Influence of surface treatment on the fluorescence of composite resins subjected to in situ bleaching.

OBJECTIVE: Use fluorescence analysis to evaluate the effect of polishing and surface sealant on the color of composite resin bleached with carbamide peroxide and subjected to staining. MATERIALS AND METHODS: Forty-eight composite resin specimens (Z250/Z350XT) were fabricated. After 24 hours stored in distilled water, all specimens were submitted to in situ bleaching with 16% home peroxide for 8 hours daily for a period of 14 days. Subsequently specimens were separated in three groups according to surface treatment proposed (group 1-polishing Sof-Lex; group 2-BisCover; group 3-control). After this, all the specimens were stained with red wine. A spectrofluorometer was used to evaluate the fluorescence in two readouts (L0-after surface treatment and L1-after staining).Data were analyzed by applying ANOVA using a statistical software program. RESULTS: No differences were shown for the factor treatment and other interactions. The lowest mean fluorescence value was found for Z350XT resin (1759.18 ± 0.13) when compared with Z250 (6863.92 ± 0.13). There was significant difference in the mean fluorescence values for all surface treatments between the two different readouts L0 (4820.93 ± 0.05) and L1 (3802.17 ± 0.05). CONCLUSION: The results suggested that all surface treatments proposed did not influenced the results of wine staining of bleached resins when compared with the control evaluated by the fluorescence method. CLINICAL SIGNIFICANCE: The purposes of this research was to find solutions, by means of surfaces treatment, to achieve restorations with a satisfactory and similar final aspect in relation to the teeth, and avoid discrepancies related to the esthetics and longevity of the restoration.

Caries removal with Er:YAG laser followed by dentin biomodification with carbodiimide and chitosan: Wettability and surface morphology analysis.

This study aimed to investigate dentin wettability and surface morphology after selective removal of carious lesion by erbium-doped yttrium aluminum garnet (Er:YAG) laser, followed by dentin biomodification with carbodiimide (EDC) and chitosan (CHI). Seventy-eight bovine dentin specimens were submitted to caries induction. Specimens were distributed according to methods of carious removal (n = 39): bur at low-speed (40,000 rpm) or Er:YAG laser (noncontact mode, 250 mJ/pulse and 4Hz). All specimens were etched with 35% phosphoric acid, and subdivided according to dentin biomodification (n = 13): Control (no biomodification), EDC or CHI. The contact angle (n = 10) between adhesive system (3M ESPE) and dentin surface was measured by a goniometer. Eighteen specimens (n = 3) were analyzed by scanning electron microscopy. Data were analyzed by two-way ANOVA and Tukey's test (α = .05). The method used to remove carious lesion did not influence the wettability of dentinal surface (p = .748). The angles produced on the remaining dentin after biomodification were influenced (p = .007). CHI promoted higher contact angles (p = .007) and EDC did not differ from the control group (p = .586). In the bur-treated group, most tubules were open, regardless of which biomodifier was used. Laser modified the organic matrix layer. CHI promoted partially closed tubules in some areas while EDC exposed dentinal tubules. Regardless of which method was used for selective removal of carious lesion, biomodification with EDC did not affect the dentin wettability, whereas CHI changed the wettability of remaining dentin. Both biomodifiers promoted a slight change on dentin morphology.

Selective removal of carious lesion with Er:YAG laser followed by dentin biomodification with chitosan.

The aim of this study was to evaluate the effect of Er:YAG laser for selective removal of carious lesion, followed by biomodification with chitosan gel where the subsurface microhardness, chemical composition, and morphological changes of the residual caries-affected dentin were examined. Artificial dentinal lesions were created by pH-cycling method (14 days) in 104 bovine specimens (5 × 5 mm). Specimens were randomly divided according to the carious removal method: bur (low-speed handpiece) or Er:YAG laser (250 mJ/4 Hz). Specimens were treated with 35% phosphoric acid and were subdivided into two groups according to dentin biomodification: without chitosan (control) and 2.5% chitosan. Forty specimens were restored with an adhesive system and composite resin. Subsurface microhardness tests were performed in sound dentin, caries-affected dentin, residual caries-affected dentin, and after the restoration. The other 64 specimens were subjected to SEM-EDS atomic analysis. Data were statistically analyzed (p < 0.05). After the Er:YAG laser excavation, the microhardness value of residual caries-affected dentin was higher (p < 0.05) than bur-treated dentin. A significant decrease in the amount of Ca, P, and Ca/P ratio was found after the removal of carious lesions with Er:YAG laser (p < 0.05). The biomodification with chitosan did not influence the microhardness and atomic percentage of Ca, P, and Ca/P ratio of residual caries-affected dentin (p > 0.05). SEM analysis showed morphological changes on residual caries-affected dentin (p > 0.05). The selective removal of carious dentin with Er:YAG laser increased microhardness of residual caries-affected dentin, changing its surface morphology and chemical composition. The biomodification with chitosan did not influence the structural and chemical composition of residual caries-affected dentin.

