CO2 laser emission modes to control enamel erosion

Considering the importance and prevalence of dental erosion, the aim of this in vitro study was to evaluate the influence of different modes of pulse emission of CO₂ laser associated or not to acidulated phosphate fluoride (APF) 1.23% gel, in controlling enamel erosion by profilometry. Ninety‐six fragments of bovine enamel were flattened and polished, and the specimens were subjected to initial erosive challenge with hydrochloric acid (pH = 2). Specimens were randomly assigned according to surface treatment: APF 1.23% gel and gel without fluoride (control), and subdivided according to the modes of pulse CO₂ laser irradiation: no irradiation (control), continuous, ultrapulse, and repeated pulse (n = 12). After surface treatment, further erosive challenges were performed for 5 days, 4 × 2 min/day. Enamel structure loss was quantitatively determined by a profilometer, after surface treatment and after 5 days of erosive challenges. Two‐away ANOVA revealed a significant difference between the pulse emission mode of the CO₂ laser and the presence of fluoride (P ≤ 0.05). The Duncan's test showed that CO₂ laser irradiation in continuous mode and the specimens only received fluoride, promoted lower enamel loss than that other treatments. A lower dissolution of the enamel prisms was observed when it was irradiated with CO₂ laser in continuous mode compared other groups. It can be concluded that CO₂ laser irradiation in continuous mode was the most effective to control the enamel structure loss submitted to erosive challenges with hydrochloric acid. Microsc. Res. Tech. 78:654–659, 2015. © 2015 Wiley Periodicals, Inc.     

In Situ analysis of CO2 laser irradiation on controlling progression of erosive lesions on dental enamel

The present study aimed to evaluate in situ the effect of CO₂ laser irradiation to control the progression of enamel erosive lesions. Fifty‐six slabs of bovine incisors enamel (5 × 3 × 2.5 mm³) were divided in four distinct areas: (1) sound (reference area), (2) initial erosion, (3) treatment (irradiated or nonirradiated with CO₂ laser), (4) final erosion (after in situ phase). The initial erosive challenge was performed with 1% citric acid (pH = 2.3), for 5 min, 2×/day, for 2 days. The slabs were divided in two groups according to surface treatment: irradiated with CO₂ laser (λ = 10.6 µm; 0.5 W) and nonirradiate. After a 2‐day lead‐in period, 14 volunteers wore an intraoral palatal appliance containing two slabs (irradiated and nonirradiated), in two intraoral phases of 5 days each. Following a cross‐over design during the first intraoral phase, half of the volunteers immersed the appliance in 100 mL of citric acid for 5 min, 3×/day, while other half of the volunteers used deionized water (control). The volunteers were crossed over in the second phase. Enamel wear was determined by an optical 3D profilometer. Three‐way ANOVA for repeated measures revealed that there was no significant interaction between erosive challenge and CO₂ laser irradiation (P = 0.419). Erosive challenge significantly increased enamel wear (P = 0.001), regardless whether or not CO₂ laser irradiation was performed. There was no difference in enamel wear between specimens CO₂‐laser irradiated and non‐irradiated (P = 0.513). Under intraoral conditions, CO₂ laser irradiation did not control the progression of erosive lesions in enamel caused by citric acid. Microsc. Res. Tech. 77:586–593, 2014. © 2014 Wiley Periodicals, Inc.     

Different bacterial models for in vitro induction of non‐cavitated enamel caries‐like lesions: Microhardness and polarized light miscroscopy analyses

The aim of this study was to compare different bacterial models for in vitro induction of non‐cavitated enamel caries‐like lesions by microhardness and polarized light microscopy analyses. One hundred blocks of bovine enamel were randomly divided into four groups (n = 25) according to the bacterial model for caries induction: (A) Streptococcus mutans, (B) S. mutans and Lactobacillus acidophilus, (C) S. mutans and L. casei, and (D) S. mutans, L. acidophilus, and L. casei. Within each group, the blocks were randomly divided into five subgroups according to the duration of the period of caries induction (4–20 days). The enamel blocks were immersed in cariogenic solution containing the microorganisms, which was changed every 48 h. Groups C and D presented lower surface hardness values (SMH) and higher area of hardness loss (ΔS) after the cariogenic challenge than groups A and B (P < 0.05). As regards lesion depth, under polarized light microscopy, group A presented significantly lower values, and groups C and D the highest values. Group B showed a higher value than group A (P < 0.05). Groups A and B exhibited subsurface caries lesions after all treatment durations, while groups C and D presented erosion‐type lesions with surface softening. The model using S. mutans, whether or not it was associated with L. acidophilus, was less aggressive and may be used for the induction of non‐cavitated enamel caries‐like lesions. The optimal period for inducing caries‐like lesions was 8 days. Microsc. Res. Tech. 78:444–451, 2015. © 2015 Wiley Periodicals, Inc.     

