Influence of Laser Irradiation Settings, during Diode-Assisted Endodontics, on the Intraradicular Adhesion of Self-Etch and Self-Curing Luting Cement during Restoration-An Ex Vivo Study

Eleftherios Terry R Farmakis; Franziska Beer; Ioannis Tzoutzas; Christoph Kurzmann; Hassan Ali Shokoohi-Tabrizi; Nikos Pantazis; Andreas Moritz

doi:10.3390/ma15072531

Influence of Laser Irradiation Settings, during Diode-Assisted Endodontics, on the Intraradicular Adhesion of Self-Etch and Self-Curing Luting Cement during Restoration-An Ex Vivo Study

Materials (Basel). 2022 Mar 30;15(7):2531. doi: 10.3390/ma15072531.

Authors

Eleftherios Terry R Farmakis¹, Franziska Beer², Ioannis Tzoutzas³, Christoph Kurzmann⁴, Hassan Ali Shokoohi-Tabrizi⁴, Nikos Pantazis⁵, Andreas Moritz⁴

Affiliations

¹ Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece.
² Independent Researcher, 1130 Vienna, Austria.
³ Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece.
⁴ Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria.
⁵ Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece.

Abstract

Background: Diode-assisted endodontics is nowadays utilized for pulp space disinfection, but little is known on the bonding potential of this lased root dentin when the tooth is restored with an intracanal polymer post. Objectives: to investigate the influence of diode laser irradiation settings, in laser-assisted endodontics, on the intraradicular bonding of composite materials. Methods: Sixteen two-rooted, maxillary first premolars were collected, prepared up to F4 (Protaper Universal. Dentsply-Maillefer, Ballaigues, Switzerland), and randomly assigned in two groups: group A (chopped mode or short pulse), diode irradiated according to protocol, pulse 25 ms, power 2.5 W, and group B (microchopped mode or ultrashort pulse), pulse 25 μs, peak power 12 W (both groups GentleRay. KaVo Dental, Biberach an der Riss, Germany). Buccal canals were irradiated, palatal ones served as controls. Canals were then obturated, post space was created in all canals, and quartz-fiber posts (ICE light Danville. Danville Materials, San Ramon, CA, USA) were cemented by self-etch self-curing cement (Max Cem Elite. Kerr, West Collins Orange, CA, USA) (Max Cem Elite. Kerr, Brea, CA, USA). A week later, teeth were sectioned horizontally in 1 mm increments. Push-out test was conducted in a Zwick testing machine (Zwick Roell, Ulm, Germany) at 1 mm/min speed, and the force required to dislodge the post from each specimen (F-max) was recorded. Weibull regression models were applied for statistical analyses. Results: Differences in F-max by group (control vs. chopped mode vs. microchopped mode) and height (meaning the apical-to-coronal position of each specimen along the root) were statistically significant (p < 0.05 in all cases). Conclusions: Short pulses (or chopped mode) had a profound positive effect on the quality of intraradicular bonding, while Ultrashort pulses (or microchopped mode) affected it negatively. In addition, apically positioned bonding proved weaker compared with more coronally located specimens.

Keywords: adhesion; diode-assisted endodontics; endodontics; glass fiber post; intraradicular post; laser; laser-assisted endodontics; polymer post; push-out test; restoration; self-curing cement; self-etch cement.