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Related papers:

title: Bonding to enamel and dentin: a brief history and state of the art, 1995.
abstract: The acid-etch technique for bonding composite resins to enamel has revolutionized the practice of restorative dentistry. The ability of clinicians to bond restorative materials to enamel has fundamentally changed such diverse areas as cavity preparation, caries prevention, and esthetic treatment options. Although bonding of resin to dentin has proved to be a difficult challenge, ongoing advances are improving the reliability and predictability of dentinal adhesion. The purpose of this article is to provide a brief history of enamel and dentinal bonding, as well as an overview of the current state of the art.

title: Enamel surface roughness analysis after laser ablation and acid-etching.
abstract: Laser-roughened enamel surfaces have been shown to provide for greater acid-resistance and enhanced restorative material/enamel bond strength. Extracted tooth enamel was irradiated with several lasers: CO2/Nd:YAG (CW), CO2 (RSP), Nd:YAG (CW), Nd:YAG (Q-switched), Argon (CW), and Ar:F excimer. Additional teeth were acid-etched. Energy densities were standardized at 25.47 J/cm2 for all mediums. Surface profile analyses were conducted with a profilometer to determine the amount of enamel surface roughness. The acid-etched samples exhibited both a greater amount of surface roughness and a qualitatively different type of enamel surface morphology than the laser-treated specimens. Independent use of the CO2 and Nd:YAG beams exhibited a moderate amount of roughness, while the coaxial CO2/Nd:YAG beam displayed surface roughness approaching that of the acid-etch samples. Different laser mediums produce enamel surface morphologies that are characteristic of a variety of inherent lasing parameters.

title: A comparison of surface roughness and composite/enamel bond strength of human enamel following the application of the Nd:YAG laser and etching with phosphoric acid.
abstract: This study was conducted to evaluate enamel morphology after laser etching and acid etching and to determine the shear bond strength of composite to acid-etched and laser-treated enamel.



Enamel from freshly extracted permanent molar teeth was subjected to either laser treatment with an Nd:YAG laser in different laser parameters or was exposed to 37% phosphoric acid for 60 s (Gluma Gel, Bayer Dental). Surface profile analysis of the enamel was undertaken with a Perthometer (S8P, Feinpruif). The results were analyzed by SPSS/PC multiple range test and Student-Newman Keuls procedure. Specimens were examined in a scanning electron microscope (SEM). Shear bond strengths of acid-etched and laser-etched enamel/composite (Brilliant Dentin, Coltene AG and Pekalux, Bayer Dental) were also determined. These results were compared by SPSS/PC multiple range test.



The acid-etched specimens exhibited a qualitatively different type of enamel surface morphology when compared with the laser-treated specimens. Laser treatment at higher exposures resulted in the formation of microcracks and fissures. No significant difference in surface roughness was observed between laser-treated enamel in three different parameters (10 pps, 0.8 W; 15 pps, 1.0 W; 20 pps, 1.25 W) and acid-etched specimens. However, the mean bond strengths of all laser-treated specimens, regardless of the test parameters, were significantly lower (p < 0.05) than the acid-etched enamel specimens.



Although the laser roughened the surface of the enamel, it did not provide a surface as retentive as a surface treated with conventional acid etching. It is concluded from this study that the Nd:YAG laser operated under the conditions described cannot be recommended as a viable alternative to acid etching.

title: Effect of laser-etch on bond strengths of glass ionomers.
abstract: This study evaluated the bond strength between glass ionomer cements and laser-etched dentin. Extracted human molars were sectioned sagittally, creating a flat surface. Samples were shear tested on an Instron testing machine, and mean bond strengths were recorded; statistical analyses indicated no significant differences between the Ketac cements. The bond strengths of both Ketac cements were significantly decreased when applied to laser-etched dentin, but bond strengths of Fuji-II were substantially elevated compared with the control values.

title: Microleakage and shear bond strength of orthodontc brackets bonded to hypomineralized enamel following different surface preparations
abstract: This study investigated the effects of several conditioning methods on shear bond strength (SBS) and microleakage of orthodontic brackets bonded to demineralized enamel.  One hundred premolars were selected and immersed in a cariogenic solution for 12 weeks. The teeth were randomly assigned into 5 groups. In groups 1 and 2, the teeth underwent acid etching for 30 and 120 seconds, respectively. In group 3, a combination of laser and acid etching was employed. A self-etch primer (SEP) was applied in group 4 and in group 5, the teeth were exposed to acidulated phosphate fluoride (APF) for 4 minutes before etching. After bracket bonding, the teeth were immersed in methylen blue for 12 hours and then were mounted in acrylic resin. SBS was determined with an Instron Universal Testing Machine and the amount of microleakage under the brackets was assessed under a stereomicroscope.  The lowest SBS was related to the SEP group and the highest one was observed in the specimens prepared by APF+acid etching. There was a significant difference in SBS (p=0.009), but not in microleakage (p=0.971) of the study groups. The SBS of the specimens treated with SEP was significantly Lower than the other groups, which were not significantly different from each other. The SEP group displayed a higher frequency of bond failure at the enamel-adhesive interface.  Enamel preparation with SEP provided the lowest SBS among the groups. All groups showed some degree of microleakage. There was no significant correlation between SBS and microleakage. Bond strength, microleakage, bonding, self-etch primer, Er:YAG laser.

title: Extracted human versus bovine teeth in laboratory studies.
abstract: The purpose of this study was to determine the shear bond strengths and microleakage of Scotchbond 2/Silux to dentin and to evaluate resin penetration into the dentinal tubules of human and bovine teeth. The shear bond strengths (SBS) were determined on occlusal dentin of 25 human permanent molars (H) and on facial dentin of 25 bovine permanent mandibular incisors (B). The test specimens were stored in physiological saline at 37 degrees C for 24 hours prior to the application of a shear load in an Instron machine at a speed of 0.5 mm/min. Microleakage (ML) of Class V restorations placed on the facial surfaces of the roots of 15 human canines (H) and 15 bovine incisors (B) was determined quantitatively. The restored teeth were thermocycled x500 in 2% methylene blue solution, the dye extracted in 50% HNO3 and the dye concentrations determined spectrophotometrically. The resin penetration into the dentinal tubules was evaluated in the SEM. The following results were obtained: SBS (MPa): H, 6.2 +/- 2.9; B, 4.4 +/- 1.2; ML (microgram dye): H, 4.7 +/- 3.2; B, 15.9 +/- 10.5. The data were analyzed by t-test. The shear bond strength of Scotchbond 2/Silux to human dentin was significantly greater (P = 0.0096) and the microleakage significantly less (P = 0.0004) than to bovine dentin despite the fact that the restorative system penetrated more densely into bovine dentin. The use of bovine teeth instead of human teeth in these types of tests is not indicated.

title: Effects of two adhesion boosters on the shear bond strength of new and rebonded orthodontic brackets.
abstract: The purpose of this study was to evaluate the effects of 2 adhesion boosters, Enhance LC (Reliance, Itasca, Ill) and All-Bond 2 (Bisco, Schaumburg, Ill), on the shear bond strength of new and rebonded (previously debonded) brackets. Sixty new and 60 sandblasted rebonded brackets were bonded to 120 extracted human premolars with composite resin and divided equally into 6 groups based on the 2 adhesion boosters used: (1) new brackets/no booster (2) rebonded brackets/no booster (3) new brackets/Enhance (4) rebonded brackets/Enhance (5) new brackets/All-Bond (6) rebonded brackets/All-Bond. Shear bond strength of each sample was tested with an Instron machine (Instron Corp, Canton, Mass). Results show that the new brackets/All-Bond group yielded the highest strength (20.8 +/- 7.5 MPa), followed by the new brackets/Enhance group (18.6 +/- 6.5 MPa), rebond brackets/All-Bond group (17.3 +/- 7.2 MPa), new brackets/no booster group (16.8 +/- 6.3 MPa), rebonded brackets/no booster group (14.2 +/- 7.2 MPa), and rebonded brackets/Enhance group (13.6 +/- 6.7 MPa). No statistically significant difference was found among the 3 groups utilizing new brackets. For groups of rebonded brackets/no booster and rebonded brackets/Enhance, bond strength was significantly lower than groups of 3 new brackets and rebonded brackets/All-Bond. Rebonded brackets/All-Bond group had comparable bond strength to all 3 new brackets groups. It was concluded that in the process of replacing a failed bracket, (1) when new brackets are used, neither All-Bond 2 or Enhance LC improves bond strength significantly, (2) without the use of any adhesion booster, sandblasted rebonded brackets yield significantly less bond strength than new brackets, (3) Enhance LC fails to increase bond strength of sandblasted rebonded brackets, (4) All-Bond 2 significantly increases bond strength of sandblasted rebonded brackets, (5) sandblasted rebonded brackets with All-Bond 2 yield comparable bond strength to new brackets.