Evaluation of microleakage in class v cavities prepared by different caries removal methods

The purpose of this study was to comparatively evaluate the effects of different caries removal methods on microleakage success of class V adhesive restorations by means of light microscopy (stereomicroscope) and scanning electron microscopy (SEM) observations. Sixty‐four human teeth with class V caries that measured with DIAGNOdent were used. The samples were divided into four groups (n = 16) randomly according to caries removing methods of conventional method, Carisolv, Papacarie, and Er,Cr:YSGG laser system. The self‐etch Clearf?l SE Bond and Clearf?l Majesty Es‐II were used as restoration materials. After thermal cycles of 2,000 (5 and 55°C) samples were immersed in a 50% wt/wt AgNO_3. Samples were finally imaged and scored under light microscopy and SEM, respectively. The data were statistically analyzed using Kruskal–Wallis H, pairwise comparison and Wilcoxon's T tests at 5% significance level (p < .05). Statistical analysis demonstrated that there was no significant difference between microleakage scores in dentin regions but there were significant difference between the Papacarie and Er,Cr:YSGGlaser in terms of leakage scores in enamel sites. No statistically significant difference in leakage scores emerged between light microscopy and SEM.     

Efficacy of calcium‐ and fluoride‐containing materials for the remineralization of primary teeth with early enamel lesion

The aim of the study was to determine the efficacy of different products containing fluoride, calcium and phosphate for enamel remineralization in eroded primary teeth. A total of 90 sound primary canine teeth were randomly divided into 5 groups of 18 teeth each: 1) control (polished enamel), 2) 5% DuraShield sodium fluoride varnish, 3) 500 ppm fluoridated toothpaste, 4) casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) cream, and 5) Clinpro White varnish containing functionalized tri‐calcium phosphate (fTCP). Enamel microhardness (EMH) was measured in all samples before and after demineralization and after 28 days of remineralization. Also 8 samples in groups 2 to 5 and four samples of sound and demineralized enamel were examined with atomic force microscopy (AFM). All data were analyzed with one‐way ANOVA (p<0.05). Mean microhardness of demineralized enamel was significantly lower than in enamel at baseline (p<0.001). Remineralization significantly increased microharness in groups 2 to 5 compared to the control group (p<0.001). Percent EMH after remineralization with CPP‐ACP was significantly higher than after fTCP (p=0.029), toothpaste (p< 0.001) or fluoride varnish (p<0.001); however, there was no significant difference between toothpaste and fluoride varnish (p=0.062). Microhardness increased more after fTCP treatment than after treatment with sodium fluoride varnish (p<0.001) or fluoridated toothpaste (p=0.045). AFM images showed that enamel roughness decreased most after treatment with fTCP, followed by CPP‐ACP, toothpaste and fluoride varnish. The efficacy of CPP‐ACP cream for remineralizing eroded enamel was greater than fluoride toothpaste, fluoride varnish or fTCP varnish. Microsc. Res. Tech. 78:801–806, 2015. © 2015 Wiley Periodicals, Inc.     

Effect of Er:YAG laser irradiation on deciduous enamel roughness and bacterial adhesion: An in vitro study