Effect of endodontic irrigants on microtensile bond strength to dentin after thermocycling and long-term water storage.

OBJECTIVE: The bond strength of adhesives in irrigated dentin behaves differently over time. The aim of this study was to evaluate the influence of long-term water storage and thermocycling on the microtensile bond strength of adhesive systems to dentin irrigated with endodontic solutions. MATERIALS AND METHODS: Sixty human molars were used after removal of the occlusal portion and exposure of the dentin by grinding. The specimens were irrigated with 2.5% NaOCl for 30 minutes and then 17% EDTA for 5 minutes and assigned to six groups according to the adhesive system (n=10): G1 and G2-Clearfil SE Bond; G3 and G4-Single Bond 2; and G5 and G6-XP Bond. The teeth were restored with composite and were subjected to water storage for different time periods. G1, G3 and G5 were stored for 24 h; G2, G4 and G6 were stored for 6 months and were subjected to thermocycling (12,000 cycles, 5°C to 55°C, 500 cycles per week for 6 months). After storage, the tooth/restoration assembly was sectioned to obtain four sticks of approximately 1 mm(2), for microtensile bond strength testing. The results were analyzed by two-way ANOVA and Tukey's test. RESULTS: Significant differences were observed among the adhesives (p<0.01). No significant differences were observed in the microtensile bond strength between samples after 24 hours of storage without thermocycling and after 6-month storage with 12,000 cycles (p<0.05). CONCLUSION: The bond strengths of G5 and G6 after irrigation with 2.5% NaOCl and 17% EDTA were significantly different from those of other groups. Long-term water storage/thermocycling had no effect on bond strength to dentin.

Influence of cavity preparation with Er:YAG Laser on enamel adjacent to restorations submitted to cariogenic challenge in situ: a polarized light microscopic analysis.

BACKGROUND AND OBJECTIVES: Er:YAG laser has been used for caries removal and cavity preparation, using ablative parameters. Its effect on the margins of restorations submitted to cariogenic challenge has not yet been sufficiently investigated. The aim of this study was to assess the enamel adjacent to restored Er:YAG laser-prepared cavities submitted to cariogenic challenge in situ, under polarized light microscopy. STUDY DESIGN/MATERIALS AND METHODS: Ninety-one enamel slabs were randomly assigned to seven groups (n = 13): I, II, III-Er:YAG laser with 250 mJ, 62.5 J/cm2, combined with 2, 3, and 4 Hz, respectively; IV, V, VI-Er:YAG laser with 350 mJ, 87.5 J/cm(2), combined with 2, 3, and 4 Hz, respectively; VII-High-speed handpiece (control). Cavities were restored and the restorations were polished. The slabs were fixed to intra-oral appliances, worn by 13 volunteers for 14 days. Sucrose solution was applied to each slab six times per day. Samples were removed, cleaned, sectioned and ground to polarized light microscopic analysis. Demineralized area and inhibition zone width were quantitatively assessed. Presence or absence of cracks was also analyzed. Scores for demineralization and inhibition zone were determined. RESULTS: No difference was found among the groups with regard to demineralized area, inhibition zone width, presence or absence of cracks, and demineralization score. Inhibition zone score showed difference among the groups. There was a correlation between the quantitative measures and the scores. CONCLUSION: Er:YAG laser was similar to high-speed handpiece, with regard to alterations in enamel adjacent to restorations submitted to cariogenic challenge in situ. The inhibition zone score might suggest less demineralization at the restoration margin of the irradiated substrates. Correlation between the quantitative measures and scores indicates that score was, in this case, a suitable complementary method for assessment of caries lesion around restorations, under polarized light microscopy.

Influence of Er:YAG laser on microhardness of enamel adjacent to restorations submitted to cariogenic challenge in situ.

