Bur Group Research Articles

The effect of surface treatment and thermal aging on the bonding of clear aligner attachments to provisional resin-based material: shear bond strength analysis.

The aim of this study is to evaluate the effect of different surface treatments on the shear bond strength (SBS) of clear aligner attachments bonded to Bis-acryl provisional crowns. 120 cylindrical bisacrylic composite material (ProTemp type) specimens were prepared and divided into six groups (n = 20) based on surface treatment, control: (no treatment); super coarse grit diamond bur, carbide bur, alumina-blasting, non-thermal plasma treatment, and Er:YAG laser treatment. The features of treated surfaces were examined using scanning electron microscopy (SEM). A flowable composite resin (Transbond XT; 3M Unitek) was bonded to the specimens forming the attachment. Half of specimens were subjected to thermal cycling (5,000 cycles). SBS was measured before and after thermal cycling. Each specimen was loaded at the attachment/resin interface at a speed of 0.5 mm/min until failure. The nature of the failure was analyzed using the composite remnants index (CRI). Two-way ANOVA and Tukey HSD were used for data analysis α = 0.5. For CRI scores analysis, Kruskal-Wallis test and Dunn's multiple comparison were used as post-hoc test. SEM analysis showed that all surface treatments altered surface properties and increase surface bonding area. The specimens treated with plasma, Er:YAG laser, and alumina-blasting had higher SBS values before and after thermal cycling. In comparison to control plasma, Er:YAG laser, and alumina-blasting showed a significant increase in SBS (P < 0.001) while carbide and diamond bur groups showed no significant differences (P > 0.05). Thermal cycling significantly decreased the SBS of control, carbide bur, diamond bur, and Er:YAG laser while no significant effect of alumina-blasting and plasma group. Er:YAG laser and plasma groups significantly exhibited more dominance for scores 2 and score 3 and the absence of score 0. Alumina-blasting, Er:YAG laser, or non-thermal plasma surface treatments increased the shear bond strength between clear aligner attachments and resin-based restorations.

Histological assessment of a novel de-epithelialization method for connective tissue grafts harvested from the palate. An experimental study in cadavers

ObjectivesThis study aims to compare the histological outcomes of three distinct de-epithelialization methods used in (connective tissue grafts) CTG harvested from the palate.Materials and methodsAn experimental study using nine cadaver head specimens was carried out to compare 3 different de-epithelialization techniques for CTG. Eighteen samples were randomly allocated to three study groups: bone scraper, diamond bur and extraoral removal with a scalpel. The main outcome variable was the graft surface percentage without epithelium remains. Additionally, the time employed, and the graft thickness were also measured.ResultsSixteen CTGs were analyzed. The extraoral scalpel group presented a total surface area with no epithelium of 58.84% (22.68) and a mean de-epithelialization time of 3.7 min; the intraoral diamond bur group had 88.24% (41.3) of the surface with no epithelium and took 1.455 min, and the intraoral bone scraper showed 97.98% (5.99) of surface without epithelium and a mean time of 0.815 min (P < 0.05). Histological analysis showed significant differences between the bone scraper and the extraoral group (P = 0.009).ConclusionThe de-epithelialization technique with a bone scraper seems to be the most effective and fastest de-epithelialization technique for CTG. These findings need to be confirmed in future clinical studies with larger samples.Clinical relevanceThe use of bone scrapers, could be a simple, effective and fast technique to de-epithelialize connective tissue grafts harvested from the palatal area for both novice and experienced surgeons.

Lefort 1 Osteotomy Study of Maxillary Bone in Caprine Skull Model: Comparison of Different Osteotomy Techniques (Piezo Versus Lindemann Bur Versus Manual Chisel).