Laser irradiation has been proposed as a preventive method against dental caries since it is capable to inhibit enamel demineralization by reducing carbonate and modifying organic matter, yet it can produce significant morphological changes. The purpose of this study was to evaluate the influence of Er:YAG laser irradiation on superficial roughness of deciduous dental enamel and bacterial adhesion. Fifty‐four samples of deciduous enamel were divided into three groups (n = 18 each). G1_control (nonirradiated); G2_100 (7.5 J/cm²) and G3_100 (12.7 J/cm²) were irradiated with Er:YAG laser at 7.5 and 12.7 J/cm², respectively, under water irrigation. Surface roughness was measured before and after irradiation using a profilometer. Afterwards, six samples per group were used to measure bacterial growth by XTT cell viability assay. Adhered bacteria were observed using confocal laser scanning microscopy (CLSM) and a scanning electron microscopy (SEM). Paired t‐, one‐way analysis of variance (ANOVA), Kruskal‐Wallis and pairwise Mann–Whitney U tests were performed to analyze statistical differences (p < .05). Before treatment, samples showed homogenous surface roughness, and after Er:YAG laser irradiation, the surfaces showed a significant increase in roughness values (p < .05). G3_100 (12.7 J/cm²) showed the highest amount of Streptococcus mutans adhered (p < .05). The increase in the roughness of the tooth enamel surfaces was proportional to the energy density used; the increase in surface roughness caused by laser irradiation did not augment the adhesion of Streptococcus sanguinis; only the use of the energy density of 12.7 J/cm² favored significantly the adhesion of S. mutans.     

Effects of Galla chinensis on the surface topography of initial enamel carious lesion: an atomic force microscopy study

To investigate the effect of Galla chinensis on the surface topography of initial enamel carious lesion, atomic force microscope (AFM) was used, and it was a new AFM application in enamel de‐/remineralization research. Bovine sound enamel slabs were demineralized to produce initial carious lesion in vitro. Then, the lesions were exposed to a pH‐cycling regime for 12 days. Each daily cycle included 4×1 min applications with one of three treatments: negative control group: deionized water; positive control group: 1 g/L aqueous solutions of NaF; experimental group: 4 g/L aqueous solutions of G. chinensis extract (GCE). The surface topography and roughness were investigated on the enamel slabs before and after pH‐cycling by AFM. 3D AFM images revealed the surface topographical changes of GCE‐treated enamel. Significant difference existed before and after the pH‐cycling among the groups. AFM offers a powerful tool for enamel de‐/remineralization research. The surface roughness results provide the evidences to remineralization of carious lesion, and indicate the potential of G. chinensis in promoting the remineralization. G. chinensis may become one more promising agent for caries prevention. SCANNING 31: 195–203, 2009. © 2010 Wiley Periodicals, Inc.     

Effect of fluoride pretreatment on primary and permanent tooth surfaces by acid-etching

This study observed the effect of fluoride application on a 37% phosphoric acid etching for 20 s of the enamel surfaces of primary and permanent teeth based on a clinical protocol employed in dental hospitals, through atomic force microscopy and scanning electron microscopy. Enamel samples were prepared from 84 exfoliated and noncarious teeth. Primary (groups 1-4) and permanent (groups 5-8) tooth samples were assigned randomly to one of eight groups based on the timing of acid-etching with 37% phosphoric acid after an acidulated phosphate fluoride (APF) treatment. Groups 1 and 5 received no fluoride application. Groups 2-4 and 6-8 were pretreated with fluoride and received acid-etching 2 weeks later (groups 2 and 6), 1 week later (groups 3 and 7), and immediately (groups 4 and 8). The acid-etching process led to a significant increase in roughness (p<0.0001), and the APF treatment led to a decrease in primary and permanent tooth surface roughness (p<0.005). An acid-etching procedure 2 weeks after performing an APF pretreatment might be recommended to obtain the maximum enamel adhesion of a resin composite.     

Effects of Er:YAG laser on bond strength of self‐etching adhesives to caries‐affected dentin

The erbium:yttrium–aluminum–garnet (Er:YAG) laser may be effective the bond strength of adhesive systems on dentine surfaces, the chemical composition and aggressiveness of adhesive systems in clinical practice. The purpose of this study was to evaluate the effects of the Er:YAG laser system with the bonding ability of two different self‐etching adhesives to caries‐affected dentine in primary molars. Ninety mid‐coronal flat dentine surfaces obtained from sound and caries‐affected human primary dentine were treated with an Er:YAG laser or a bur. The prepared surfaces were restored with an adhesive system (Xeno V; Clearfil S³) and a compomer (Dyract Extra). The restored teeth were sectioned with a low‐speed saw and 162 samples were obtained. The bond strength of the adhesive systems was tested using the micro‐tensile test method. The data were statistically analyzed. A restored tooth in each group was processed for scanning electron microscopy evaluation. The values of the highest bond strength were obtained from the Clearfil S³‐Er:YAG laser‐sound dentine group in all groups. (24.57 ± 7.27 MPa) (P > 0.05). The values of the lowest bond strength were obtained from the Xeno V‐Er:YAG laser‐sound dentine group in all groups (11.01 ± 3.89 MPa). It was determined that the Clearfil S³ increased the bond strength on the surface applied with Er:YAG laser according to the Xeno V. Microsc. Res. Tech. 77:282–288, 2014. © 2014 Wiley Periodicals, Inc.     