title: The effect of long-term water storage on the tensile strength of orthodontic brackets bonded with resin-reinforced glass-ionomer cements.
abstract: The purpose of this study was to evaluate in vitro the effect of water storage on the tensile bond strength of orthodontic brackets bonded with Vitremer and Fuji II LC resin-reinforced glass-ionomer cements. Seventy-two extracted human premolars were randomly divided into 6 groups and the bonding strengths of the resin-reinforced glass-ionomer cements were compared to control groups bonded with Concise composite resin at 24 hours and 9 months. The brackets were bonded on prepared teeth and a tensile load was applied to dislodge the brackets held in a special device from Lloyd 1000R testing machine. The effects of duration of water exposure, type of bonding material and interaction between long-term water exposure and type of bonding material on the bonding strength were described using the Weibull regression model. The mean tensile bond strength of resin-reinforced glass-ionomers after 24 hours water storage was significantly lower than the mean of the control samples. The results of this study showed no effect of water exposure on the tensile bond strength of brackets bonded with Vitremer glass-ionomer cement. The mean bonding strength of brackets bonded with Fuji II LC without enamel pre-conditioning significantly increased after 9-months water storage as compared to Fuji samples exposed to water for 24 hours. The results of this investigation allow to conclude: 1. Long-term water storage had not decreased the bond strength of resin-reinforced glass-ionomers applied as orthodontic adhesives, 2. Weibull regression model is an adequate and flexible tool to evaluate the bonding properties of dental materials.

title: The effect of erbium, chromium:yttrium–scandium–gallium–garnet laser etching on marginal integrity of a resin-based fissure sealant in primary teeth
abstract: The aim of this in vitro study was to evaluate the effect of erbium, chromium:yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser pretreatment alone, or associated with acid etching, on the quality of marginal integrity (microleakage and marginal gap) of a resin-based fissure sealant in primary teeth. Fifty sound primary molar teeth were randomly assigned to one of five study groups, pretreated as follows: (1) 35% orthophosphoric acid etching; (2) 2.5 W laser etching; (3) 3.5 W laser etching; (4) 2.5 W laser + 35% orthophosphoric acid etching; (5) 3.5 W laser + 35% orthophosphoric acid etching. After surface pretreatment, a resin-based sealant (ClinPro) was applied to the fissures. Sample teeth were then subjected to thermocycling and stored thereafter in distilled water at 37°C for 1 month. Following immersion in 0.5% basic fuchsin solution for 24 h, three bucco-lingual slices of each sample tooth were scored under a stereo-microscope. Statistical analysis was performed with Kruskal–Wallis one-way analysis of variance (ANOVA) and Pearson chi-square tests. The level of significance was set at P < 0.05. Microleakage scores of group 1 were significantly less than those of groups 2 and 3 (P < 0.05), whereas no statistically significant difference was observed between groups 1, 4 and 5 (P > 0.05). In terms of marginal gap formation, no significant difference was observed between groups (P > 0.05). It was concluded that Er,Cr:YSGG laser etching did not eliminate the need for acid etching. When combined with acid etching, Er,Cr:YSGG laser seems to be as effective as conventional acid etching.

title: Differences in bonding to acid-etched or Er:YAG-laser-treated enamel and dentin surfaces.
abstract: YAG (erbium-doped yttrium aluminium garnet) lasers have been effective in the removal of dental tissues. It has been suggested that they are also useful for preparing dental surfaces for adhesion, but results to date have been controversial.



This study compared the tensile strength of bracket-tooth bonds obtained after preparation of the surface for adhesion (dentin or enamel) by conventional acid-etching or by Er:YAG laser etching and investigated microstructure of resin-tooth interfaces using the 2 procedures.



Eighty healthy human premolars were used. Brackets were cemented to acid-etched enamel, laser-etched enamel, acid-etched dentin, or laser-etched dentin (20 teeth per group). Dentin was previously exposed using a high-speed handpiece. Acid-etching was with 37% orthophosphoric acid (15 seconds for enamel, 5 seconds for dentin). Laser etching was with Er:YAG laser (four 200 mJ pulses per second for enamel; four 160 mJ pulses per second for dentin). Brackets were bonded with autocuring resin paste, having first applied a primer (dentin only) and then light-cured bonding resin. Tensile strength was determined with a universal testing machine. Data were analyzed with 2-way ANOVA and subsequent t test with Bonferroni correction. Fracture patterns were compared by the Wilcoxon test with Bonferroni correction. For SEM studies of the resin-tooth interface, a total of 12 premolars were used (3 for each tissue per treatment combination).



Mean tensile bond strength for acid-etched enamel (14.05 +/- 5.03 MPa) was significantly higher (P<.05) than for laser-etched enamel (8.45 +/- 3.07 MPa), and significantly higher (P<.05) for acid-etched dentin (4.70 +/- 2.50 MPa) than laser-etched dentin (2.48 +/- 1.94 MPa). Bond failure after laser etching was due to microcohesive fracture of tooth tissue. SEM studies of both resin-enamel and resin-dentin interfaces indicated extensive subsurface fissuring after laser etching.



Adhesion to dental hard tissues after Er:YAG laser etching is inferior to that obtained after conventional acid etching. Enamel and dentin surfaces prepared by Er:YAG laser etching show extensive subsurface fissuring that is unfavorable to adhesion.

title: Effect of laser preparation on bond strength of a self-adhesive flowable resin
abstract: The aim of this in vitro study was to evaluate the effect of laser treatment on shear bond strength of a self-adhesive flowable resin composite to human dentin. Eighty extracted sound human molar teeth were used for the study. The teeth were sectioned mesiodistally and embedded in acrylic blocks. The dentin surfaces were ground wet with 600-grit silicon carbide (SiC) paper. They were randomly divided into two preparation groups: laser (Er:YAG laser, with 12 Hz, 350 mJ energy) and control (SiC). Each group was then divided into two subgroups according to the flowable resin composite type (n = 20). A self-adhesive flowable (Vertise Flow) and a conventional flowable resin (Premise Flow) were used. Flowable resin composites were applied according to the manufacturer’s recommendations using the Ultradent shear bond Teflon mold system. The bonded specimens were stored in water at 37 °C for 24 h. Shear bond strength was tested at 1 mm/min. The data were logarithmically transformed and analyzed using two-way analysis of variance and Student–Newman–Keul’s test at a significance level of 0.05. The self-adhesive flowable resin showed significantly higher bond strength values to laser-prepared surfaces than to SiC-prepared surfaces (p < 0.001). The conventional flowable resin did not show such differences (p = 0.224). While there was a significant difference between the two flowable resin composites in SiC-prepared surfaces (p < 0.001), no significant difference was detected in laser-prepared surfaces (p = 0.053). The bond strength of a self-adhesive flowable resin composite differs according to the type of dentin surface preparation. Laser treatment increased the dentin bonding values of the self-adhesive flowable resin.

