Thermal effects and morphological aspects of human dentin surface irradiated with different frequencies of Er:YAG laser

This study reports the effects on micromorphology and temperature rise in human dentin using different frequencies of Er:YAG laser. Sixty human dentin fragments were randomly assigned into two groups (n = 30): carious or sound dentin. Both groups were divided into three subgroups (n = 10), according to the Er:YAG laser frequency used: 4, 6, or 10 Hz (energy: 200 mJ; irradiation distance: 12 mm; and irradiation time: 20 s). A thermocouple adapted to the tooth fragment recorded the initial temperature value (°C); then, the temperature was measured after the end of the irradiation (20 s). Morphological analysis was performed using images obtained with scanning electron microscope. There was no difference between the temperatures obtained with 4 and 6 Hz; the highest temperatures were achieved with 10 Hz. No difference was observed between carious and sound dentin. Morphological analyses revealed that all frequencies promoted irregular surface in sound dentin, being observed more selectively ablation especially in intertubular dentin with tubule protrusion. The caries dentin presented flat surface for all frequencies used. Both substrates revealed absence of any signs of thermal damage. It may be concluded that the parameters used in this study are capable to remove caries lesion, having acceptable limits of temperature rise and no significant morphological alterations on dentin surface. Microsc. Res. Tech. 2012. © 2012 Wiley Periodicals, Inc.     

Influence of Er:YAG laser frequency on dentin caries removal capacity

The purposes of this study were to evaluate in vitro the influence of different frequencies of Er:YAG laser on the human dentin caries removal capacity. Thirty fragments obtained from third molars were randomly assigned into three groups (n = 10) according to the laser frequency used: 4, 6, and 10 Hz. The caries lesion (±1 mm deep) was induced before the irradiation by S.mutans cultures for 6 weeks. The specimens of all groups were irradiated with 200 mJ of energy in noncontact and focused mode under constant refrigeration (water flow: 2.5 mL/min). Quantitative analysis of the caries removal was performed by DIAGNOdent^TM and the Axion Vision^TM software. Qualitative analysis was performed by Scanning electron microscope (SEM) and light microscope (LM). Data were analyzed by ANOVA and Fishers' tests. The DIAGNOdent^TM revealed that the caries removal was similar with 4 and 6 Hz and was superior with 10 Hz (P < 0.05). The analysis with Axion Vision^TM software revealed that the caries removal was similar with 6 and 10 Hz and the 4 Hz group promoted the lowest caries removal. Through SEM morphologic analysis, some specimens irradiated with 4 Hz presented, under the demineralized dentin, a disorganized collagenous matrix. The LM images revealed that all frequencies used promoted irregular caries removal, being observed over preparations with 6 and 10 Hz. It can be concluded that the increase of Er:YAG laser frequency provided a higher dentin caries removal without selectivity to the disorganized dentin. Microsc. Res. Tech., 2010. © 2010 Wiley‐Liss, Inc.     

Effect of super short pulse Er:YAG laser on human dentin—Scanning electron microscopy analysis

This study evaluated the effect of different pulse widths in the morphological characteristics of human dentin irradiated with Er:YAG in cavity preparation protocols and dentin pretreatment. Dentin discs with 2 mm thickness were obtained from 18 human molars. The experimental groups were composed from two variables: (1) clinical protocol—cavity preparation (E = 200 mJ/20 Hz)—and pretreatment (E = 80 mJ/2 Hz); and (2) pulse duration—50, 300, and 600 μs. This formed six experimental groups (n = 3): G1 (E = 200 mJ/20 Hz/50 μs); G2 (E = 200 mJ/20 Hz/300 μs); G3 (E = 200 mJ/20 Hz/600 μs); G4 (E = 80 mJ/2 Hz/50 μs); G5 (E = 80 mJ/2 Hz/300 μs); G6 (E = 80 mJ/2 Hz/600 μs). The samples were irradiated with the Er:YAG laser by noncontact mode at a focal distance of 7 mm from the target point under continuous water spray (60% water and 40% air). After the irradiation, they were processed for scanning electron microscopy (SEM). Morphological analysis showed an irregular dentin surface, absence of smear layer with opening of the exposure of dentinal tubules and protruding peritubular dentin—without indications of changes for all protocols used. Regardless of the analyzed experimental group, the dentin surface showed a microretentive morphology characteristic of ablation. The G1 and G4 showed a rougher surface when compared to other groups. Finally, we concluded that the pulse width can influence the morphological characteristics of the irradiated dentin tested in different clinical indications. The larger surface irregularity caused by regulation with less pulse width (50 µs) seems more appropriate to get a microretentive pattern necessary for successful adhesives restoration procedures. Microsc. Res. Tech. 78:472–478, 2015. © 2015 Wiley Periodicals, Inc.     

