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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.

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.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.Significant differences were observed among the adhesives (p

The aim of this study was to evaluate the effect of cavity preparation with Er:YAG laser on dentin adjacent to restorations submitted to cariogenic challenge in situ, by subsuperficial microhardness analysis. Bovine incisors were sectioned, flattened, and polished, resulting in 40 dentin slabs. The slabs were randomly assigned to four groups ( n  = 10), according to the cavity preparation method: I—high-speed handpiece (control); II—Er:YAG laser (160 mJ; 3 Hz); III—Er:YAG laser (260 mJ; 3 Hz); IV—Er:YAG laser (300 mJ; 3Hz). Cavities were restored with composite resin, and the specimens were fixed in intra-oral appliances, which were worn by 10 volunteers for 14 days for simulating cariogenic challenge in situ. During the experimental period, 20% sucrose solution was dripped over each specimen 6 times a day. Samples were removed, sectioned, and examined for subsuperficial Knoop microhardness at 100, 200, and 300 μm from the restoration and at 30 μm from dentin surface. Split-plot analysis of variance showed no significant difference among the cavity preparation techniques ( p  = 0.1129), among distances ( p  = 0.9030), as well as no difference in the interaction between the main factors ( p  = 0.7338). It was concluded that the cavity preparation with Er:YAG laser did not influence on dentin microhardness submitted to cariogenic challenge in situ.

This study evaluates in situ the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser parameters on the development of caries-like lesions adjacent to dental restorations. One hundred fifty bovine enamel slabs were randomly allocated among 15 volunteers. The specimens were subdivided into ten groups: nine experimental groups prepared with Er:YAG laser (300 mJ output, frequency of 2, 4 or 6 Hz, water flow rate of 2.0, 5.0, or 8.0 mL/min) and one control group (high-speed handpiece). The prepared cavity was restored with a composite resin, and the slabs were mounted on palatal appliance to be installed in the volunteers to the cariogenic challenge. After this, the specimens were sectioned to the longitudinal microhardness measurements. Data were submitted to Friedman and Wilcoxon paired tests. All groups prepared with Er:YAG laser demonstrated microhardness values higher than those prepared with high-speed handpiece, which showed the lowest microhardness values (24.86). The group prepared with Er:YAG laser (2 Hz–2.0 mL/min) showed the highest microhardness values (152.43), followed by those prepared with Er:YAG laser (2 Hz–5.0 mL/min) (133.08) and Er:YAG laser (2 Hz–8.0 mL/min) (91.61), respectively. The groups Er:YAG laser with 4 and 6 Hz of frequency and water flow rates of 2.0, 5.0, and 8.0 mL/min showed microhardness values lower than the groups cited above and showed statistical similarity among them. The Er:YAG laser parameters employed to cavity preparation influenced the acid resistance of the irradiated substrate, and the Er:YAG laser was capable to control the development of caries-like lesions around composite resin restorations.

This study evaluated the combined effect of fluoride compounds and CO 2 laser in controlling the permeability of eroded enamel. Bovine enamel slabs (3 × 2 mm) were cycled twice through an alternating erosion and remineralization regimen. Slabs were immersed in 20 ml of orange juice (pH 3.84) for 5 min under agitation, rinsed with deionized water, and stored in artificial saliva for 4 h to form erosive lesions. Specimens were then divided into four groups ( n  = 10), which were treated for 1 min with either a control or with one of the following gels: amine fluoride (AmF), titanium tetrafluoride (TiF 4 ), or sodium fluoride (NaF). Half of the specimens were irradiated with a CO 2 laser ( λ  = 10.6 μm; 2.0 W). Specimens were cycled two more times through the aforementioned erosion–remineralization regimen and were subjected to permeability assessment. ANOVA demonstrated a significant interaction between fluoride and laser treatment ( p  = 0.0152). Tukey’s test showed that when fluoride was applied alone, TiF 4 resulted in lower enamel permeability than that observed after application of the placebo gel. Intermediate permeability values were noted after NaF and AmF had been used. A significant reduction in enamel permeability was obtained when fluoride was combined with CO 2 laser treatment, with no difference between fluoride gels. Permeability of eroded enamel may be reduced by combining the application of fluoride gels with CO 2 laser irradiation.