In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model. Twelve caprine skulls were used for the study. Skulls were divided into 3 groups: (1) manual chisel group, (2) Lindemann bur group, and (3) piezo osteotomy group. Bilateral osteotomies were performed on each skull. Results were evaluated with three-dimensional computerized tomography scans and macroscopic observations of the mucosal tears and soft tissue. The mean length of the bone gap in the manual, Lindemann, and piezo groups was 4.8 (±0.7), 3.38 (±1.49), and 1.39 (±0.3) mm, respectively ( P < 0.05). The mean number of comminuted fractures in the manual, Lindemann, and piezo groups was 5.5 (±1.4), 1.6 (±0.3), and 0.6 (±0.5), respectively ( P < 0.05). Mucosal tearing and soft tissue damage based on subjective inspection observations were negligible in the piezo technique. Soft tissue and mucosal damage were observed significantly more in the manual chisel osteotomy method compared with the other 2 techniques. We anticipate that piezo, which has started to be used in new application areas besides rhinoplasty, will continue to be used more widely, especially in reconstructive orthognathic surgery, due to the minimal damage it causes to tissues. With the long-term results, much healthier interpretations can be made.

Comparative Efficacy of Ceramic Burs and Scalpels in Gingivectomy Procedures for Orthodontic Patients: A Case Series

Background: Orthodontic treatment often leads to gingival hyperplasia, which may complicate oral hygiene and necessitate surgical interventions such as gingivectomy. This study compared the efficacy of ceramic burs versus scalpels in gingivectomy procedures for orthodontic patients, focusing on periodontal outcomes and pain. Methods: This case series describes six orthodontic patients with gingival hyperplasia. The patients were between 15-25 years and were non-smokers. They underwent gingivectomy using two methods: ceramic burs (NTI® Soft Tissue Trimmers) and traditional scalpels. Preoperative oral hygiene instructions were given, and intraoral photographs were obtained. Clinical measurements included the plaque index (PI), gingival index (GI), and bleeding index (BI). Bleeding, pain (using a visual analog scale), and periodontal indices were assessed at several time points postoperatively. Results: Both groups showed significant improvements in gingival hyperplasia, PI, and mean GI. However, the ceramic bur group experienced lower postoperative pain compared to the scalpel group. One patient in the scalpel group required analgesics for pain management. The results highlighted the effective management of gingival hyperplasia with both methods but with a potential advantage in pain management for the ceramic bur group. Conclusion: This study indicated that both ceramic burs and scalpels are effective for gingivectomy in orthodontic patients. Ceramic burs might offer a less painful alternative, although both methods effectively manage gingival hyperplasia. Further studies with a larger sample size and longer follow-ups are required to confirm the present findings and potentially recommend ceramic burs as a preferred method for gingivectomy.

In vitro pilot study comparing a novel implantoplasty sonic instrumentation protocol with a conventional protocol using burs.

The aim of implantoplasty (IP) is to remove titanium implant layers that have been contaminated and to smoothen the implant surfaces so they retain less plaque. However, existing IP methods are very invasive and reduce implant wall thickness. To investigate the suitability of novel sonic tips in IP and to compare this novel protocol with conventional abrasive procedures. Thirty dental implants (Ø 4.1 mm, 10 mm length) were distributed in three groups and investigated according to the protocol of Sivolella etal., with modifications to the instrument's feed rate, the applied contact force, and the speed of implant rotations per minute. The upper third of the implant was processed with a diamond-coated bur (BUR) or novel non-diamond-coated sonic tips (AIRSCALER). After standardized IP, the surfaces were analyzed by tactile profilometry and scanning electron microscopy (SEM). Changes in implant weight, implant material loss, and implant fracture strength were assessed. The mean roughness (Ra , Sa ), implant material loss, and change in implant weight were significantly lower in the AIRSCALER group than in the BUR group, whereas the mean compression resistance values were significantly higher in the AIRSCALER group than in the BUR group. IP with uncoated sonic tips smoothes the surfaces and reduces structural loss of the implant in the area of microthreads. This new IP method could be of great clinical importance, especially for implants with microthreads and reduced diameter or wall thickness.

Evaluation of the Efficacy of Minimal Invasive Methods Versus Conventional Methods for Caries Removal in Primary Molars.