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.     

The use of Er:YAG laser for cavity preparation: an SEM evaluation

OBJECTIVE: The purpose of this study was to evaluate morphological changes in cavities prepared by the Er:YAG laser (2.94 mum) at different parameters of irradiation and by a diamond bur. EXPERIMENTAL DESIGN: Cavities were prepared on 27 human molars (n = 3): G1, 15 Hz/160 mJ enamel/6 Hz/200 mJ dentin; G2, 15 Hz/180 mJ enamel/6 Hz/200 mJ dentin; G3, 15 Hz/160 mJ enamel/6 Hz/250 mJ dentin; G4, 15 Hz/180 mJ enamel/6 Hz/250 mJ dentin; G5, 15 Hz/180 mJ enamel/10 Hz/180 mJ dentin; G6, 15 Hz/160 mJ enamel/10 Hz/180 mJ dentin; G7, 15 Hz/160 mJ enamel/10 Hz/160 mJ dentin; G8, 15 Hz/180 mJ enamel/10 Hz/160 mJ dentin; G9, diamond bur. For SEM analysis, samples were fixed (2.5% glutaraldheyde, 12 h, 4 degrees C), dehydrated (25-100% ethanol), dried, and sputter-coated with gold. RESULTS: Despite the changes on energy and repetition-rate settings, all laser-treated samples showed no evidence of thermal damage or signs of burning and melting. Er:YAG laser ablated dental hard tissues showed exposed enamel prisms, dentin surface without smear layer, and opened dentinal tubules. CONCLUSION: Different Er:YAG laser parameters were effective for ablation of hard tissues, creating an irregular and microretentive morphological pattern without hard tissue damage.     

Long‐term chlorhexidine effect on bond strength to Er:YAG laser irradiated‐dentin

This study evaluates the bond strength of dentin prepared with Er:YAG laser or bur, after rewetting with chlorhexidine on long‐term artificial saliva storage and thermocycling. One hundred and twenty human third molars were sectioned in order to expose the dentin surface (n = 10). The specimens were randomly divided in 12 groups according to treatment and aging: Er:YAG laser rewetting with deionized water (LW) and 24 h storage in artificial saliva (WC); LW and 6 months of artificial saliva storage + 12.000 thermocycling (6M), LW and 12 months of artificial saliva storage + 24.000 thermocycling (12M), Er:YAG laser rewetting with 2% chlorhexidine (LC) and WC, LC and 6M, LC and 12M, bur on high‐speed turbine rewetting with deionized water (TW) and WC, TW6M, TW12M, bur on high‐speed turbine + 2% chlorhexidine (TC) and WC, TC and 6M, TC and12M. The specimens were etched with 35% phosphoric acid, washed, and dried with air. Single Bond 2 adhesive was applied and the samples were restored with a composite. Each tooth was sectioned in order to obtain 4 sticks, which were submitted to microtensile bond strength test (µTBS). The two‐way ANOVA, showed no significant differences for the interaction between the factors and for the aging factor. Tukey 5% showed that the LC group had the lowest µTBS. The rewetting with chlorhexidine negatively influenced the bond strength of the preparation with the Er:YAG laser. The artificial saliva aging and thermocycling did not interfere with dentin bond strength. Microsc. Res. Tech. 77:37–43, 2014. © 2013 Wiley Periodicals, Inc.     