The ultra-thin porcelain laminates provide the esthetic harmony to the smile compromised by the presence of diastema between maxillary incisors. Objective: To report the dental aesthetic recovery with ultra-thin porcelain laminates, so-called “contact lenses”. Case report: Patient sought treatment reporting presence of diastema between the anterior teeth. After the clinical examination, impressions were made to obtain study models and diagnostic wax-up. Home bleaching was conducted using 10% carbamide peroxide for 21 days. Next, the mock-up with bisacrylic self-curing composite resin and the functional impression were conducted. For cementation, dental surfaces were etched with 37% phosphoric acid followed by applying the adhesive system. The resin cement was inserted within internal part of the contact lenses previously treated with hydrofluoric acid and silane, and the prosthetic samples were positioned over the labial surfaces of the anterior teeth. After light-curing, the finishing procedure was performed. Conclusion: Ultra-thin porcelain laminates (contact lenses) were viable, efficient, and conservative procedures for recovering dental esthetic, with no need of invasive procedures.

Introduction: The crown lengthening surgery and the transurgical restoration are alternative procedures to enable the restoration of teeth inaccessible to the conventional techniques and restore the lost biological space. Objective: This study aimed to present clinically the reconstruction of a right maxillary second molar through crown lengthening surgery associated with transurgical restoration with composite resin in a patient treated in the Integrated Clinics of the University of Ribeirão Preto. Case report: Patient E.H.C.V., female, aged 51 years, attended the dental clinic of the University of Ribeirão Preto. The anamnesis showed a favorable health history and the clinical examination showed great tooth crown destruction of tooth #17. The treatment planning included the crown lengthening periodontal surgery with regularization of alveolar bone on the buccal surface of tooth #17, rubber dam isolation, the restauration of the compromised area with composite resin, and suture in the same session. After 7 days, the sutures were removed and the restoration polished. Conclusion: It can be concluded that the use of this technique is a viable, fast, and satisfactory solution, with good results, favoring the health and aesthetics, returning function and better social life to the patient.

The color change of teeth is frequent in the dental office and has important role in smile harmony. Objective: To discuss through case report the dental bleaching technique associated with enamel microabrasion to remove localized white spots on the maxillary incisors and canines. Case report: Patient, female, aged 18 years, attended the Clinic of the University of Ribeirão Preto complaining about the negative aesthetics of her smile due to the presence of white spots on teeth #13, #12, #11, #21, #22 and #23. After detailed anamnesis and clinical examination, the spots were diagnosed as enamel demineralization caused by cariogenic challenge occurred during the use of orthodontic brackets. Dental bleaching technique with 38% hydrogen peroxide was applied followed by enamel microabrasion with 6.6% hydrochloric acid and silicon carbide paste. After absolute isolation, 1 mm thick paste was applied on enamel stain with the aid of resin composite polishing abrasive rubber. Each application was followed by copious washing and analysis of the stain removal with wet enamel surface. In total, six applications of 10 seconds each were used. Finally, enamel polishing was executed with felt discs and diamond paste, and topical application of fluoride. Conclusion: It was concluded that bleaching associated with enamel microabrasion technique is a safe, simple, and effective option for solving the esthetics of teeth with white spots.

Introduction: The ultra-thin porcelain laminates provide the esthetic harmony to the smile compromised by the presence of diastema between maxillary incisors. Objective: To report the dental aesthetic recovery with ultra-thin porcelain laminates, so-called \"contact lenses\". Case report: Patient sought treatment reporting presence of diastema between the anterior teeth. After the clinical examination, impressions were made to obtain study models and diagnostic wax-up. Home bleaching was conducted using 10% carbamide peroxide for 21 days. Next, the mock-up with bisacrylic self-curing composite resin and the functional impression were conducted. For cementation, dental surfaces were etched with 37% phosphoric acid followed by applying the adhesive system. The resin cement was inserted within internal part of the contact lenses previously treated with hydrofluoric acid and silane, and the prosthetic samples were positioned over the labial surfaces of the anterior teeth. After light-curing, the finishing procedure was performed. Conclusion: Ultra-thin porcelain laminates (contact lenses) were viable, efficient, and conservative procedures for recovering dental esthetic, with no need of invasive procedures.

The crown lengthening surgery and the transurgical restoration are alternative procedures to enable the restoration of teeth inaccessible to the conventional techniques and restore the lost biological space. Objective: This study aimed to present clinically the reconstruction of a right maxillary second molar through crown lengthening surgery associated with transurgical restoration with composite resin in a patient treated in the Integrated Clinics of the University of Ribeirão Preto. Case report: Patient E.H.C.V., female, aged 51 years, attended the dental clinic of the University of Ribeirão Preto. The anamnesis showed a favorable health history and the clinical examination showed great tooth crown destruction of tooth #17. The treatment planning included the crown lengthening periodontal surgery with regularization of alveolar bone on the buccal surface of tooth #17, rubber dam isolation, the restauration of the compromised area with composite resin, and suture in the same session. After 7 days, the sutures were removed and the restoration polished. Conclusion: It can be concluded that the use of this technique is a viable, fast, and satisfactory solution, with good results, favoring the health and aesthetics, returning function and better social life to the patient.