Stress and strain distribution in demineralized enamel: A micro‐CT based finite element study

Physiological oral mechanical forces may play a role on the progression of enamel carious lesions to cavitation. Thus, the aim of this study was to describe, by 3D finite element analysis, stress, and strain patterns in sound and carious enamel after a simulated occlusal load. Micro‐CT based models were created and meshed with tetrahedral elements (based on an extracted third molar), namely: a sound (ST) and a carious tooth (CT). For the CT, enamel material properties were assigned according to the micro‐CT gray values. Below the threshold corresponding to the enamel lesion (2.5 g/cm³) lower and isotropic elastic modulus was assigned (E = 18 GPa against E₁ = 80 GPa, E₂ = E₃ = 20 GPa for sound enamel). Both models were imported into a FE solver where boundary conditions were assigned and a pressure load (500 MPa) was applied at the occlusal surface. A linear static analysis was performed, considering anisotropy in sound enamel. ST showed a more efficient transfer of maximum principal stress from enamel to the dentin layer, while for the CT, enamel layer was subjected to higher and concentrated loads. Maximum principal strain distributions were seen at the carious enamel surface, especially at the central fossa, correlating to the enamel cavity seen at the original micro‐CT model. It is possible to conclude that demineralized enamel compromises appropriate stress transfer from enamel to dentin, contributing to the odds of fracture and cavitation. Enamel fracture over a dentin lesion may happen as one of the normal pathways to caries progression and may act as a confounding factor during clinical diagnostic decisions. Microsc. Res. Tech. 78:865–872, 2015. © 2015 Wiley Periodicals, Inc.     

Micromorphology analysis and bond strength of two adhesives to Er,Cr:YSGG laser‐prepared vs. Bur‐prepared fluorosed enamel

Preservation of enamel during composite veneer restorations of fluorosed teeth could be achieved by conservative preparation with Erbium lasers. This study evaluated the effect of fluorosed enamel preparation with Er,Cr:YSGG vs. conventional diamond bur on the micromorphology and bond strength of a self‐etch and an etch‐and‐rinse adhesives. Er,Cr:YSGG laser or diamond bur preparation was performed on the flattened midbuccal surfaces of 70 extracted human premolars with moderate fluorosis (according to Thylstrup and Fejerskov index, TFI = 4–6). Adper Single Bond (SB) with acid etching for 20 or 40 s and Clearfil SE Bond (SEB) alone or with additional etching was applied in four laser groups. The same adhesive procedures were used in three bur groups except for 40 s of etching along with SB. After restoration, microshear bond strength was measured (MPa). Data were analyzed using ANOVA and Tamhane tests (α = 0.05). Six additional specimens were differently prepared and conditioned for scanning electron microscopy evaluation. The highest and lowest bond strengths were obtained for bur‐prepared/SB (39.5) and laser‐prepared/SEB (16.9), respectively, with a significant difference (P = 0.001). The different adhesive procedures used associated to two adhesives exhibited insignificantly lower bonding in laser‐prepared groups compared to bur‐prepared ones (P > 0.05), with the exception of additional etching/SEB, which bonded significantly higher to bur‐prepared (36.4) than to laser‐prepared enamel (18.7, P = 0.04). Morphological analyses revealed a delicate etch pattern with exposed enamel prisms on laser‐prepared fluorosed enamel after acid etching and less microretentive pattern after self‐etching primer. The etch‐and‐rinse adhesive was preferred in the laser‐prepared fluorosed enamel in terms of bonding performance. Microsc. Res. Tech. 77:779–784, 2014. © 2014 Wiley Periodicals, Inc.     