title: Effects of Er:YAG laser on enamel bonding of composite materials
abstract: Cylinders of microfil light-cured composite resin were bonded to the labial enamel surface of bovine incisor teeth which had previously been subjected to different laser treatments. One part of the tooth surfaces were laser treated in a defocused way only, another part with a different overlaying pattern of focused laser pulses. Specimens were thermocycled and the adhesion of the composites were determined by tensile strength tests. The best results were obtained by laser conditioning of the enamel surface in a defocused way with an overlaying fine pattern of focused single shots. The tensile strength reached 92.5% of the acid etched bonding.

title: Comparative Study of the Shear Bond Strength of Flowable Composite in Permanent Teeth Treated with Conventional Bur and Contact or Non-Contact Er:YAG Laser.
abstract: The aim of this study was to evaluate and compare the in vitro effect of the Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser with different radiation distances and high-speed rotary treatment on the shear bond strength of flowable composite to enamel of human permanent posterior teeth.



freshly extracted human molar teeth with no caries or other surface defects were used in this study (n=45). The teeth were randomly divided into 3 groups. Group 1: treated with non-contact Er:YAG Laser and etched with Er:YAG laser, Group 2: treated with contact Er:YAG Laser and etched with Er:YAG laser, Group 3 (control): treated with diamond fissure bur and etched with acid phosphoric 37%. Then the adhesive was applied on the surafces of the teeth and polymerized using a curing light appliance. Resin cylinders were fabricated from flowable composite. Shear bond strength was tested at a crosshead speed of 0.5 mm/min.



The amount of Shear Bond Strength (SBS) in the 3 treatment groups was not the same (P<0.05).The group in which enamel surfaces were treated with diamond fissure bur and etched with acid (conrtol group) had the highest mean shear bond strength (19.92±4.76) and the group in which the enamel surfaces were treated with contact Er:YAG laser and etched with Er:YAG laser had the lowest mean shear bond strength (10.89±2.89). Mann-whitney test with adjusted P-value detected significant difference in shear bond strength between the control group and the other 2 groups (P < 0.05).



It was concluded that both contact and non-contact Er:YAG laser treatment reduced shear bond strength of flowable resin composite to enamel in comparison with conventional treatment with high speed rotary. Different Er:YAG laser distance irradiations did not influence the shear bond strength of flowable composite to enamel.

title: Shear Strength of Composite Bonded to Er:YAG Laser-prepared Dentin
abstract: An Er:YAG laser coupled with a cooling stream of water effectively removes dental hard tissues. However, before such a system can be deemed clinically viable, some safety and efficacy issues must be addressed. We compared the bonding of composite to dentin following the preparation of the dentinal surface with either an Er:YAG laser (A = 2.94 pm) or a standard dental bur and with and without a subsequent acid-etching treatment. The crowns of extracted human molars were removed, revealing the underlying dentin. We removed an additional thickness of material with either a dental handpiece or an Er:YAG laser (350 mj/pulse at 6 Hz) by raster-scanning the samples under a fixed handpiece or laser. Comparable surface roughnesses were obtained. Several samples from each group received an acid-conditioning treatment. A cylinder of composite was bonded onto the prepared surfaces. The dentin-composite bond was then shear-stressed to failure on a universal testing apparatus. The results indicate that laser-irradiated samples had improved bond strengths compared with acid-etched and handpiece controls. SEM photographs of the surfaces show exposed tubules following the laser treatment; tubules could also be exposed with acid etching. We conclude that Er:YAG laser preparation of dentin leaves a suitable surface for strong bonding of an applied composite material.

title: Scanning electron microscopic analysis of diseased and healthy dental hard tissues after Er:YAG laser irradiation: in vitro study.
abstract: The aim of this study was to treat carious lesions, sound dentin, and enamel either with conventional methods or with an Er:YAG laser and to compare the results. Thirty freshly extracted carious human teeth were divided into two groups. In the first group, lesions were treated with burs in a dental handpiece; in the second group, we used the Er:YAG laser with parameters recommended by the manufacturer (Kavo). After treatment, the teeth were prepared for scanning electron microscopic observation. On laser-treated teeth, scaly, flaky, rough surfaces were seen: surfaces were clean with several morphological reliefs that may enhance bonding resin restoration. The Er:YAG laser beam can ablate carious dentin with an energy level of 250 mJ at 2 Hz. Sound dentin can be cut at 300 mJ and 2 Hz; for enamel, 350 mJ and 3 Hz are required. The Er:YAG laser seems to be effective in the treatment of carious lesions and in cavity preparation in vitro.

title: Comparison of the shear bond strength of 2 self-etch primer/adhesive systems.
abstract: Conventional adhesive systems use 3 different agents-an enamel conditioner, a primer solution, and an adhesive resin for bonding orthodontic brackets to enamel. A unique characteristic of some new bonding systems in operative dentistry is that they combine the conditioning and priming agents into a single application. Combining conditioning and priming saves time and should be more cost-effective to the clinician and indirectly to the patient. The purpose of this study was to assess and compare the effects of mix and no-mix self-etch primers/bonding systems on the shear bond strengths of orthodontic brackets. The brackets were bonded to extracted human molars according to the following protocols. In group I, a self-etch acidic primer/adhesive system, Transbond Plus (3M Unitek, Monrovia, Calif), was applied on the enamel surface as suggested by the manufacturer; it has 2 components that must be mixed before use. The brackets were then bonded with Transbond XT and light-cured for 20 seconds. In group II, a no-mix self-etch bracket adhesive system, Ideal 1 (GAG International, Islandia, NY), was applied to the teeth as suggested by the manufacturer. The self-etch primer has 1 component that does not need to be mixed before use. The brackets were then bonded with the adhesive and light-cured for 20 seconds. The in vitro findings indicated that the shear bond strength comparisons (t = 0.681) of the 2 adhesive systems were not significantly different (P =.501). The mean shear bond strength of the 2-component acid etch primer was 5.9 +/- 2.7 MPa, and the mean for the 1-component system was 6.6 +/- 3.2 MPa. The clinician should consider the bond strength and the ease of application of the various components of the bracket bonding systems available on the market.

title: Shear bond strength of orthodontic brackets with newly developed antibacterial self-etch adhesive.
abstract: Because the enamel adjacent to brackets may be affected by microorganisms, an antibacterial adhesive may be a useful choice to prevent and reduce demineralization. The purpose of this in vitro study was to determine the (1) shear bond strength of a self-etch and an antibacterial self-etch adhesive for orthodontic metal brackets and (2) bond failure interface of a self-etch and an antibacterial self-etch adhesive using a modified adhesive remnant index (ARI). Twenty-four defect-free premolars were randomly assigned into two groups. The teeth received the following treatments-group 1: Transbond Plus Self-Etching Primer + Transbond XT; group 2: antibacterial dentin bonding system (ABF) + Transbond XT. All samples were stored in deionized water at 37 degrees C for 48 hours. Shear debonding tests were performed at a crosshead speed of five mm/min. The results in megapascals were (median, minimum, maximum) group 1: 8.53, 4.59, 12.63; group 2: 9.79, 4.01, 22.10, respectively. Mann-Whitney test revealed that the difference between the groups was not statistically significant (P = .2, P > .05). Failed brackets were examined by an optical microscope at 16x magnification to determine the bond failure interface using a modified ARI. The predominant mode of failure for both groups was at the bracket-adhesive interface. ABF may have sufficient mechanical properties and also an antibacterial effect that makes it a good choice for orthodontic bonding.