OBJECTIVE: This study assessed the effect of the Er:YAG laser on enamel adjacent to restorations submitted to cariogenic challenge in situ, by microhardness analysis. BACKGROUND DATA: The influence of Er:YAG laser energy on secondary caries formation has been investigated in vitro. However, no research involving demineralization around cavities prepared with the Er:YAG laser under intra-oral conditions has yet been described. MATERIALS AND METHODS: Slabs of enamel were randomly assigned to seven groups (n = 12), according to the cavity preparation technique: groups I, II, and III--Er:YAG laser, 250 mJ, at 2, 3, and 4 Hz, respectively; groups IV, V, and VI--350 mJ, at 2, 3, and 4 Hz, respectively; group VII--high-speed handpiece (control). Cavities were restored and the specimens were fixed in intra-oral appliances and worn by 12 volunteers for 14 d. Sucrose solution was applied to each slab 6 times/d. Samples were removed, sectioned, and examined for microhardness at 100, 200, and 300 microm (factor distance), and 30, 60, and 90 microm (factor depth), from the restoration and enamel surface, respectively. RESULTS: Analysis of variance according to a split-plot model showed no difference among the cavity preparation techniques, among distances, or among depths, as well as no difference in the interaction between the factors of cavity preparation and distance. A significant difference was found in the interaction of cavity preparation and depth (p < 0.0001), as identified by contrast technique. CONCLUSION: The results revealed that the Er:YAG laser did not differ from conventional cavity preparation with regard to enamel microhardness.

Adhesion of a self-etching system to dental substrate prepared by Er:YAG laser or air abrasion.

The purpose of this study was to assess the microtensile bond strength of a self-etching adhesive system to enamel and dentin prepared by Er:YAG laser irradiation or air abrasion, as well as to evaluate the adhesive interfaces by scanning electron microscopy (SEM). For microtensile bond strength test, 80 third molars were randomly assigned to five groups: Group I, carbide bur, control (CB); II, air abrasion with standard tip (ST); III, air abrasion with supersonic tip (SP); IV, Er:YAG laser 250 mJ/4 Hz (L250); V, Er:YAG laser 300 mJ/4 Hz (L300). Each group was divided into two subgroups (n = 8) (enamel, E and dentin, D). E and D surfaces were treated with the self-etching system Adper Prompt L-Pop and composite buildups were done with Filtek Z-250. Sticks with a cross-sectional area of 0.8 mm(2) (+/-0.2 mm(2)) were obtained and the bond strength tests were performed. Data were submitted to ANOVA and Tukey's test. For morphological analysis, disks of 30 third molars were restored, sectioned and prepared for SEM. Dentin presented the highest values of adhesion, differing from enamel. Laser and air-abrasion preparations were similar to enamel. Dentin air-abrasion with standard tip group showed higher bond strength results than Er:YAG-laser groups, however, air-abrasion and Er:YAG laser groups were similar to control group. SEM micrographs revealed that, for both enamel and dentin, the air-abrasion and laser preparations presented irregular adhesive interfaces, different from the ones prepared by rotary instrument. It was concluded that cavity preparations accomplished by both Er:YAG laser energies and air abrasion tips did not positively influence the adhesion to enamel and dentin.

Assessment of in vitro methods used to promote adhesive interface degradation: a critical review.

UNLABELLED: One factor that has a great influence on clinical performance of dental restorations is their resistance to degradation. Morphological changes in the structure of tooth-restoration interface aged in the oral environment have been reported. However, even though the in vivo performance is the ultimate testing environment for predicting the behavior of restorations because of the complexity of intraoral conditions, in vitro models such as thermocycling, mechanical loading, pH cycling, and aging of materials in distilled water, NaOCl, and food-simulating solutions may provide important information about the fundamental mechanisms involved in resin-tooth interface degradation. Most recently, the effect of host-derived enzymes and the storage in deproteinizing solutions (such as aqueous NaOCl) on the degradation of resin-dentin bonds has also been described. This review considers the importance of these in vitro methods on bond durability interface in an attempt to understand the behavior of restoratives over time. The first section is focused on the mechanism of in vivo biodegradation, whereas the second looks at studies that have described the influence of water storage, NaOCl storage, host-derived matrix metalloproteinases, thermocycling, mechanical loading, pH cycling, and food-simulating solutions on the degradation of the adhesive interface. It is obvious that these methodologies do not occur separately in the oral cavity, but that each one has a specific importance in the mechanisms of bond degradation. CLINICAL SIGNIFICANCE: The in vitro methods used to simulate bond degradation may describe important points related to the clinical performance of restorations. This article evaluates the mechanism of the in vivo biodegradation of adhesive interfaces as well as the influences that various testing methods have on these bonds.

Influence of Er:YAG laser on cavity preparation and surface treatment in microleakage of composite resin restorations.