Evaluating the efficacy of two "minimal invasive methods"of caries removal (Brix 3000/ceramic bur) in comparison with the conventional method in the management of dental caries in primary molars. Materials and methods: A sum of 60 teeth from children ranging from four to nineyears old of both sexes were selected for this study and randomly assigned to three groups: Group I (Brix 3000), Group II (ceramic bur), and Group III (diamond bur), with 20 teeth per group. Regarding the efficacy of caries removal, the Brix 3000 group had significantly the lowest efficacy, while the ceramic bur and diamond bur groups were significantly the highest without significant differences between the ceramic and diamond groups. Regarding caries removal time, the Brix 3000 group was significantly the highest, while the diamond bur group was significantly the lowest, and the ceramic bur group was intermediate between them. Regarding pain perception, the Brix 3000 and ceramic bur groups were significantly the lowest, with insignificant differences between them, while the diamond bur group was significantly the highest. Ceramic bur is an excellent alternative treatment for caries removal in children in comparison with conventional methods and CMCR. Brix 3000®, despite being less painful in comparison with drilling methods, has lower efficacy and efficiency.

Assessment of clinical outcomes and patient response to gingival depigmentation using a scalpel, ceramic bur, and diode laser 980 nm

ObjectiveThis research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.Materials and methodsTwenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points.ResultsAt 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups.ConclusionWhile diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures.Clinical relevanceGingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.

Evaluation and Comparison of the Efficacy of Chemo-Mechanical, Mechanical Methods of Caries Removal under Self-Illuminated Light Microscope and Stereomicroscope – An In Vitro Study

BACKGROUND&#x0D; There are different caries removal methods including conventional rotary caries removal, atraumatic restorative therapy, air abrasion, lasers, and chemo-mechanical caries removal (CMCR). Chemo-mechanical caries removal is an alternative treatment for active caries, that involves the caries removal of only infected dental tissue and acts by the dissolution of carious lesions with natural or synthetic agents.&#x0D; Aim&#x0D; Comparison of chemo-mechanical material (CariSolv) and the mechanical method (Smart bur &amp; Carbide bur) of caries removal under a self-illuminated microscope and stereomicroscope in terms of efficacy and time duration.&#x0D; METHODS&#x0D; Tooth was sectioned in 4 parts and grouped into 4 as group 1, group 2, group 3, and group 4. Each group was treated with different caries removal methods of carbide bur, smart bur, CariSolv and control group. Examined under self-illuminated and stereomicroscope at 10 different points from middle to periphery.&#x0D; RESULTS&#x0D; Carbide bur specimens have a negligible amount of affected dentin and there is a destruction of dentinal tubules when compared to the smart bur group &amp; CariSolv group. Showing affected dentin thickness in 4 groups at 10 different positions from the middle part of the lesion to the periphery (i.e., towards CEJ &amp; cusp tip) by using a stereomicroscope.&#x0D; CONCLUSIONS&#x0D; The CariSolv group demonstrated the presence of affected dentine higher and took twice the time to remove caries but was easy to induce and conserved the healthy tooth structure when compared to carbide and smart bur groups. Less amount of affected dentine was seen in the carbide bur group but there was a destruction of sound dentine.&#x0D;

Farklı Frez Türlerinin Kullanımında Açığa Çıkan Sıcaklık Değerlerinin Değerlendirilmesi

Aim: In our study, we aimed to measure the amount of released head by recording it with a thermal camera during the osteotomies made utilizing round, fissure and lindemann burs to the synthetic bone blocks to simulate the mandible ramus region which is often preferred when obtaining autogenous bone from the mouth. Material and Methods: The burs in our study were used at rotational speeds of 10000 rpm and 15000 rpm and feed rates of 60 mm/min and 90 mm/min, and each osteotomy was made with a CNC milling machine in order to standardize the applied force. Results: According to the results of our study, the highest temperatures were observed in the fissure bur groups, and the round bur and lindemann bur groups gave similar results. In addition, when the feed rate is increased from 60 mm/min to 90 mm/min in all groups at constant rotational speed, the heat released increases significantly. When the groups are evaluated within themselves; the temperature values observed at 15000 rpm and 60 mm/min feed rate in the groups using round bur were found to be significantly lower than the group observed at 10000 rpm and 60 mm/min feed rates (p=0.028), in fissure bur groups, the temperature values observed at 10000 rpm and 60 mm/min feed rate were significantly lower than the values observed at 15000 rpm and 60 mm/min feed rates (p=0.028). No statistically significant difference was observed between the heat exchange averages of the 10000 rpm and 15000 rpm groups at a Lindemann bur 60 mm/min feed rate (p=0.182). Conclusion: This study has shown that while the generated heat in the bone is thought to increase when the bur speeds are increased, the head generated according to bur designs can decrease and it is necessary to operate according to the characteristic features of the preferred bur.