title: Phosphoric acid incorporated with acidulated phosphate fluoride gel etchant effects on bracket bonding.
abstract: The aim of this study was to evaluate the effects of etching with phosphoric acid incorporated in an acidulated phosphate fluoride (APF) gel on the bonding of a bracket and the loss of sound enamel. In the control group, the enamel was etched with 37% phosphoric acid for 30 seconds. In the experimental groups, the enamel was etched for 30 seconds with 37% phosphoric acid blended with 1.23% APF gel at various ratios (25%, 33%, 50%, 67%, and 75% APF gel). The brackets were bonded with Transbond XT light-cured orthodontic adhesive according to the manufacturer's instructions. The specimens were then treated under three different conditions: 37 degrees C for one hour, 37 degrees C for 24 hours, and thermocycling (2500 times) between 5 degrees C and 55 degrees C in deionized water. The shear bond strength of 10 specimens in each condition was measured and the results analyzed using a Tukey multiple comparison test (P = .05). The shear bond strength decreased significantly as the fraction of the APF gel increased in the experimental etchant. An apparent increase in the adhesive remnant index score was also observed in the large fraction of the APF gel. To minimize the damage of the sound enamel surface during the etching and debonding procedures, a mixture of phosphoric acid and an APF gel (50% and 67% APF fraction) can be used as an phosphoric acid etchant substitute without loss of the proper bracket bond strength.

title: Bond strength evaluation of self-etch and total-etch adhesive systems on intact and ground human enamel
abstract: The aim of this study was to evaluate the bond strength of adhesive
systems to intact and ground enamel. Enamel blocks from buccal and
lingual surfaces of third molars were used for bonding procedures.
Intact or ground (600-grit SiC paper) enamel surfaces were bonded using
two "etch&rinse" adhesives (Prime&Bond 2.1 and Single Bond),
three self-etching primer systems (Optibond Solo Plus SE; Tyrian
SPE/One-Step Plus and UniFil Bond) or two self-etching adhesives
(One-Up Bond F and Xeno III). A 6-mm composite crown was built on the
bonded surfaces and samples were stored for 24 hs at 37°C. Samples
were sectioned into 0.9-mm-thick slabs, each slab trimmed to a
cross-sectional area of 0.8 mm2 and specimens loaded to failure at a
crosshead speed of 0.5 mm/min, using a universal testing machine.
Microtensile bond strength data (n=6) were analyzed using Kruskal-
Wallis and Dunn tests. Differences in bond strength between intact and
ground surfaces were not significant for both "etch&rinse"
adhesives, Tyrian SPE/One-Step Plus, UniFil Bond and Xeno III systems.
The enamel surface preparation resulted in higher bond strength for
Optibond Solo Plus SE and One-Up Bond F systems. Enamel preparation
using 600-grit SiC paper is unlikely to affect resin-enamel bond
strengths.

title: Laser etching of enamel for direct bonding.
abstract: The application of laser irradiation to etch dental enamel in preparation for direct bonding of orthodontic appliances has been studied. Forty extracted human teeth were divided into four groups of 10 teeth. Within each group, five teeth were subjected to a 30 sec acid etch of the buccal enamel surface; the other five in each group were etched with a laser. Four power settings on the laser etching unit were used: 80mJ, 1W, 2W and 3W. After etching, brackets were adhered to the prepared buccal enamel surfaces with composite resin. Shear bond strength was tested 7 days later. The findings showed that an acceptable shear bond strength, viz. > or = 0.6 kg/mm, could be achieved at laser power settings of 1 to 3W but not at the lowest setting (80 mJ). However, the mean shear bond strengths obtained with laser treatment of the enamel at 80mJ, 1W and 2W were lower (p < 0.01 or 0.001) than that achieved with acid etching.

title: Bond strengths of porcelain laminate veneers to tooth surfaces prepared with acid and Er,Cr:YSGG laser etching.
abstract: The erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) hydrokinetic laser system has been successful in the ablation of dental tissues. It has been reported that this system is also useful for preparing tooth surfaces for adhesion, but results to date have been controversial.



This in vitro study evaluated the bond strengths of porcelain laminate veneers to tooth surfaces after etching with acid and Er,Cr:YSGG laser conditioning.  Forty extracted caries- and restoration-free human maxillary central incisors were used. The teeth were sectioned 2 mm below the cementoenamel junction. The crowns were embedded in autopolymerizing acrylic resin with the labial surfaces facing up. The labial surfaces were prepared with.05 mm reduction to receive porcelain veneers. The teeth were divided into 4 groups of 10 specimens. Thirty specimens received 1 of the following surface treatments before the bonding of IPS Empress 2 laminate veneers: (1) laser radiation from an Er,Cr:YSGG laser unit; (2) 37% orthophosphoric acid; and (3) 10% maleic acid. Ten specimens received no surface treatment and served as the control group. The veneers were bonded with dual-polymerizing resin, Variolink II. One microtensile specimen from each of the cervical and incisal thirds measuring 1.2 x 1.2 mm was prepared with a slow-speed diamond saw sectioning machine with a diamond-rim blade. These specimens were attached to opposing arms of the microtensile testing device with cyanoacrylate adhesive and fractured under tension at a crosshead speed of 1 mm/min, and the maximum load at fracture (Kg) was recorded. The data were analyzed with a 2-way analysis of variance and Tukey HSD tests (alpha=.05).



No statistically significant differences were found among the bond strengths of veneers bonded to tooth surfaces etched with Er,Cr:YSGG laser (12.1 +/- 4.4 MPa), 37% orthophosphoric acid (13 +/- 6.5 MPa), and 10% maleic acid (10.6 +/- 5.6 MPa). The control group demonstrated the lowest bond strength values in all test groups. Statistically significant differences were found between the bond strengths of cervical and incisal sections (P<.001).



In vitro microtensile bond strengths of porcelain laminate veneers bonded to tooth surfaces that were laser-etched showed results similar to orthophosphoric acid or maleic acid etched tooth surfaces.

title: Atomic analysis and knoop hardness measurement of the cavity floor prepared by Er,Cr:YSGG laser irradiation in vitro.
abstract: In the present study, the compositional changes and knoop hardness of the cavity floor prepared by Er,Cr:YSGG laser irradiation was compared with that of the conventional bur cavity. Fifteen laser and 15 bur cavities were cross-sectioned, and subjected to atomic analysis by SEM-EDX and knoop hardness test. Statistical analyses were performed using the Mann-Whitney U-test; a value of P < 0.01 was considered significant. Surface characteristics of the prepared cavities were also investigated by light microscopy and scanning electron microscopy (SEM). The results showed that the quantities of Ca (Ca weight %) and P (P weight %) were increased significantly in the laser cavity floor but no significant differences were found between the Ca/P ratio and knoop hardness number of laser and bur cavities. The SEM observation revealed that the lased cavity surface was irregular and there was also the absence of a smear layer; the orifice of dentinal tubules was exposed. Er,Cr:YSGG laser device is considered as one of the most effective and safe devices for cavity preparation because of its many advantages. This includes easy delivery system, minimal thermal damage to the surrounding tissues, minimal thermal-induced changes of dental hard tissue compositions, and favourable surface characteristic.

title: Shear bond strength and SEM evaluation of composite bonded to Er:YAG laser-prepared dentin and enamel.
abstract: The purpose of this study was to evaluate dentin and enamel bond strength to resin composite following high-speed rotary or Er:YAG laser preparation using a total etch adhesive system. The microstructure of resin-tooth interfaces was also investigated.



Human dentin and enamel specimens were prepared with a high-speed handpiece (KaVo) or Er:YAG laser (DELight) at manufacturer's recommended settings and etched with either 37% H(3)PO(4), laser etched, or not etched. Composite rods (Z-250, 3M/ESPE) were bonded to specimens with an adhesive (Adper Scotchbond Multi-Purpose, 3M/ESPE). After thermocycling, specimens were tested in shear to failure.



Two-factor ANOVA detected significant differences in the main effects of preparation and etch type, and interaction (p<0.001). Post hoc analyses showed that in both dentin and enamel, only the acid-etched specimens had significantly higher mean bond strengths, with rotary-prepared specimens having significantly higher mean bond strengths versus laser prepared specimens. Within each preparation type, in both dentin and enamel, acid etch was better than laser etch, and laser etch was better than no etch. Scanning electron microscopy of laser-ablated specimens demonstrated significant surface scaling and subsurface fissuring beyond normal resin penetration depth.