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.     

Effects of ultramorphological changes on adhesion to lased dentin-Scanning electron microscopy and transmission electron microscopy analysis

Dentin irradiation with erbium lasers has been reported to alter the composite resin bond to this treated surface. There is still a lack of studies reporting the effect of erbium lasers on dentin organic content and elucidating how laser treatment could interfere in the quality of the resin-dentin interface. This study aimed to evaluate the effect of erbium laser irradiation on dentin morphology and microtensile bond strength (μTBS) of an adhesive to dentin. Seventy-two dentin disks were divided into nine groups (n = 8): G1-Control (600-grit SiC paper); Er:YAG groups: G2- 250 mJ/4 Hz; G3- 200 mJ/4 Hz; G4- 180 mJ/10 Hz; G5- 160 mJ/10 Hz; Er,Cr:YSGG groups: G6- 2 W/20 Hz; G7- 2.5 W/20 Hz; G8- 3 W/20 Hz; G9- 4 W/20 Hz. Specimens were processed for cross-sectional analysis by scanning electron microscopy (SEM) (n = 3), transmission electron microscopy (TEM) (n = 2), and adhesive interface (n = 3). Forty-five dentin samples (n = 5) were restored and submitted to μTBS testing. ANOVA (α = 5%) revealed that G1 presented the highest μTBS values and irradiated groups did not differ from each other. TEM micrographs showed a superficial layer of denatured collagen fibrils. For SEM micrographs, it was possible to verify the laser effects extending to dentin subsurface presenting a rough aspect. Cross-sectional dentin micrographs of this hybridized surface revealed a pattern of modified tags with ringlike structures around it. This in vitro study showed that erbium laser irradiation interacts with the dental hard tissue resulting in a specific morphological pattern of dentin and collagen fibrils that negatively affected the bond strength to composite resin.     

Effects of Er,Cr:YSGG laser parameters on dentin bond strength and interface morphology

Previous studies have shown the effects of Er,Cr:YSGG laser irradiation on the dentin bond strength; but there are few reports that show the significance of the irradiation with different laser parameters on dentin bond strength and interface morphology. This in‐vitro study attempted to evaluate the microtensile bond strength (μTBS) and interface morphology of resin‐dentin interfaces, either followed by treatment with Er,Cr:YSGG laser irradiation with different parameters or not. The flattened dentin samples of 35 bovine teeth were embedded into acrylic blocks and randomly divided into seven groups according to surface treatments using Er,Cr:YSGG lasers with different parameters: 3 W/20 Hz, 3 W/35 Hz, 3 W/50 Hz, 1.5 W/20 Hz, 1.5 W/35 Hz, 1.5 W/50 Hz, or no laser treatment (n = 5). Composite buildups were done over bonded surfaces and stored in water (24 hours at 37°C). Specimens were sectioned into sticks that were subjected to μTBS testing and observed under FE‐SEM. Control groups (27.70 ± 7.0) showed statistically higher values than laser‐irradiated groups. There were no significant differences among laser groups. Despite that, increasing the pulse frequency yielded slightly higher bond strength. Depending on laser settings, Er,Cr:YSGG laser irradiation caused interfacial gaps and resin tags with wings morphology. With the parameters used in this study, Er,Cr:YSGG laser irradiation promoted morphological changes within resin‐dentin interfaces and negatively influenced the bond strength of adhesive systems. Microsc. Res. Tech. 78:1104–1111, 2015. © 2015 Wiley Periodicals, Inc.     