Chemical and crystallographic study of remineralized surface on initial carious enamel treated with Galla chinensis

To investigate the morphologic, chemical and crystallographic characters of remineralized surface on initial carious enamel treated with Galla chinensis, scanning electron microscopy equipped with energy dispersive analysis spectroscopy were used, and X‐ray microdiffraction (microzone XRD) was used for the first time to analyze in situ the microzone crystallite of remineralized surface on carious enamel. Bovine sound enamel slabs were demineralized to produce initial carious lesion in vitro. Then, the lesions were exposed to a pH‐cycling regime for 12 days of remineralization. Each daily cycle included 4×1 min applications with one of the three treatments: distilled and deionized water (DDW); 1 g/L NaF; 4 g/L G. chinensis extract (GCE). After the treatments, some rod‐like deposits and many irregular prominences were found on GCE‐treated enamel surface, and the intensities of Ca and P signals showed a tendency to increase; Ca:P ratio was significantly higher than that of DDW‐treated enamel. X‐ray microdiffraction showed hydroxyapatite was still the main component of GCE‐treated enamel, and the crystallinity was increased, the crystal lattice changed gently with decreased lattice parameter a. These results indicated the potential of GCE in promoting the remineralization of initial enamel carious lesions, and supported the previous hypothesis about GCE mechanism. Combined with the anti‐bacteria and demineralization inhibition properties of GCE, the natural G. chinensis may become one more promising agent for caries prevention. SCANNING 31: 236–245, 2009. © 2010 Wiley Periodicals, Inc.     

Does laser etching have an effect on application mode of a universal adhesive?—A microleakage and scanning electron microscopy evaluation

This study aimed to evaluate the microleakage of a universal adhesive's different application modes incorporated with Er,Cr:YSGG laser on Class V resin composite restorations. Sound human molar teeth (n = 30) were used for microleakage evaluations. Specimens with 60 standardized Class V cavities were divided into five groups according to the adhesive modes of universal adhesive, Adhese Universal (n = 12). Group 1‐etch‐and‐rinse mode with phosphoric acid; Group 2‐etch‐and‐rinse mode with Er,Cr:YSGG laser; Group 3‐selective‐etch mode with phosphoric acid; Group 4‐selective‐etch mode with Er,Cr:YSGG laser; Group 5‐self‐etch. After restorations were performed with a resin composite, Tetric N‐Ceram, the specimens were polished and subjected to thermocycling (10,000X). Following immersion in 0.5% basic fuschin for a day, the teeth were sectioned and the degree of microleakage was determined along the tooth‐resin composite interface using a light microscopy(40X). Five specimens from each group were examined by scanning electron microscopy. The Kruskal–Wallis, Siegel Castello, and Wilcoxon tests were used for statistical analyses (α = .05). At the enamel margins, significant differences were obtained among the groups (p < .05). Significantly higher microleakage scores were detected in Group 5 in comparison with Groups 1, 2, and 3. There were no significant differences between different adhesive strategies at the dentin margins (p > .05). While analyzing enamel and dentin microleakage scores, no statistically significant differences were observed in Groups 4 and 5 (p > .05). The laser application time and the adhesive modes of universal adhesives could affect the microleakage at the enamel margins. Different adhesive modes of universal adhesives combined with laser etching had no influence on the microleakage scores of dentin margins.     

Enamel alteration following tooth bleaching and remineralization

The purpose of this study was to compare the effects of professional tooth whitening agents containing highly concentrated hydrogen peroxide (with and without laser activation), on the enamel surface; and the potential of four different toothpastes to remineralize any alterations. The study was performed on 50 human molars, divided in two groups: treated with Opalescence^® Boost and Mirawhite^® Laser Bleaching. Furthermore, each group was divided into five subgroups, a control one and 4 subgroups remineralized with: Mirasensitive^® hap+, Mirawhite^® Gelle?, GC Tooth Mousse? and Mirafluor^® C. The samples were analysed by SEM/3D‐SEM‐micrographs, SEM/EDX‐qualitative analysis and SEM/EDX‐semiquantitative analysis. The microphotographs show that both types of bleaching cause alterations: emphasized perikymata, erosions, loss of interprizmatic substance; the laser treatment is more aggressive and loss of integrity of the enamel is determined by shearing off the enamel rods. In all samples undergoing remineralization deposits were observed, those of toothpastes based on calcium phosphate technologies seem to merge with each other and cover almost the entire surface of the enamel. Loss of integrity and minerals were detected only in the line‐scans of the sample remineralized with GC Tooth Mousse?. The semiquantitative EDX analysis of individual elements in the surface layer of the enamel indicates that during tooth‐bleaching with HP statistically significant loss of Na and Mg occurs, whereas the bleaching in combination with a laser leads to statistically significant loss of Ca and P. The results undoubtedly confirm that teeth whitening procedures lead to enamel alterations. In this context, it must be noted that laser bleaching is more aggressive for dental substances. However, these changes are reversible and can be repaired by application of remineralization toothpastes.     

