J Adv Prosthodont.  2013 Nov;5(4):457-463. 10.4047/jap.2013.5.4.457.

The effect of a diode laser and traditional irrigants on the bond strength of self-adhesive cement

• Tuncdemir
• Yildirim C
• Ozcan E
• Polat S

• KMID: 2176539
• DOI: http://doi.org/10.4047/jap.2013.5.4.457

Abstract

PURPOSE
The purpose of this study was to compare the effect of a diode laser and traditional irrigants on the bond strength of self-adhesive cement.
MATERIALS AND METHODS
Fifty-five incisors extracted due to periodontal problems were used. All teeth were instrumented using a set of rotary root canal instruments. The post spaces were enlarged for a No.14 (diameter, 1.4 mm) Snowlight (Abrasive technology, OH, USA) glass fiber reinforced composite post with matching drill. The teeth were randomly divided into 5 experimental groups of 11 teeth each. The post spaces were treated with the followings: Group 1: 5 mL 0.9% physiological saline; Group 2: 5 mL 5.25% sodium hypochlorite; Group 3: 5 mL 17% ethylene diamine tetra acetic acid (EDTA), Group 4: 37% orthophosphoric acid and Group 5: Photodynamic diode laser irradiation for 1 minute after application of light-active dye solution. Snowlight posts were luted with self-adhesive resin cement. Each root was sectioned perpendicular to its long axis to create 1 mm thick specimens. The push-out bond strength test method was used to measure bond strength. One tooth from each group was processed for scanning electron microscopic analysis.
RESULTS
Bond strength values were as follow: Group 1 = 4.15 MPa; Group 2 = 3.00 MPa; Group 3 = 4.45 MPa; Group 4 = 6.96 MPa; and Group 5 = 8.93 MPa. These values were analysed using one-way ANOVA and Tukey honestly significant difference test (P<.05). Significantly higher bond strength values were obtained with the diode laser and orthophosphoric acid (P<.05). There were no differences found between the other groups (P>.05).
CONCLUSION
Orthophosphoric acid and EDTA were more effective methods for removing the smear layer than the diode laser. However, the diode laser and orthophosphoric acid were more effective at the cement dentin interface than the EDTA, Therefore, modifying the smear layer may be more effective when a self-adhesive system is used.

Keyword

Bond strength; Diode laser; Fiber post; Smear layer

MeSH Terms

Acetic Acid
Axis, Cervical Vertebra
Characidae
Dental Pulp Cavity
Dentin
Edetic Acid
Ethylenes
Glass
Incisor
Lasers, Semiconductor*
Methods
Phosphoric Acids
Resin Cements
Smear Layer
Sodium Hypochlorite
Tooth
Acetic Acid
Edetic Acid
Ethylenes
Phosphoric Acids
Resin Cements
Sodium Hypochlorite

Figure

• 

  Fig. 1 Schematic view of the root and dentin disc specimens.

• 

  Fig. 2 SEM images of the post spaces treated with (A) NaCI (0.9%) shows the smear layer covering root canal dentin surface, (B) NaOCl (5.25%) shows the smear layer covering root canal dentin surface, (C) EDTA (17%) shows the open dentinal tubule and (D) 37% H3PO4 shows the open dentinal tubules and erosion of the tubule orifices (E) HELBO TheraLite Laser shows the smear layer covering the root canal dentin surface (Original magnification, ×1000).

• 

  Fig. 3 Cross-sectional image of the debonded dentin discs. (A) Mixed failure (cement debonded both dentin and post) in NaCI group, (B) Mixed failure (cement debonded both dentin and post) in NaOCl group, (C) Mixed failure (cement debonded both dentin and post) in EDTA group, (D) Mixed failure (cement debonded both dentin and post) in orthophosphoric acid group, (E) Post-cement failure (cement debonded only post) in HELBO TheraLite Laser group. c: Cement, d: Dentin, p: Post. Red arrows show the debonding failure (Original magnification, ×40).

• 

  Fig. 4 Schematic view of the debonded interfaces: (A) before push out, (B) dentin-cement failure, (C) post-cement failure, (D) both dentin-cement and post-cement failure (mixed failure).

Reference

1. Qualtrough AJ, Mannocci F. Tooth-colored post systems: a review. Oper Dent. 2003; 28:86–91. PMID: 12540124.

2. Ferrari M, Mannocci F. A 'one-bottle' adhesive system for bonding a fibre post into a root canal: an SEM evaluation of the post-resin interface. Int Endod J. 2000; 33:397–400. PMID: 11307217.