Morphological and chemical changes in human deciduous dentin after phosphoric acid,self‐etching adhesive and Er: YAG laser conditioning

The morphological and chemical changes in deciduous dentin produced by different conditioning protocols were evaluated in this in vitro study. Eighty primary dentin samples were divided into eight groups (n = 10): G1, acid etching; G2, self‐etching adhesive; G3, G4, Er: YAG laser irradiation at 25.5 and 38.2 J cm^?2, respectively; 10 Hz and spray irrigation. Groups 5, 6, 7, and 8 were irradiated at previous densities, and then phosphoric acid or self‐etching adhesive conditioning was applied. Scanning electron microscopy (SEM) and energy dispersive X‐ray spectroscopy (EDS) were used to evaluate chemical and morphological changes. Paired t‐test and One‐way ANOVA were used for statistical analysis (p ≤ 0.05). All samples showed different morphology with specific characteristics according to the conditioning protocol. Changing element concentration values are expressed in atomic percent (at %). After conditioning, there were statistically significant differences (p ≤ 0.05) for p at% and Ca/P in all groups; highlighting the following additional findings by group: G1, G7, and G8 showed changes in all elements studied, G2 presented a decrease in C at% and increased Ca at%, G3 and G4 exhibited at% changes in C, trace elements and Ca. Furthermore, G5 showed at% changes in O and trace elements; while G6 changes were observed on C at%, O at% and trace elements at%. Dentin morphology and chemical composition varied in accordance with the conditioning protocol, with characteristics specific for each one that could have clinical implications for the retention and bond strength performance of adhesive materials.     

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I-4 Hz; II-6 Hz, and III-10 Hz. Specimens in group B were submitted to a pH-cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal-Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin.     

Analysis of the interfacial micromorphology of adhesive systems in cavities prepared with Er,Cr:YSGG, Er:YAG laser and bur

The purpose of this in vitro study was to evaluate the interaction pattern of adhesive systems on laser and bur cavities. Cavities were prepared according to the following groups (n=9): (G1) conventional diamond bur (No. 1013); (G2) Er:YAG laser (250 mJ, 4 Hz, 80.6 J/cm2); (G3) Er,Cr:YSGG laser (3.5 W, 20 Hz, 61.7 J/cm2). After cavity preparation, specimens were divided into three subgroups differing the adhesive systems used (n=3): (GA) AdheSE; (GB) Clearfil standard error (SE) Bond; (GC) Single Bond. After insertion of a micro-hybrid composite resin, the specimens were sectioned across the bonded surface dividing the teeth into two halves, which were prepared for SEM analysis. Cavities prepared with laser appeared to be more irregular than the bur cavities. Different patterns of gap formation and resin tags could be observed, showing the differences, advantages, and disadvantages of both types of cavities. Under the settings of the present study, resin tags were more pronounced in lased dentin than bur prepared dentin independently of the bonding systems used. On the other hand gap formation between dentin and resin in laser prepared cavities was observed suggesting collagen alteration.     

Real-time enzymatic degradation of human dentin collagen fibrils exposed to exogenous collagenase: an AFM study in situ

Objective: This study was carried out to observe the enzymatic degradation of human dentin collagen fibrils exposed to exogenous collagenase in situ using atomic force microscopy, to understand the characteristics of the enzymatic degradation of collagen fibrils on dentin specimens. Methods: Polished dentin specimens from caries‐free third molars were etched with citric acid, and then treated with an aqueous solution of 6.5% NaOCl for 120 s. The specimen was then put into a fluid cell and treated with a mixed solution of collagenase I (MMP‐1) and collagenase II (MMP‐8) for 9 h. AFM with contact mode was performed in situ to monitor the enzymatic degradation process of the dentin collagen fibrils. The distinctly topographic changes of the dentin surface were recorded continuously during different stages of the enzymatic degradation process. Results: The mixed solution of exogenous collagenase I and collagenase II could degrade dentin organic matrix (mainly collagen) efficiently, and the structures of dentin substrate were clearly exposed. Conclusion: It is possible to carry out real‐time observations on the enzymatic biodegradation process of human dentin collagen fibrils on dentin specimens with atomic force microscopy in situ. By this means, the fine structures of the etched dentin substrate were clearly revealed, possibly contributing to the related study of human dentin in vitro.     