Quantitative and Qualitative Assessment of Enamel Surface following Two Composite Removal Methods after Bracket Debonding

Aims: To evaluate and compare morphology and roughness of the enamel surface after debonding and polishing by two methods: aluminum oxide disks (Shofu, Super-Snap) and 30-fluted tungsten carbide bur (Strauss and Co.) using a surface roughness tester and a scanning electron microscope (SEM), respectively. Subjects and Methods: For this study, we selected 15 orthodontic patients with bonded metal brackets. After the completion of fixed orthodontic treatment, metal brackets for the maxillary central incisors were removed with a debonding plier. For every patient, teeth were chosen on a random basis to be finished and polished with Super-Snap aluminum oxide disks on one side (n = 15) and with 30-fluted tungsten carbide bur (n = 15) on the other side. Epoxy resin was used to obtain the replicas of maxillary anterior teeth (before and after tooth polishing). SEM analysis was done for five samples from each group. Results: The average roughness after resin removal in the 30-fluted tungsten carbide bur group (0.328 mm ± 0.099) was found to be significantly higher when compared to the Super-Snap aluminum oxide disks (0.299 mm ± 0.109). Conclusions: The Super-Snap aluminum oxide disks resulted in superior finishing and polishing than 30-fluted tungsten carbide bur.

Effects of Er: YAG, Er,Cr: YSGG, and Nd: YAG laser irradiation and adhesive systems on the immediate and long-term bond strength of dentin: a systematic review and meta-analysis.

At present, lasers are increasingly used in the oral clinical field, and research and applications in dental hard tissue treatment are also increasing. The effect of laser etching dentin on the bonding strength of composite resin reported in the literature is still inconclusive. The purpose of this review was to evaluate whether laser etching can improve the immediate and long-term bonding strength of dentin and investigate the effect of different types of adhesives on the bonding strength of dentin. Two reviewers performed a literature search up from January 2012 to November 2021 in four databases: MEDLINE (PubMed), Web of Science, EMBASE, and the Cochrane Library. A total of 25 studies were included in the meta-analysis. The Cochrane Collaboration Bias Risk Assessment tool was used to evaluate the quality of the included literature, and an analysis was carried out using Review Manager Software version 5.3. The aging bond strength of dentin after erbium (Er): yttrium aluminum garnet (YAG) laser treatment was significantly lower than that of dentin in the bur group (P < 0.00001). At the same time, the bond strength of dentin immediately and aging after (Er), chromium-doped (Cr): yttrium scandium gallium garnet (YSGG) laser treatment was lower than that of dentin in the bur group (P < 0.05). There was no significant difference in the immediate and aging bonding strength among samples in the Er: YAG laser, Er, Cr: YSGG laser, and blank control groups (no laser or bur). The aging bond strength of samples after neodymium-doped (Nd): YAG laser treatment was higher than that of samples in the blank control group (P < 0.05); in addition, the performance of self-etching adhesive was slightly better than that of acid etching adhesive. Regardless of the applied surface treatment and the adhesive employed, dentin after aging showed significant bond degradation (P < 0.05). There was high heterogeneity of bond strength between different groups, and the small number of studies and the contradictory results may be the main reasons for this outcome.

Effects of Irradiation by Carbon Dioxide Laser Equipped With a Water Spray Function on Bone Formation in Rat Tibiae.