3. Mannocci F, Bertelli E, Watson TF, Ford TP. Resin-dentin interfaces of endodontically-treated restored teeth. Am J Dent. 2003; 16:28–32. PMID: 12744409.

4. Monticelli F, Toledano M, Tay FR, Cury AH, Goracci C, Ferrari M. Post-surface conditioning improves interfacial adhesion in post/core restorations. Dent Mater. 2006; 22:602–609. PMID: 16289722.

5. Goracci C, Raffaelli O, Monticelli F, Balleri B, Bertelli E, Ferrari M. The adhesion between prefabricated FRC posts and composite resin cores: microtensile bond strength with and without post-silanization. Dent Mater. 2005; 21:437–444. PMID: 15826700.

6. Mumcu E, Erdemir U, Topcu FT. Comparison of micro push-out bond strengths of two fiber posts luted using simplified adhesive approaches. Dent Mater J. 2010; 29:286–296. PMID: 20495284.

7. Hikita K, Van Meerbeek B, De Munck J, Ikeda T, Van Landuyt K, Maida T, Lambrechts P, Peumans M. Bonding effectiveness of adhesive luting agents to enamel and dentin. Dent Mater. 2007; 23:71–80. PMID: 16426673.

8. Gerth HU, Dammaschke T, Züchner H, Schäfer E. Chemical analysis and bonding reaction of RelyX Unicem and Bifix composites-a comparative study. Dent Mater. 2006; 22:934–941. PMID: 16364427.

9. Radovic I, Monticelli F, Goracci C, Vulicevic ZR, Ferrari M. Self-adhesive resin cements: a literature review. J Adhes Dent. 2008; 10:251–258. PMID: 18792695.

10. Serafino C, Gallina G, Cumbo E, Ferrari M. Surface debris of canal walls after post space preparation in endodontically treated teeth: a scanning electron microscopic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97:381–387. PMID: 15024364.

11. Hayashi M, Takahashi Y, Hirai M, Iwami Y, Imazato S, Ebisu S. Effect of endodontic irrigation on bonding of resin cement to radicular dentin. Eur J Oral Sci. 2005; 113:70–76. PMID: 15693832.

12. Bitter K, Paris S, Pfuertner C, Neumann K, Kielbassa AM. Morphological and bond strength evaluation of different resin cements to root dentin. Eur J Oral Sci. 2009; 117:326–333. PMID: 19583763.

13. Monticelli F, Ferrari M, Toledano M. Cement system and surface treatment selection for fiber post luting. Med Oral Patol Oral Cir Bucal. 2008; 13:E214–E221. PMID: 18305446.

14. Piwowarczyk A, Bender R, Ottl P, Lauer HC. Long-term bond between dual-polymerizing cementing agents and human hard dental tissue. Dent Mater. 2007; 23:211–217. PMID: 16494937.

15. Zehnder M. Root canal irrigants. J Endod. 2006; 32:389–398. PMID: 16631834.

16. Hülsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J. 2003; 36:810–830. PMID: 14641420.

17. Erdemir A, Ari H, Güngüneş H, Belli S. Effect of medications for root canal treatment on bonding to root canal dentin. J Endod. 2004; 30:113–116. PMID: 14977310.

18. Pecora JD, Brugnera-Júnior A, Cussioli AL, Zanin F, Silva R. Evaluation of dentin root canal permeability after instrumentation and Er:YAG laser application. Lasers Surg Med. 2000; 26:277–281. PMID: 10738290.

19. Dederich DN, Zakariasen KL, Tulip J. Scanning electron microscopic analysis of canal wall dentin following neodymium-yttrium-aluminum-garnet laser irradiation. J Endod. 1984; 10:428–431. PMID: 6593419.

20. Alfredo E, Silva SR, Ozório JE, Sousa-Neto MD, Brugnera-Júnior A, Silva-Sousa YT. Bond strength of AH Plus and Epiphany sealers on root dentine irradiated with 980 nm diode laser. Int Endod J. 2008; 41:733–740. PMID: 18798921.

21. Bystrom A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol. 1985; 1:170–175. PMID: 3865763.

22. Perez F, Calas P, de Falguerolles A, Maurette A. Migration of a Streptococcus sanguis strain through the root dentinal tubules. J Endod. 1993; 19:297–301. PMID: 8228750.