In vitro assessment of laser efficiency for caries prevention in pits and fissures

This study aimed to assess the in vitro efficacy of the lasers Er:YAG, Nd:YAG, and CO(2) operating in the low energy mode for caries prevention in pits and fissures. Forty-five caries-free enamel occlusal sections were randomly divided into three groups: G1 - Er:YAG (80 mJ/2 Hz); G2 - Nd:YAG Laser (1 W and 10 Hz); and G3 - CO(2) Laser (0.4 W and 20 Hz). After surface treatment, the samples were submitted to challenge with acid consisting of a 10-day immersion in demineralizing (6 h) and remineralizing solution (18 h). Next, enamel demineralization was quantitatively evaluated by subsurface microhardness test and polarized-light microscopy (PLM, mm(2)) and qualitatively assessed by scanning electron microscopy. The Wilcoxon test was used for comparison of each group with its own control. ANOVA (α = 5%) was employed for comparison among groups, and Fisher's LSD multiple comparison test was applied, to check the difference in means. Concerning the microhardness analyses, statistical difference between control, and experimental areas was only detected for the CO(2) group. Experimental values were higher than the controls. As for PLM analyses, smaller demineralized areas were measured for G2 (Nd:YAG) and G3 (CO(2)) compared with the control areas. In conclusion, the present findings suggest that the CO(2) laser should be selected in order to increase the enamel resistance to acid in pits and fissures.     

Dentin erosion by whitening mouthwash associated to toothbrushing abrasion: A focus variation 3D scanning microscopy study

The aim of this study was to determine the erosive potential of hydrogen peroxide (HP) containing mouthwash on dentin assessed by Focus variation three‐dimensional (3D) microscopy. Twenty dentin slabs were selected and randomly allocated into two groups (n = 10): DW—Distilled water (pH = 7.27) and HP—1.5% (pH = 3.78). Each specimen was cyclically demineralized (4 × 60 s/day, 10 days) with HP or DW and brushed 3×/day (200 g, 150 strokes—toothpaste with 1,450 ppmF as NaF). Between the challenges, the specimens were exposed to artificial saliva. Afterward, dentin loss was analyzed using focus variation 3D microscopy, and the data were submitted to unpaired t‐test (α = 0.05). Statistically significant difference was found between the mean wear rate (μm, ±SD) of HP (1.98 ± 0.51) and DW (1.45 ± 0.39). The results suggest that the use of HP‐containing mouthwash associated to brushing may increase the risk of tissue loss and focus variation 3D microscopy may be used as a technique for quantifying dental wear. Microsc. Res. Tech. 76:904–908, 2013. © 2013 Wiley Periodicals, Inc.     

Effects of sodium hypochlorite as dentin deproteinizing agent and aging media on bond strength of two conventional adhesives

This study evaluated the effect of 10% sodium hypochlorite (NaOCl) as deproteinizing agent and storage media on bond strength (BS) of two etch‐and‐rinse adhesive systems to dentin. Twenty‐eight sound extracted human third molars were divided in four groups (n = 7), according to dentin treatment (conventional etching or etching followed by 10% NaOCl application) and adhesive systems (GB—Gluma 2Bond and OS—One‐Step). After dentin treatments and adhesive application, a composite block was built‐up on dentin surface and teeth were serially sectioned to obtain bonded sticks specimens. The sticks were submitted to three aging conditions: (24H) 24 hr in water (immediate), (SH) 3 hr of NaOCl accelerated‐aging or (1Y) 1 year of water storage. Afterward, submitted to microtensile bond strength test (μTBS), failure modes and adhesive interfaces analyzes. Data were analyzed by two‐way analysis of variance (ANOVA) and Tukey's test (α = .05). Dentin deproteinization before bonding significantly reduced μTBS for GB‐treated group (p < .05), regardless the aging conditions. Water storage for 1 year (1Y) and NaOCl accelerated‐aging (SH) decreased μTBS for both adhesives. Yet, the groups stored in NaOCl (SH) exhibited the lowest BS results (p < .05). Bond strength of deproteinized dentin was dependent on the adhesive system composition and NaOCl accelerated‐aging promoted decreased bond strength and further degradation than water storage for 1 year.     

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.     