Irradiation of tissue with carbon dioxide (CO2) laser shows a characteristic thermal effect that causes vaporization of tissue in the target region. However, the thermal effect in places other than the target region induces tissue damage. Two methods are used: high reactive-level laser therapy (HLLT), aimed at surgical treatment, and low reactive-level laser therapy (LLLT), aimed at cell and tissue activation. In both, vaporization of tissue is induced by thermal damage. A water spray function may ameliorate thermal damage from CO2 laser irradiation. In this study, we irradiated CO2 laser on rat tibiae with or without a water spray function and examined the effects of this technique on bone metabolism. Bone defects were created in rat tibiae by dental bur in a Bur group and by laser in laser irradiation groups with (Spray group) and without (Air group) water spray function. At 1 week postoperatively, histological analyses of tibiae were performed using hematoxylin and eosin staining, immunohistochemical staining (IHC) with anti-sclerostin antibody, and 3-dimensional (3D) observation using micro-computed tomography. Histological findings and 3D observation confirmed induction of new bone formation following laser irradiation in both the Air and Spray groups. No bone formation was seen in the Bur group. IHC revealed that the activity of osteocytes in the region of irradiated cortical bone was markedly impaired in the Air group, but osteocyte impairment was ameliorated in the Spray group and absent in the Bur group. The water spray function appears effective in reducing thermal damage to tissues irradiated by CO2 laser. CO2 lasers with water spray function may be useful in bone regeneration therapy.

Evaluation of the enamel nano-topography influenced by different techniques of interproximal reduction: An atomic force microscopic study.

Interproximal enamel reduction is a part of the orthodontic treatment as a method of space generation in addition to other vast indications. Some studies found that different techniques might impose changes to the enamel surface that alter its topography, which in turn might influence its integrity and susceptibility to caries. Polishing, however, after this procedure is thought to be helpful to reduce these adverse effects. To evaluate the nano-topography of the enamel surfaces after interproximal reduction (IPR) and determine its influence on enamel surface roughness and examine the need for polishing to minimise these influences, when combined with topical fluoride application. A total of 60 proximal surfaces of 40 extracted maxillary premolars (10 premolars left unprepared as the control group) were reduced with different stripping instruments (discs, burs and manual strip system). The surface roughness of enamel was analysed with an atomic force microscope to determine the results quantitatively as well as qualitatively on the nanoscopic scale. One of each proximal surface was followed by polishing and fluoride varnish after the reduction. The results showed that surface roughness was increased in all groups without polishing. The greatest mean roughness was recorded for the disc group (212 ±125.7), followed by the bur group (172 ±93.1) and manual strips (153.8±106.7). The difference between the groups, however, was not significant for both mean roughness (P = 0.656) and height (P = 0.737). The parameters were decreased after polishing in all groups but the difference between methods was not significant for both parameters (P = 0.946 and P = 0.849); however, the mean height was reduced to nearly half the reading in the bur and manual strip method. The disc group only showed a statistically significant decrease in surface roughness with polishing (P < 0.05). All other results were not significant. All methods of interproximal reduction do not influence enamel surface nanotopography significantly with and without polishing. Polishing resulted in significant reduction of surface roughness only in the disc group.

Simulation of CAD/CAM milling on lithium disilicate: Mechanical and topographic analyses of surface grinding different protocols