Microstructure and mineral composition of dental enamel of permanent and deciduous teeth

Purpose: This study evaluated and compared in vitro the microstructure and mineral composition of permanent and deciduous teeth's dental enamel. Methods: Sound third molars (n = 12) and second primary molars (n = 12) were selected and randomly assigned to the following groups, according to the analysis method performed (n = 4): Scanning electron microscopy (SEM), X‐Ray diffraction (XRD) and Energy dispersive X‐ray spectrometer (EDS). Qualitative and quantitative comparisons of the dental enamel were done. The microscopic findings were analyzed statistically by a nonparametric test (Kruskal‐Wallis). The measurements of the prisms number and thickness were done in SEM photomicrographs. The relative amounts of calcium (Ca) and phosphorus (P) were determined by EDS investigation. Chemical phases present in both types of teeth were observed by the XRD analysis. Results: The mean thickness measurements observed in the deciduous teeth enamel was 1.14 mm and in the permanent teeth enamel was 2.58 mm. The mean rod head diameter in deciduous teeth was statistically similar to that of permanent teeth enamel, and a slightly decrease from the outer enamel surface to the region next to the enamel‐dentine junction was assessed. The numerical density of enamel rods was higher in the deciduous teeth, mainly near EDJ, that showed statistically significant difference. The percentage of Ca and P was higher in the permanent teeth enamel. Conclusions: The primary enamel structure showed a lower level of Ca and P, thinner thickness and higher numerical density of rods. Microsc. Res. Tech., 2010. © 2009 Wiley‐Liss, Inc.     

Effect of laser preparation on adhesion of a self‐adhesive flowable composite resin to primary teeth

The aim of the study was to evaluate the adhesion of a self‐adhering flowable composite resin to primary tooth enamel and dentin after silicon carbide paper (SiC) and laser pretreatment. Adhesive properties were evaluated as shear bond strength (SBS) and scanning electron microscopic (SEM) characteristics. A total 120 primary canine teeth were randomly divided into two groups to study enamel and dentin. Each group was divided into 6 subgroups (n = 10) according to type of surface preparation (SiC or Er:YAG laser) of enamel or dentin. Three methods were used to build cylinders of restoration on tooth surface: OptiBond All‐In‐One + Premise Flowable composite, OptiBond All‐In‐One + Vertise Flow and Vertise flow. After restoration, samples were tested for SBS and failure mode. Twenty eight samples were examined by SEM. The results of the study showed SBS of Vertise Flow was lower than others in enamel and dentin samples pretreated with SiC and in dentin samples pretreated with laser (P < 0.001). Compared to SiC pretreatment, laser pretreatment led to a significantly higher SBS with Vertise Flow on enamel (P < 0.001). Vertise Flow associated with the adhesive led to a higher SBS in enamel and dentin compared to Vertise Flow alone. Adhesive and mixed failure modes were observed more frequently in Vertise Flow groups. SEM images showed that Vertise Flow led to more irregularities on enamel and more open dentinal tubules after laser ablation compared SiC pretreatment. Microsc. Res. Tech. 79:334–341, 2016. © 2016 Wiley Periodicals, Inc.     

Morphological changes produced by acid dissolution in Er:YAG laser irradiated dental enamel

Several scientific reports have shown the effects of Er:YAG laser irradiation on enamel morphology. However, there is lack of information regarding the morphological alterations produced by the acid attack on the irradiated surfaces. The aim of this study was to evaluate the morphological changes produced by acid dissolution in Er:YAG laser irradiated dental enamel. Forty‐eight enamel samples were divided into four groups (n = 12). GI (control); Groups II, III, and IV were irradiated with Er:YAG at 100 mJ (12.7 J/cm²), 200 mJ (25.5 J/cm²), and 300 mJ (38.2 J/cm²), respectively, at 10 Hz without water irrigation. Enamel morphology was evaluated before‐irradiation, after‐irradiation, and after‐acid dissolution, by scanning electron microscopy (SEM). Sample coating was avoided and SEM analysis was performed in a low‐vacuum mode. To facilitate the location of the assessment area, a reference point was marked. Morphological changes produced by acid dissolution of irradiated enamel were observed, specifically on laser‐induced undesired effects. These morphological changes were from mild to severe, depending on the presence of after‐irradiation undesired effects. Microsc. Res. Tech. 77:410–414, 2014. © 2014 Wiley Periodicals, Inc.     