Adhesion to laser-ablated or laser-etched dentin and enamel was inferior to that of conventional rotary preparation and acid etching.

title: Microleakage of class V glass ionomer restorations after conventional and Er:YAG laser preparation.
abstract: The aim of this study was to investigate the microleakage in class V cavities following Er:YAG laser or conventional preparation restored with two conventional glass ionomer cements (cGIC) and to evaluate the effect of conditioning on laser-prepared surfaces.



Information on this topic related to cGIC is scarce.



Sixty class V cavities were assigned to six groups: I and IV were Er:YAG-lased, II and V Er:YAG-lased and conditioned, and III and VI conventionally prepared and conditioned. Groups I, II, and III, were restored with Ketac Fil Plus Applicap; groups IV, V, and VI were restored with Fuji IX GP Capsule. Then, teeth were stored in distilled water (37 degrees C, 24 h), thermal cycled 1500 times (5-55 degrees C), placed in a 2% aqueous solution of methylene blue (37 degrees C, 24 h), embedded in acrylic resin, sectioned oro-facially, and analyzed for leakage.



Statistically significant differences between occlusal and cervical regions were observed (p < 0.05). Group III showed significantly more microleakage at the occlusal margin compared to group II (p = 0.022). Group V showed significantly more microleakage at the gingival margin than group VI (p = 0.022). Leakage on the occlusal margins was significantly higher in group III than in group VI (p = 0.038). Scanning electron microscopy indicated that conditioning of laser-prepared dentin with Ketac conditioner partially closed the tubules' orifices, whereas the use of GC conditioner completely obliterated the tubules.



The application of Ketac Fil Plus to laser-prepared enamel and dentin resulted in a better and more reproducible seal compared to conventionally prepared tooth surfaces. When using the more viscous Fuji IX application, Er:YAG lasing did not improve marginal adaptation.

title: Laser etching of enamel for orthodontic bonding.
abstract: The purposes of this study were to assess the shear bond strength, the surface characteristics, and the adhesive remnant index scores of teeth prepared for bonding with erbium, chromium doped: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching, and to compare laser etching with phosphoric-acid etching and a self-etching primer.



Sixty-four premolars, extracted for orthodontic purposes, were randomly divided into 4 groups, and a different method was used to prepare the tooth enamel in each group for bonding: irradiation for 15 seconds with a 0.75-W Er,Cr:YSGG laser; irradiation for 15 seconds with a 1.5-W Er,Cr:YSGG laser; etching with 37% phosphoric acid; application of a self-etching primer. After surface preparation, standard edgewise stainless steel premolar brackets were bonded; 1 tooth in each group was not bonded and was examined under a scanning electron microscopic. The brackets were debonded 24 hours later; shear bond strengths were measured, and adhesive remnant index scores were recorded.



Irradiation with the 0.75-W laser produced lower shear bond strengths than the other methods. No statistically significant differences were found between 1.5-W laser irradiation, phosphoric-acid etching, and self-etching primer. Adhesive remnant scores were compared with the chi-square test, and statistically significant differences were found between all groups; when the 0.75-W laser irradiation group was excluded, no statistically significant differences were observed.



Irradiation with a 1.50-W laser produced sufficient etching for orthodontic bonding, but irradiation with the 0.75-W laser did not.

title: Tensile bond strength of Er,Cr:YSGG laser-irradiated human dentin and analysis of dentin-resin interface.
abstract: As the bond strength of composite resin to Er,Cr:YSGG laser-irradiated dentin has not yet been evaluated, the objectives of this study were to investigate the tensile bond strength and to analyze the resin-dentin interface among bur-cut/acid-etched, Er,Cr:YSGG laser-ablated/acid-etched and Er,Cr:YSGG laser-ablated human dentin.



Crown dentin disks prepared from extracted human third permanent molars were used for the observation of surface morphological changes by scanning electron microscope (SEM). The laser energy parameters were 3.5 W and 20 Hz with water spray (air pressure level, 80%; water pressure level, maximum level). Another group of crown dentin disks were prepared for composite resin restoration and observation of resin-dentin bond interface after demineralization in 6N hydrochloric acid (HCl) for 1 min and deproteinization in 1% sodium hypochlorite solution (NaOCl) for 10 min. The tensile bond strengths of the three groups were measured by a universal testing machine at a crosshead speed of 0.5 mm/min. Fracture types at the dentin-resin interface were analyzed using the digital stereoscopic microscope and fractured surfaces of the debonded specimens were examined by SEM.



All three groups showed that the treated surfaces were free of dentin debris and smear layer. The peritubular dentin protruded from the surrounding intertubular dentin after laser irradiation. The dentin-resin interface treated with Er,Cr:YSGG laser irradiation and acid etching demonstrated numerous resin tags converging into a bulge and then diverging again. The length of resin tags was greater than 100 microm. The tensile bond strengths of bur-cut/acid-etched, laser-ablated/acid-etched and laser-ablated human dentin were 5.37+/-1.51, 5.17+/-1.41 and 3.29+/-0.86 MPa, respectively. No statistical significance was found between the bur-cut/acid-etched and laser-ablated/acid-etched groups. The predominant fracture modes of bur-cut/acid-etched, laser-ablated/acid-etched and laser-ablated human dentin were Type 1 (50%), Type 2 (70%) and Type 1 (70%), respectively.



Er,Cr:YSGG laser irradiation affects adversely adhesion of resin to dentin but acid etching following laser irradiation could increase the tensile bond strength as high as that of bur-cut/acid-etched human dentin.

title: Microleakage of composite restorations after acid or Er-YAG laser cavity treatments.
abstract: The purpose of this study was to compare microleakage of Class V restorations following acid, laser or laser and acid treatment of cavity walls.



Standardized lingual and buccal Class V preparations were made in 18 human extracted third molars. The preparations were randomly assigned to three equal groups (n=12). Group 1: cavities were treated with 35% phosphoric acid. Group 2: cavities were irradiated with an Er-YAG laser at 2Hz and 250mJ on dentin and 300mJ on enamel, with water cooling. Group 3: cavities were irradiated with the laser before acid etching. Scotchbond 1 Adhesive System and Z100 resin composite were used for restorations. The specimens were stored in water for 24h at 37 degrees C and thermally cycled (500x) between 6-60 degrees C. After 24h immersion in 0.5% basic fuchsin, dye penetration was recorded according to an ordinal scale. Data were analysed using non-parametric statistical tests (Kruskal-Wallis and Mann-Whitney).



On the occlusal walls, microleakage in acid etched cavities was significantly lower than that achieved after laser treatment (P<0.001) or after both treatments (P<0.05). On the gingival walls, no statistical differences were found.



