Evaluation of Er:YAG laser and EDTAC on dentin adhesion of six endodontic sealers.

The effect of Er:YAG laser application and EDTAC on the adhesion of epoxy resin-based endodontic sealers to human dentin was evaluated in vitro. A total of 99 extracted human maxillary molars with their crowns worn flat were used. The teeth were divided into 3 groups: group 1, the dentin surface received no treatment; group 2, EDTAC was applied to the dentin surface for 5 min; group 3, the dentin surface received Er:YAG laser application (2.25 W potency; 11 mm focal distance; 4 Hz frequency; 200 mJ energy; 62 J total energy; 313 mean impulse). Three teeth from each group were analyzed by scanning electron microscopy for changes in dentin surface. The epoxy resin root canal sealers used were: AH Plus, Topseal, Sealer 26, AH 26, and Sealer Plus. The zinc oxide eugenol-based sealer Fillcanal was used as control. Adhesion was measured with a Universal testing machine. The results showed a statistically significant difference at the level of 1% among the dentin treatments. The dentin treated with Er:YAG laser showed greater adhesion with the sealers than dentin treated with EDTAC which was greater than dentin that received no treatment. The Tukey test showed the formation of 5 groups in decreasing order of adhesion: AH Plus, Topseal and Sealer 26, AH 26, Sealer Plus, and Fillcanal (Grossman cement).

Evaluation of dentin root canal permeability after instrumentation and Er:YAG laser application.

BACKGROUND AND OBJECTIVES: Smear layer removal with EDTA from root canal walls allows greater cleaning and disinfection of root canals. However, because Er:YAG laser acts on the removal of the smear layer, the objective of investigation was to analyze in vitro the effect of Er:YAG laser on dentin root canal wall permeability after endodontic instrumentation and irrigation with water or sodium hypochlorite and Er:YAG laser application. STUDY DESIGN/MATERIALS AND METHODS: A total of 25 extracted human maxillary incisors were divided into five groups: Group I, instrumentation with deionized distilled water as the irrigating solution; Group II, instrumentation with 1% sodium hypochlorite as the irrigating solution; Group III, instrumentation with deionized distilled water as the irrigating solution and Er:YAG laser application; Group IV, instrumentation with 1% sodium hypochlorite solution as the irrigating solution and Er:YAG laser application; Group V, instrumentation only up to #20 file with deionized distilled water as the irrigating solution and Er:YAG laser irradiation. The laser parameters were 15 Hz, 140 mJ, total energy 42 J, 300 pulses (Kavo Key Laser). Copper sulfate (10%) was used to evaluate dentin permeability. The penetration of copper ions into the dentinal tubules was observed using 1% rubeanic acid, which reveals copper ions, forming a stained compound ranging in color from deep blue to black. Transverse sections (500-microm thick) were obtained with a diamond disk from the cervical, middle, and apical thirds. RESULTS: The instrumentation of the root canal that used water as the irrigating solution followed by Er:YAG laser irradiation promoted the greatest increase in dentin permeability. The use of Er:YAG laser, 1% sodium hypochlorite + Er:YAG, and 1% sodium hypochlorite used alone showed an intermediate capacity of increasing dentin permeability. The use of water as the irrigating solution without Er:YAG laser promoted the least dentin permeability. CONCLUSIONS: The use of water as the irrigating solution after instrumentation and Er:YAG laser irradiation was an effective procedure for increasing dentin permeability.