enamel.

In situ study of the anticariogenic potential of fluoride varnish combined with CO2 laser on enamel

OBJECTIVE This in situ study evaluated the effect of fluoride varnish combined with CO2 laser in controlling enamel demineralization caused by cariogenic challenges. DESIGN In a crossover study conducted in 2 phases of 14 days each, 14 volunteers (n = 14) wore palatal appliances with bovine enamel slabs treated with fluoride varnish + CO2 laser (FV + CO2), fluoride varnish (FV), nonfluoride placebo varnish (PV) and nonfluoride placebo varnish + CO2 laser (PV + CO2). Drops of sucrose solution were dripped onto enamel slabs allowing the accumulation of biofilm. At the first phase, half of the volunteers received 4 enamel slabs treated with FV while the remainders received slabs exposed to the PV with and without CO2 laser. In the second phase, the vonlunteers were reversed treatments. The slabs were evaluated for cross-sectional microhardness (CSMH) and the concentration of loosely bound fluoride (CaF2) and firmly bound fluoride (FAp). The concentration of fluoride in biofilm were also determined. RESULTS Two-way ANOVA showed that the CSMH values were higher in laser-irradiated enamel, regardless of the fluoride varnish. Friedman test showed that FV group presented significantly larger amount of fluoride in biofilm (P < 0.05). In the enamel, the largest amount of fluoride was found in the groups FV + CO2, which was not different from FV (P > 0.05). CONCLUSION The synergistic effect of fluoride varnish and CO2 laser on enamel demineralization was not observed, however, CO2 laser reduces enamel demineralization. CLINICAL SIGNIFICANCE CO2 laser might reduce the demineralization of subsurface enamel, although its association with a high concentrated fluoride therapy may not result in a positive synergistic interaction.