Laser irradiation of enamel is not a valid alternative to acid-etching pretreatment for resin composite materials adhesion. Acid etching alone gave the lowest microleakage at the occlusal margin. No differences were found for microleakage on gingival wall, although lased dentin surfaces presented several characteristics that appear to be advantageous for bonding.

title: Adhesion of Er:YAG laser‐irradiated dentin and composite resins: Application of various treatments on irradiated surface
abstract: The investigation of adhesion between an Er:YAG laser‐irradiated surface and composite resin is very important to ensure the best clinical results. The purpose of this investigation is to determine if the application of various treatments on Er:YAG laser‐irradiated dentin surface affects the tensile bond strength between dentin and composite resins.

title: Micro-tensile bond strength of two adhesives to Erbium:YAG-lased vs. bur-cut enamel and dentin.
abstract: The purpose of the study was to assess the hypotheses that laser irradiation is equally effective for bonding as traditional acid-etch procedures, and that tooth substrate prepared either by Erbium:YAG laser or diamond bur is equally receptive to adhesive procedures. Buccal/oral enamel and mid-coronal dentin were laser-irradiated using an Erbium:YAG laser. A total-etch adhesive (OptiBond FL) applied with and without prior acid-etching and a self-etch adhesive (Clearfil SE Bond) were employed to bond the composite. The micro-tensile bond strength (microTBS) was determined after 24 h of storage in water. Failure patterns were analysed using a stereo-microscope, and samples were processed for Field-emission Scanning Electron Microscopy (Fe-SEM) evaluation. Unbonded, lased enamel and dentin surfaces were evaluated using Fe-SEM as well. The total-etch adhesive bonded significantly less effectively to lased than to bur-cut enamel/dentin. Laser 'conditioning' was clearly less effective than acid-etching. Moreover, acid etching lased enamel and dentin significantly improved the microTBS of OptiBond FL. The self-etch adhesive performed equally to lased as to bur-cut enamel, but significantly less effectively to lased than to bur-cut dentin. It is concluded that cavities prepared by laser appear less receptive to adhesive procedures than conventional bur-cut cavities.

title: Influence of implant bed preparation using an Er:YAG laser on the osseointegration of titanium implants: a histomorphometrical study in dogs.
abstract: The aim of the present study was to evaluate the influence of implant bed preparation using an Er:YAG laser on the osseointegration of titanium implants. A total of 24 implant channels were prepared in the lower jaws of four beagle dogs using (i) an Er:YAG laser device (ERL), or (ii) conventional drills (CD) according to a split-mouth design (n=6 implant channels per animal). Three screw-type titanium implants of different manufacturers were randomly inserted in both groups to evaluate submerged healing at 2 and 12 weeks. Width of the peri-implant gap (WPG) and bone-to-implant contact (BIC) were assessed histomorphometrically. There were no identifiable signs of any thermal side effects in both groups. ERL osteotomy frequently resulted in wide peri-implant gaps particularly in the apical area of the implant supporting bone. The following mean scores were assessed (+/-s.d.): WPG (2 weeks): ERL: 0.89+/-0.48 mm; CD: 0.27+/-0.09 mm (P<0.001 respectively); BIC (2 weeks): ERL: 34.5+/-7.76%; CD: 48.5+/-11.08% (P<0.001 respectively); BIC (12 weeks): . Within the limits of the present study, it was concluded that ERL may represent a promising tool for implant bed preparation.

title: Pyogenic granuloma of the oral cavity: Comparative study of its clinicopathological and immunohistochemical features
abstract: There are two histological types of pyogenic granuloma (PG) of the oral cavity: the lobular capillary hemangioma (LCH) and non‐LCH type. The aim of the present study was to examine and compare the clinical features, etiological factors, diameter of vascular elements and immunohistochemical features of LCH and non‐LCH histological types of PG to determine whether they are two distinct entities. Thirty cases of LCH and 26 cases of non‐LCH PG were retrieved and retrospectively studied. Clinically, LCH PG occurred more frequently (66.4%) as sessile lesion whereas non‐LCH PG occurred as pedunculated (77%). Non‐LCH PG was associated more frequently (86.4%) with etiological factors. The lobular area of the LCH PG contained a greater number of blood vessels with small luminal diameter than did the central area of non‐LCH PG. In the central area of non‐LCH PG a significantly greater number of vessels with perivascular mesenchymal cells non‐reactive for α‐smooth muscle actin and muscle‐specific actin was present than in the lobular area of LCH PG. The differences found in the present study suggest that the two histological types of PG represent distinct entities.

title: Bactericidal effect of the Er:YAG laser on dental implant surfaces: an in vitro study.
abstract: The aim of the in vitro study was to examine the bactericidal effect of an Er:YAG laser on common dental implant surfaces.



Seventy-two titanium platelets with 3 different surfaces--sandblasted and acid-etched (SA), titanium plasma-sprayed (TPS), and hydroxyapatite-coated (HA)--were incubated with a suspension of Streptococcus sanguinis (ATCC 10556). Irradiation at pulse energies of 60 and 120 mJ and a frequency of 10 pps was performed on a computer-controlled XY translation stage. After laser treatment the specimens were sonicated and the bacterial growth examined by counting colony forming units on blood agar plates. Temperature elevations during irradiation were investigated using K-type thermocouples. Laser treated implant surfaces were analyzed by means of electron microscopy.



Compared to non-irradiated specimens, mean bacterial reductions of 99.51% (SA), 98.39% (HA), and 99.6% (TPS) at a pulse energy of 60 mJ and 99.92% (SA), 99.85% (HA), and 99.94% (TPS) at 120 mJ were calculated. At these laser parameters, no excessive temperature elevations or morphological implant surface alterations were detected.



Even at low energy densities, the Er:YAG laser has a high bactericidal potential on common implant surfaces. Clinical studies are justified to evaluate the applicability and efficacy of the Er:YAG laser in the treatment of peri-implantitis.

title: The use of Er:YAG, Nd:YAG and Ga-Al-As lasers in periapical surgery: a 3-year clinical study.
abstract: In an attempt to increase the successful rate of endodontic surgical procedures this study proposes the use of an association of three lasers in apicectomy: Er:YAG laser, (wavelength 2.94 microm pulse mode), Nd:YAG laser (wavelength 1.064 microm, pulse mode), and Ga-Al-As laser, (wavelength of 790 nm, continuous wave).



Previous studies have shown the low success rate of apicectomy by conventional methods due to the presence of remaining bacteria in the surgical site.



The Er:YAG laser was used to perform osteotomy and root resection without vibration, discomfort, less contamination of the surgical site, and no smear-layer on the dentine surface. The Nd:YAG laser irradiation through a fiber performed sealing of the dentinal tubules and bacterial reduction of the cavity bone. In addition, the improvement of healing and better post-operative achieved with the Ga-Al-As laser encourages the use of those lasers in periapical surgeries.



Three years follow-up examination of the clinical case showed radiographically significant decrease of the radiolucent periapical area and no clinical signs and symptoms.



The outcome of this clinical case indicates that the use of those lasers could be considered an alternative, suitable, and useful method to perform an apicectomy.

title: Lasers in oral and maxillofacial surgery.
abstract: Because of their many advantages, lasers have become indispensable in OMS as a modality for soft tissue surgery. Based on manufacturer estimates, approximately 10% to 20% of all oral and maxillofacial surgeons have one or more lasers in their offices, and most surgeons have access to lasers in the hospital. Lasers not only enhance the current surgical options for treatment, but also have expanded the scope of practice. There are many uses for lasers in OMS, and the advent of new wavelengths will undoubtedly lead to new procedures that can be performed with them.  see text] elusive use is hard tissue surgery. Although the Er:YAG has been approved for hard tissue use in the United States and currently is being used in general dentistry, it is still not yet practical or proven for large-volume osseous or extraction surgery, in which the greatest opportunity for innovation and clinical use exists. With future research, it is possible that the right wavelength laser will be developed for this purpose, allowing an increased base of procedures performed with lasers in OMS.