OBJECTIVE: The purpose of this study was to assess microleakage on class V cavities prepared by Er:YAG laser with varying surface treatment. BACKGROUND DATA: There has been little reported research on microleakage at cavities prepared and treated with Er:YAG laser. METHODS: Fifty preparations using Er:YAG laser or a highspeed handpiece were developed. The surface treatment was performed as follows: Er:YAG laser (group 1); 35% phosphoric acid (group 2); laser + acid (group 3); finishing with low-speed + laser + acid (group 4); conventional preparation developed with a high-speed handpiece + acid (group 5--control). The samples were restored with Single Bond/Z250, thermocycled, isolated, and immersed in a 50% AgNO(3) solution. The restorations were sectioned, and the microleakage was measured in milimeters using a specific computer software. Data were analyzed employing ANOVAand Tukey test. RESULTS: Statistical analysis showed that group 5 (G5) obtained the lowest results of microleakage (22.05%), and it was statistically similar (p > 0.05) to G1 (37.7%) and different (p < 0.05) from the other groups (G2 = 50.4%; G3 = 43%; G4 = 44.2%). The occlusal margins (22.62%) demonstrated less microleakage (p < 0.05) than the cervical margins (56.32%). CONCLUSION: The use of Er:YAG laser for cavity preparation and surface treatment negatively influenced the marginal sealing of composite resin restorations.

Comparative study of the dentin/adhesive systems interface after treatment with Er:YAG laser and acid etching using scanning electron microscope.

BACKGROUND AND OBJECTIVES: To assess dentin/adhesive systems interface after dentin conditioning with Er:YAG laser. STUDY DESIGN/MATERIALS AND METHODS: Twenty-four dentin half-disks were assigned to 3 groups: All Bond 2 (AB); Optibond Solo Plus (OP); and Clearfil Liner Bond 2V (CL), which were divided into three sub-groups, according to dentin surface treatment: Er:YAG laser; Er:YAG laser plus acid; acid solely. After the adhesive protocol, specimens were embedded in resin, sectioned, and prepared for SEM analysis. Each area was examined under 1,500x magnification to assess the hybrid layer. RESULTS: Acid conditioning provided to AB and OP thick and homogeneous hybrid layer, as well as conical and uniform tags. The same pattern was observed for CL. In general, dentin treatment with laser, even when associated to acid, promoted irregular and thin hybrid layer, as well as scarce and thin tags. CONCLUSIONS: Er:YAG laser influenced the adhesive systems interface, hampering hybrid layer formation.

Bond strength to dentin of primary teeth irradiated with varying Er:YAG laser energies and SEM examination of the surface morphology.

BACKGROUND AND OBJECTIVES: This study aimed to assess in vitro the influence of Er:YAG laser energy on the shear bond strength of a total-etch adhesive to lased dentin of primary teeth, and observe under SEM the morphological appearance of laser-ablated dentin surfaces. STUDY DESIGN/MATERIALS AND METHODS: For SBS, specimens were irradiated with the energies 60 mJ/2 Hz (G2), 80 mJ/2 Hz (G3), 100 mJ/2 Hz (G4). Control (G1) was not irradiated. Dentin surfaces were acid-etched, Single Bond adhesive (3 M) was applied, and resin cylinders were fabricated from Z250 resin (3 M). Bond strength was tested in shear (0.5 mm/min). For morphological analysis, specimens were irradiated using the same energies, either or not acid-etched, and observed by SEM. RESULTS AND CONCLUSIONS: SBS means, in MPa, were: G1-17.89(+/-4.75); G2-12.34(+/-4.85); G3-10.30(+/-3.67); G4-10.41(+/-4.20). Overall, Er:YAG laser irradiation of primary teeth dentin, prior to the adhesive protocol, adversely affected bond strength. Furthermore, it was noticed that even though there was no significant difference among the Er:YAG laser-treated groups, the increase of laser energy resulted in increasingly cratered surfaces, regardless of acid-etching association.

Influence of air abrasion preparation on microleakage in glass ionomer cement restorations.

The aim of this study was to assess microleakage in class V cavities prepared by air abrasion or high-speed dental bur and restored with different glass ionomer cements. Sixty bovine incisors were equally divided into 6 groups: I, II and III (preparation by high-speed) and IV, V and VI (preparation by air abrasion). Groups I and IV were restored with Fuji IX; groups II and V with Ketac Molar; and groups III and VI with Vitremer. After 24 h (37 degrees C), specimens were thermocycled, isolated with nail varnish, immersed in a 0.2% Rhodamine B solution for 24 hours, sectioned longitudinally and analyzed for microleakage using an optical microscope connected to a digital camera and a computer. The images were digitized and a software allowed the quantitative evaluation of microleakage in millimeters. Data were analyzed by Wilcoxon and Kruskal-Wallis tests. It was observed that there were significant differences (p < 0.05) between incisal (enamel) and cervical (dentine/cementum) margins, mainly for Ketac Molar; there was no difference (p > 0.05) between preparation methods, except for group II (high-speed/Ketac Molar) that showed higher infiltration; regarding the materials, Ketac Molar demonstrated the highest microleakage values (p < 0.05), and only Vitremer sealed completely both margins of restorations. It was concluded that air abrasion preparation did not influence microleakage in class V restorations with the employed glass ionomer cements.