Mechanical and micromorphological evaluation of chlorhexidine-mediated dentin remineralization

Chlorhexidine (CHX) has been reported to reduce self-degradation of collagen fibrils by inhibiting host-derived protease activity in demineralized dentin. Theoretically, if the collagen fibril scaffold of demineralized dentin maintains its original crosslinkage pattern on treatment with CHX and appropriate supplementation with necessary mineral sources, dentin remineralization may occur in demineralized lesions. In this study, we provide direct mechanical and micromorphological evidence for the ability of CHX to promote remineralization of demineralized dentin. Specifically, with respect to demineralized dentin blocks treated with different concentrations of CHX (0.02-2%) and stored in simulated body fluid, we have observed a significant increase in the elastic modulus of dentin treated with relatively high concentrations of CHX (0.2 and 2%) as storage time increased, whereas the elastic modulus of the non-CHX treated control group decreased. We have also observed a dense mineral deposition along collagen fibrils in the dentin group treated with 0.2 and 2% CHX via field emission scanning electron microscopy.     

Chemical and morphological changes in human dentin after Er:YAGlaser irradiation: EDS and SEM analysis

Sixty samples of human dentin were divided into six groups (n = 10) and were irradiated with Er:YAG laser at 100 mJ–19.9 J/cm², 150 mJ–29.8 J/cm², 100 mJ–35.3 J/cm², 150 mJ–53.0 J/cm², 200 mJ–70.7 J/cm², and 250 mJ–88.5 J/cm², respectively, at 7 Hz under a water spray. The atomic percentages of carbon, oxygen, magnesium, calcium, and phosphorus and the Ca‐to‐P molar ratio on the dentin were determined by energy dispersive X‐ray spectroscopy. The morphological changes were observed using scanning electron microscopy. A paired t‐test was used in statistical analysis before and after irradiation, and a one‐way ANOVA was performed (P ≤ 0.05). The atomic percent of C tended to decrease in all of the groups after irradiation with statistically significant differences, O and Mg increased with significant differences in all of the groups, and the Ca‐to‐P molar ratio increased in groups IV, V, and VI, with statistically significant differences between groups II and VI. All the irradiated samples showed morphological changes. Major changes in the chemical composition of dentin were observed in trace elements. A significant increase in the Ca‐to‐P ratio was observed in the higher energy density groups. Morphological changes included loss of smear layer with exposed dentinal tubules. The changes produced by the different energy densities employed could have clinical implications, additional studies are required to clarify them. Microsc. Res. Tech. 78:1019–1025, 2015. © 2015 Wiley Periodicals, Inc.     

Effect of final irrigation protocols on microhardness and erosion of root canal dentin

The aim of this study was to evaluate the effect of final irrigation protocols (17% EDTA, BioPure MTAD, SmearClear, and QMiX) on microhardness and erosion of root canal dentin. Fifty roots were sectioned transversely at the cement–enamel junction and each root was sectioned horizontally into 4‐mm‐thick slices. The samples were divided into five groups (n = 10) according to the final irrigation protocol: G1: distilled water (control group); G2: 17% EDTA; G3: BioPure MTAD; G4: SmearClear; and G5: QMiX. The dentin microhardness was then measured with a load of 25 g for 10 s. Initially, the reference microhardness values were obtained for the samples without any etching. The same samples were then submitted to the final irrigation protocols. A new measure was realized and the difference between before and after the procedures was the dentin microhardness reduction. In sequence, the specimens were submitted to SEM analysis to verify the dentinal erosion. The Kruskal Wallis and Dunn tests (α = 5%) were used to compare the results. The dentin microhardness decreased for all final irrigation protocols. There was no significant difference between groups 2, 3, 4, and 5 (P > 0.05), but this groups presented significant dentin microhardness reduction than G1 (P < 0.05). In G2, occurred the highest incidence of dentinal erosion (P < 0.05). 17% EDTA, BioPure MTAD, SmearClear, and QMiX promoted significant dentin microhardness reduction. Dentinal tubules erosion was promoted by 17% EDTA. Microsc. Res. Tech., 76:1079–1083, 2013. © 2013 Wiley Periodicals, Inc.