title: Fracture Load of Tooth Restored with Fiber Post and Experimental Short Fiber Composite
abstract: This study evaluated the load bearing capacity of anatomically designed canines restored with FRC posts and experimental short fiber composite resin (FC). The effect of using three different types of tooth preparation and woven net on the fracture load was also investigated. Further aim was to evaluate the failure mode of each restoration.  80 maxillary frasaco-canines were divided into 10 groups (n=8). The anatomic crowns were cut perpendicular at CEJ of the tooth. Group 1 was composed of teeth with flattened surface. Groups 2, 3 & 4 were prepared of teeth with 2 mm ferrule. In the third group, everStick Net was applied above the ferrule. Group 5 was composed of teeth with large box type preparation. The root canals were enlarged, sandblasted and then surface treated with Stick resin for 5 min. Two types of FRC root canal posts were used. The crowns were prepared either with composite resin or with FC. A static load until failure was applied to the crowns at a 45 degrees angle. Failure modes were visually examined.  ANOVA revealed that use of FRC-post and tooth preparation (p<0.001) had significant effect on fracture load of FRC-crown. The crowns made from only FC gave comparable fracture load to groups with FRC-post. No significant difference was found in load-bearing capacity between restorations reinforced with FRC net-substructure and those without (p>0.001). Chi-square test revealed that both, crown design and existence of FRC-post effected significantly fracture types (p<0.001).  FC demonstrated similar load bearing capacity with restorations reinforced with FRC post. The presence of ferrule around the tooth increased the load bearing capacity significantly.  EET – endodontically treated teeth; FRC – fiber-reinforced composite; semi-IPN – semi-interpenetrating network; CEJ – cementoenamel junction; FC – experimental short fiber composite; SiC – silicon carbide abrasive paper; N – newton; FEM – finite element method.

title: Fracture strength of endodontically-treated teeth restored with post and cores and composite cores only.
abstract: This study compared the fracture strength of different conditioned metallic posts, fiber-reinforced-composite posts and composite cores only in teeth without coronal tooth structure and determined failure modes after the fracture test. Post spaces were prepared in the root canals, and the teeth were randomly divided into seven experimental groups: Gr1: Titanium posts (ParaPost) + Silano-Pen (Bredent) + silane; Gr2: Titanium posts + 30 microm CoJet-Sand (3M ESPE) + silane; Gr3: Titanium posts + 50 microm Al2O3 + V-primer (Sun Medical); Gr4: Titanium posts + 50 microm Al2O3 + Alloy primer (Kuraray); Gr5: E-glass FRC post (EverStick); Gr6: Polyethylene fiber (Ribbond) + Resin impregnation and Gr7: Resin composite core only, with no posts. The posts were cemented using Panavia F 2.0 (Kuraray); coronal parts of the roots were etched, primed, bonded and composite cores were built-up. After thermocycling (5 degrees C-55 degrees C, 6000x), the fracture strength test was performed. The fracture strength of titanium posts (408 +/- 122 - 550 +/- 149 N) was significantly higher (p<0.05) than that of FRC posts (321 +/- 131 and 267 +/- 108 N for Everstick and Ribbond, respectively) or the group without posts (175 +/- 70 N) (Gr7) (ANOVA, Tukey's test). The group without posts resulted in complete core detachment (100%). In the E-glass FRC group, 60% adhesive core fracture occurred, covering >1/3 of the core and, in the polyethylene FRC group, 100% post-core detachment at the canal opening was observed. In all the titanium post applied groups (Gr1-Gr4), the posts remained in place with partial detachment of the core material from the post surface at varying degrees, depending on the conditioning method used. When no coronal tooth structure exist, the metal posts showed higher fracture strength values as opposed to the FRC post or no-post approach.

title: Continuous and Short Fiber Reinforced Composite in Root Post-Core System of Severely Damaged Incisors
abstract: The aim of this study was to determine the static load-bearing capacity of endodontically treated maxillary incisors restored with post-core complex made of experimental fiber composite resin (FC) and complete crown made of particulate filler composite (PFC). Further aim was to evaluate the effect of FC resin on the failure mode of the restoration.



The experimental composite resin (FC) was prepared by mixing 22.5 wt% of short E-glass fibers (3 mm in length) and 22.5 wt% of semi-interpenetrating polymer network (IPN) resin with 55 wt% of silane treated silica fillers. Thirty extracted sound upper central incisors were used. Twenty teeth were prepared by cutting the clinical crown 2 mm above the cemento-enamel junction horizontally. Restorations were made by two techniques (n=10). Group A (control group) contained samples of sound incisor teeth. Group B had teeth restored using glass fiber post (everStick, Stick- Teck) and PFC (Filtek Z250, 3M-ESPE) to build up core and complete crown. In Group C, the teeth were restored with FC as post-core and complete crown of PFC. The root canals were prepared and posts were cemented with a dual cure resin cement. The restorations were polymerized with a hand-light curing unit. All restored teeth were stored in water at room temperature for 24 h before they were statically loaded with speed of 1.0 mm/min until fracture. Data were analyzed using ANOVA (p=0.05). Failure modes were visually examined.



ANOVA revealed that restored incisors (Group B and C) had a statistically significantly lower load-bearing capacity (p<0.05) than the control group. Restorations made from FC post-core and PFC coverage (Group C) gave force value of 363 N (112 SD), which was higher than the value of Group B (211 N, 50 SD).



Within the limitations of this study, the teeth restored with experimental fiber composite post-core demonstrated higher load bearing capacity than those with fiber post and PFC core.

title: Post-endodontic restorations with adhesively luted fiber-reinforced composite post systems: a review.
abstract: To review the literature on adhesive luting of fiber-reinforced composite posts (FRC) to provide evidence for the clinical procedure of restoring endodontically treated teeth using FRC posts.



Data focusing on bonding behavior between root canal dentin, luting agent, and FRC post in vitro as well as in vivo performance of teeth restored with FRC posts were reported. These data were identified by searches of "PubMed", "Scopus", and "Cochrane Library" databases with the terms "post-endodontic restoration", "fiber post", "adhesive luting", "root canal dentin", "clinical study", and "pre-treatment fiber post". Papers published up to September 2007 were selected, and most relevant references were chosen. Cross-referencing of significant papers identified additional relevant articles.



FRC posts seem to have become increasingly popular for the restoration of endodontically treated teeth. Compared to metal posts, FRC posts revealed reduced fracture resistance in vitro, along with a usually restorable failure mode. Bonding behavior among FRC post, luting agents, and root canal dentin demonstrated varying results. Bond strengths between FRC posts and resin cements can be enhanced by using various pre-treatment procedures; however, bonding to root canal dentin still seems to be challenging. Most clinical studies investigating survival rates of teeth restored with FRC posts revealed promising results, but risk factors (e.g., the loss of coronal tooth structure) have not been studied intensively. In addition, randomized controlled clinical long term trials are scarce.

title: INFLUENCE OF POST TYPES AND SIZES ON FRACTURE RESISTANCE IN THE IMMATURE TOOTH MODEL
abstract: The purpose of this study was to determine the effect of post types and sizes on fracture resistance in immature tooth model with various restorative techniques. Bovine incisors were sectioned 8 mm above and 12 mm below the cementoenamel junction to simulate immature tooth model. To compare various postand-core restorations, canals were restored with gutta-percha and resin core, or reinforced dentin wall with dual-cured resin composite, followed by placement of D.T. LIGHT-POST, ParaPost XT, and various sizes of EverStick Post individually. All of specimens were stored in the distilled water for 72 hours and underwent 6,000 thermal cycles. After simulation of periodontal ligament structure with polyether impression material, compressive load was applied at 45 degrees to the long axis of the specimen until fracture was occurred. Experimental groups reinforced with post and composite resin were shown significantly higher fracture strength than gutta-percha group without post placement (p < 0.05). Most specimens fractured limited to cervical third of roots. Post types did not influence on fracture resistance and fracture level significantly when cement space was filled with dual-cured resin composite. In addition, no statistically significant differences were seen between customized and standardized glass fiber posts, which cement spaces were filled with resin cement or composite resin individually. Therefore, root reinforcement procedures as above in immature teeth improved fracture resistance regardless of post types and sizes.