23. Kennedy WA, Walker WA 3rd, Gough RW. Smear layer removal effects on apical leakage. J Endod. 1986; 12:21–27. PMID: 3512756.

24. Gençoğlu N, Samani S, Günday M. Dentinal wall adaptation of thermoplasticized gutta-percha in the absence or presence of smear layer: a scanning electron microscopic study. J Endod. 1993; 19:558–562. PMID: 8151244.

25. Gutmann JL. Adaptation of injected thermoplasticized guttapercha in the absence of the dentinal smear layer. Int Endod J. 1993; 26:87–92. PMID: 8330939.

26. Ari H, Yaşar E, Belli S. Effects of NaOCl on bond strengths of resin cements to root canal dentin. J Endod. 2003; 29:248–251. PMID: 12701772.

27. Demiryürek EO, Külünk S, Saraç D, Yüksel G, Bulucu B. Effect of different surface treatments on the push-out bond strength of fiber post to root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108:e74–e80. PMID: 19615650.

28. Kenshima S, Francci C, Reis A, Loguercio AD, Filho LE. Conditioning effect on dentin, resin tags and hybrid layer of different acidity self-etch adhesives applied to thick and thin smear layer. J Dent. 2006; 34:775–783. PMID: 16621219.

29. Mayhew JT, Windchy AM, Goldsmith LJ, Gettleman L. Effect of root canal sealers and irrigation agents on retention of preformed posts luted with a resin cement. J Endod. 2000; 26:341–344. PMID: 11199751.

30. Takeda FH, Harashima T, Kimura Y, Matsumoto K. A comparative study of the removal of smear layer by three endodontic irrigants and two types of laser. Int Endod J. 1999; 32:32–39. PMID: 10356467.

31. Rosales-Leal JI, Osorio R, Toledano M, Cabrerizo-Vílchez MA, Millstein PL. Influence of eugenol contamination on the wetting of ground and etched dentin. Oper Dent. 2003; 28:695–699. PMID: 14653282.

32. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004; 30:559–567. PMID: 15273636.

33. Hülsmann M, Peters OA, Dummer PMH. Mechanical preparation of root canals: shaping goals, techniques and means. Endodc Topics. 2005; 10:30–76.

34. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009; 35:791–804. PMID: 19482174.

35. Wu MK, Wesselink PR. A primary observation on the preparation and obturation of oval canals. Int Endod J. 2001; 34:137–141. PMID: 11307262.

36. De-Deus G, Gurgel-Filho ED, Magalhães KM, Coutinho-Filho T. A laboratory analysis of gutta-percha-filled area obtained using Thermafil, System B and lateral condensation. Int Endod J. 2006; 39:378–383. PMID: 16640636.

37. Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. J Endod. 1997; 23:725–727. PMID: 9487845.

38. Zicari F, Couthino E, De Munck J, Poitevin A, Scotti R, Naert I, van Meerbeek B. Bonding effectiveness and sealing ability of fiber-post bonding. Dent Mater. 2008; 24:967–977. PMID: 18177701.

39. Ferrari M, Cagidiaco MC, Grandini S, De Sanctis M, Goracci C. Post placement affects survival of endodontically treated premolars. J Dent Res. 2007; 86:729–734. PMID: 17652200.

40. Vichi A, Grandini S, Ferrari M. Comparison between two clinical procedures for bonding fiber posts into a root canal: a microscopic investigation. J Endod. 2002; 28:355–360. PMID: 12026918.

41. Weichman JA, Johnson FM. Laser use in endodontics. A preliminary investigation. Oral Surg Oral Med Oral Pathol. 1971; 31:416–420. PMID: 5277394.

42. Altundasar E, Ozçelik B, Cehreli ZC, Matsumoto K. Ultramorphological and histochemical changes after ER, CR:YSGG laser irradiation and two different irrigation regimes. J Endod. 2006; 32:465–468. PMID: 16631850.

43. Esteves-Oliveira M, de Guglielmi CA, Ramalho KM, Arana-Chavez VE, de Eduardo CP. Comparison of dentin root canal permeability and morphology after irradiation with Nd:YAG, Er:YAG, and diode lasers. Lasers Med Sci. 2010; 25:755–760. PMID: 20422240.