Resin-tooth interfacial morphology and sealing ability of one-step self-etch adhesives: microleakage and SEM study

OBJECTIVES: To compare microleakage of three self‐etch adhesives and to analyze enamel surface morphology and interfacial morphology of resin–enamel and resin–dentin interface under scanning electron microscope (SEM). EXPERIMENTAL DESIGN: Study was conducted in 65 extracted human premolars. Class V cavities were prepared in 45 teeth and assigned to three groups (n = 15) according to three self‐etch adhesives (OptiBond All‐in‐One, iBond, and Adper Prompt L‐Pop). After restoration, 10 samples from each group were used to assess microleakage at enamel and dentin margin. Five samples from each group were used for analysis of interfacial morphology at resin–enamel and resin–dentin interface under SEM. Remaining 20 teeth were used to prepare flat enamel buccal surfaces to analyze the difference in surface morphology after treatment with three adhesives (n = 5 each) and 36% phosphoric acid treatment (n = 5). PRINCIPAL OBSERVATIONS: At enamel margin, Prompt L‐Pop depicted least leakage of all the three adhesives and also showed best interfacial adaptation under SEM. At dentin margin, OptiBond All‐in‐One showed significant less leakage than iBond and Prompt L‐Pop. On flat enamel surface, phosphoric acid produced the most retentive etching pattern when compared with the three adhesives. CONCLUSION: Prompt L‐Pop showed the best bonding effectiveness in enamel, whereas OptiBond All‐in‐One performed significantly better in dentin. Microsc. Res. Tech. 2012. © 2012 Wiley Periodicals, Inc.     

Remineralization effects of self-assembling peptide P11-4 associated with three materials on early enamel carious lesions: An in vitro study

The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P₁₁-4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P₁₁-4, (3) fluoridate toothpaste (FT), (4) P₁₁-4 + FT, (5) casein phosphopeptide–amorphous calcium phosphate (CPP–ACP), (6) P₁₁-4 + CPP–ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P₁₁-4 + BT. The surface enamel microhardness (EMH) and energy-dispersive X-ray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05). EMH after demineralization was significantly lower than the baseline value (p < .001). The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P₁₁-4 was significantly lower than the others (p < .001). The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.     

Energy dispersive X‐ray spectrometry study of the protective effects of fluoride varnish and gel on enamel erosion

Background: Dental erosion is a risk factor for dental health, introduced by today's lifestyle. Topical fluoride applications in the form of varnishes and gel may lead to deposition of fluoride on enamel. Purpose: This in vitro study aimed to evaluate the effect of two fluoride varnishes and one fluoride gel on the dissolution of bovine enamel by acids. Methods: Enamel samples (72) were divided (n = 8): artificial saliva (control‐G1), Pepsi Twist® (G2), orange juice (G3), Duraphat® + Pepsi Twist® (G4), Duraphat® + orange juice (G5), Duofluorid® + Pepsi Twist® (G6), Duofluorid® + orange juice (G7), fluoride gel + Pepsi Twist® (G8), and fluoride gel + orange juice (G9). Fluoride gel was applied for 4 min and the varnishes were applied and removed after 6 h. The samples were submitted to six cycles (demineralization: Pepsi Twist® or orange juice, 10 min; remineralization: saliva, 1 h). Samples were analyzed by energy‐dispersive X‐ray fluorescence (144 line‐scanning). Results: The amount of Ca and P decreased significantly in the samples of G2 and G3, and the Ca/P ratio decreased in G3. Mineral gain (Ca) was greater in G9 samples than in G4 > G3 > G5 > G1, and (P) greater in G7 samples than in G9 > G4‐6 > G2‐3. Conclusions: The protective effect of Duofluorid® was significantly lower than fluoride gel against orange juice. The fluoride varnishes can interfere positively with the dissolution of dental enamel in the presence of acidic beverages. Fluoride gel showed the best protection level to extrinsic erosion with low costs. Microsc. Res. Tech., 2011. © 2010 Wiley‐Liss, Inc.