title: Effect of Cementation Technique of Individually Formed Fiber-Reinforced Composite Post on Bond Strength and Microleakage
abstract: The aim of this study was to evaluate the effect of two different cementation techniques of individually formed E-glass fiber-reinforced composite (FRC) post on bond strength and microleakage.  The crowns of extracted third molars were removed and post preparation was carried out with parapost drills (diameter 1.5 mm). After application of bonding agents individually formed FRC posts (everStick POST, diameter 1.5 mm) were cemented into the post spaces with either ParaCem®Universal or self-adhesive RelyX™Unicem, using two different cementation techniques: 1) an “indirect (traditional) technique” where the post was prepolymerized prior application of luting cement and insertion into the post space or 2) a “direct technique” where the uncured post was inserted to the post space with luting cement and light-polymerized in situ at the same time. After water storage of 48 hours, the roots (n = 10/group) were cut into discs of thickness of 2 mm. A push-out force was applied until specimen fracture or loosening of the post. A microleakage test was carried out on roots which were not subjected to the loading test (n= 32) to evaluate the sealing capacity of the post-canal interface. The microleakage was measured using dye penetration depth under a stereomicroscope.  Higher bond strength values (p<0.05) and less microleakage (p<0.05) were obtained with the “direct technique” compared to the “indirect technique”. None of the FRC posts revealed any dye penetration between the post and the cement.  The “direct technique” seems to be beneficial when cementing individually formed FRC posts.

title: A Comparative Evaluation Of Fracture Resistance And Penetration Of Bonding Resin Into Three Different Fiber Reinforced Posts Using Confocal Microscope
abstract: To evaluate the fracture resistance of teeth restored with three different fiber reinforced composite posts and to compare the depth of penetration of the bonding resin into the fiber posts, using a confocal microscope.  Seventy freshly extracted human premolars were selected for the study. Out of these, sixty teeth were randomly divided into three groups of twenty teeth each for each of the three post systems under review namely, group IEverStick post; group II-FRC Postec Plus post and group III-Mirafit Carbon fiber post. Each group of twenty teeth was further divided into two so that ten specimens were used to evaluate fracture resistance (Study 1) and ten specimens were used to observe the penetration of bonding resin (Study 2). The clinical crowns were removed; root canal treatment was done on each root and the fiber posts were luted according to manufacturers’ instructions. The remaining ten teeth served as control (group IV) for Study 1, in which only root canal treatment was done and no posts were placed. The specimens were mounted in a customised metal jig and fracture resistance was tested in a Universal Testing Machine. To evaluate the depth of penetration of the bonding resin into the posts, the bonding resins namely, Stick resin, Excite DSC and silanating agent, Monobond S were labeled with Rhodamine B and the posts were luted according to manufacturers’ instructions. Transverse sections were made at cervical, middle and apical levels of the root and depth of penetration of the bonding resin was calculated using a confocal LASER scanning microscope. Data were tabulated and statistically analyzed using oneway ANOVA and Tukey-HSD procedure. Significantly higher failure loads were recorded for root canal treated teeth without posts (group IV: 1668.4±9.8 N). The mean fracture resistance of group III (1204.4±4.0 N) was significantly higher than that of group I (950.1±4.7 N) and group II (751.9±2.6 N) (P <0.001). The mean depth of penetration of bonding resin in all three sections of the post was significantly higher in group I than in group II and group III (P< 0.001).Conclusion: Within the limitations of this in vitro study, it can be concluded that teeth restored with Mirafit carbon fiber posts recorded significantly higher fracture resistance values. Although EverStick posts showed maximum bonding resin penetration, which has clinical implications in achieving a good coronal seal, the fracture resistance values were lesser than those of carbon fiber posts.

title: Fracture resistance of roots endodontically treated with a new resin filling material.
abstract: The authors evaluated the fracture resistance of endodontically treated teeth filled with either gutta-percha or a new resin-based obturation material.



The authors prepared and randomly divided 80 single-canal extracted teeth into five groups: lateral and vertical condensation with gutta-percha, lateral and vertical condensation with the new resin-based obturation material, and a control group with no filling material. The specimens were stored in 100 percent humidity for two weeks, mounted in polyester resin and loaded to failure.



The authors found statistically significant differences among the experimental groups (P < .05). The groups with the new material displayed higher mean fracture loads and the gutta-percha groups lower mean fracture load values than the control unfilled group. However, the differences were not significant. The groups with the new material displayed significantly higher mean fracture loads than gutta-percha groups independent of the filling technique used.



Filling the canals with the new resin-based obturation material increased the in vitro resistance to fracture of endodontically treated single-canal extracted teeth when compared with standard gutta-percha techniques.  If other properties of the new resin-based obturation material compare favorably with those of gutta-percha for filling the root canal, it should be considered as a replacement for gutta-percha, as the results of this study indicate that it could provide enhanced resistance to tooth fracture.

title: Microtensile bond strength of resin-post interfaces created with interpenetrating polymer network posts or cross-linked posts.
abstract: The purpose of this study was to evaluate the microtensile strength of composite bonded to interpenetrating polymer network (IPN) or cross-linked glass fibre posts and to observe the failure modes by using light and scanning electron microscopy.



Twenty posts containing IPN resin matrix and 20 posts containing cross-linked epoxy polymer matrix were used for testing. One half of the posts from each type was treated with Stick Resin, the other half was treated with OptiBond. Composite resin was used to build up a block on the bonding surface. Tensile strength data was analysed statistically using the non-parametric Kaplan-Meier survival analysis. The distribution of failure modes as a function of post type/bonding agent was evaluated using the chi(2) test.



The mean tensile strength values were lower for the groups bonded with OptiBond and higher for the groups bonded with Stick Resin (p = 0.017), the type of post used had no statistical significance (p = 0.263). All the IPN posts showed cohesive failure within the post The cross-linked posts demonstrated a higher number of adhesive failures and lower number of cohesive failures within the post (chi(2) = 0.0001).



Stick Resin was more effective than OptiBond in bonding composite cores to fibre posts. Post fracture was the failure mode of IPN posts, debonding of the composite core was the failure mode of most of cross-linked posts. These different failure modes may appear clinically in endodontically treated teeth restored with the post types tested in this study.

title: Microtensile bond strength of glass fiber posts cemented with self-adhesive and self-etching resin cements.
abstract: To evaluate the bond strength of glass fiber posts to intraradicular dentin when cemented with self-etching and self-adhesive resin cements.



Forty-eight single-rooted human teeth were decoronated, endodontically treated, post-space prepared and divided into 8 groups (n = 6). The glass fiber posts used were: Exacto (EA) (Angelus) and everStick (ES) (StichTeck), which were cemented with two self-adhesive resin cements: BisCem (BIS) (Bisco) and Rely-X Unicem (UNI) (3M/ESPE), and two self-etching resin cements: Esthetic Cementing System NAC100 (NAC) (Kuraray) and Panavia-F (PAN) (Kuraray). Specimens were thermocycled between 5°C and 55 °C for 1000 cycles and stored in water at 37°C for 1 month. Four 1-mm-thick (in cross section) rods were obtained from the cervical region of the roots. Specimens were then subjected to microtensile testing in a special machine (BISCO; Schaumburg, IL, USA) or a crosshead speed of 0.5 mm/min. Microtensile bond strength (μTBS) data were analyzed with two-way ANOVA and Tukey's tests.



Means (and SD) of μTBS (MPa) were: EA/PAN: 10.3 (4.1), EA/NAC: 14 (5.1) EA/BIS: 16.4 (4.8), EA/UNI: 19.8 (5.1), ES/PAN: 25.9 (6.1), ES/NAC: 29.1 (7), ES/BIS: 28.9 (6), ES/UNI: 30.5 (6.6). ANOVA indicated significant differences among the groups (p < 0.001). Mean μTBS values obtained with ES post were significantly higher than those obtained with EA (p < 0.001). For EA, Tukey's test indicated that higher μTBS means were obtained with the self-adhesive resin cements (BIS and UNI), which were statistically significantly different (p < 0.05) from values obtained with the self-etching resin cements (PAN and NAC). Different cements had no significant effects on the bond strength values of ES post (p > 0.05). μTBS values obtained with ES post were significantly higher than those obtained with EA post irrespective of the resin cement used.



everStick posts resulted in the highest mean μTBS values with all cements. Self-adhesive cements performed well in terms of bond strength.