The aim of this study was to evaluate the topography and the fatigue performance of lithium disilicate glass-ceramic after surface grinding through different laboratory protocols used to simulate the Computer-aided design/Computer-aided manufacturing (CAD/CAM) milling. Ceramic discs (IPS e.max CAD, Ø = 13.5 mm × 1.2 mm of thickness) were produced through different methodologies: milling in CAD/CAM system (CAD/CAM group); produced in-lab with a polished surface (POL group); or produced through in-lab methods and randomly distributed into five groups according to different grinding protocols to simulate the CAD/CAM milling [grinding with a CAD/CAM bur coupled to a mandrel (CAD/CAM Bur group); fine diamond bur using oscillatory movements (DBO group); fine diamond bur in x and y axes of the disc (DBXY group); #60-grit silicon carbide sandpaper (SiC group); and #60-grit wood sandpaper (WS group)]. The specimens were fatigue tested (n = 15) according to the step-stress method (initial load: 60 N; step-size: 20 N; 10,000 cycles/step; 20 Hz frequency). A roughness analysis was performed on all specimens, while fractal dimension (FD) and fractography were performed on representative samples. The Kaplan-Meier analysis showed that the POL (293.3 N) group presented better fatigue performance (higher load and number of cycles for failure) (p < 0.05) than the other groups (CAD/CAM = 222.7 N; CAD/CAM Bur = 181.3 N; DBO = 184.0 N; DBXY = 192.0 N; SiC = 182.6 N; WS = 182.6 N). For roughness, only the SiC (Ra = 1.616; Rz = 10.465) and WS (Ra = 1.673; Rz = 10.655) groups produced statistically similar Ra (μm) and Rz (μm) values to the CAD/CAM (Ra = 1.628; Rz = 9.571) group (p > 0.05). The surface created by CAD/CAM milling and POL group exhibited more complexity (FD) higher values than the experimental groups. For the ceramic surface topography images, the CAD/CAM milling visibly produced a uniform surface compared to the other groups; however, the POL group was the smoothest. The DBO, DBXY, SiC, and WS groups resulted in similar characteristics of surface topography. Therefore, although the SiC and WS groups showed similar roughness to the control group (CAD/CAM), no in-lab simulation method was fully capable to mimic the mechanical performance of the CAD/CAM-milled lithium disilicate glass-ceramic.

Effect of Clinically Relevant Smear Layers and pH of Universal Adhesives on Dentin Bond Strength and Durability.

To evaluate the effects of different smear layers on the microtensile bond strength (µTBS) of a reference two-step self-etch adhesive and two universal adhesives. Mid-coronal dentin of 90 teeth was exposed and divided into three bur groups (coarse diamond, fine diamond, or tungsten carbide). Each bur-prepared group was further divided into three adhesive groups: Clearfil SE Bond (SE, Kuraray Noritake), Single Bond Universal (SB; 3M Oral Care), and G-Premio Bond (GP, GC). After adhesive application, 4-mm-thick resin composites were built up. Half of the teeth in each bur-adhesive group were used in immediate µTBS testing, and the others were tested after thermal aging (n = 5). Rectangular sticks were prepared using a low-speed diamond saw. For each tooth, 6 central sticks were used in the µTBS test. Statistical analysis was performed using three-way ANOVA and Bonferroni tests (α = 0.05). SE presented higher µTBS than universal adhesives and SB presented higher µTBS than GP regardless of dentin surface preparation and thermal aging (p ˂ 0.05). For SE and SB, the tungsten carbide bur demonstrated higher immediate and aged µTBS than did the extra-fine diamond bur (p ˂ 0.05). The immediate µTBS was similar for GP with all bur types (p ˃ 0.05); the tungsten carbide and extra-fine diamond burs presented higher µTBS than did the coarse-diamond bur after thermal aging (p ˂ 0.05). Dentin surface preparation and adhesive type had significant effects on µTBS. The smear layer created with an extra-fine diamond or tungsten carbide bur is favorable when mild and ultra-mild self-etch adhesives are used.

Optical coherence tomography evaluation of deep dentin crack removal techniques

BackgroundThis in vitro study used optical coherence tomography for noninvasive evaluation of the effectiveness of current clinical techniques to remove deep coronal dentin cracks. MethodsStandard dentin cracks were induced on the pulpal floor of 40 decoronated, extracted, sound human posterior teeth using a diamond disk, resembling cracks extending from marginal ridges. The specimens were randomly assigned to 1 of 5 treatment groups for crack removal using airborne-particle abrasion or a bur (fissure, small round, medium round, or tapered fine diamond). Optical coherence tomographic scans were obtained before and after the crack removal. Three-dimensional image registration analyzed the amount of dentin removed and the dimensions of cracks initiated or propagated in each treatment group. ResultsParticle abrasion resulted in the smallest crack propagation in each dimension, which was significantly different from all bur groups (Mann-Whitney, P < .01). Removed dentin depth and width differed among burs (P < .05). All burs resulted in a degree of crack formation, and there was no difference in crack dimensions among bur groups (P > .05). The amount of removed dentin during crack treatment was the largest in the particle abrasion group, which was significantly different from those of the bur groups (Mann-Whitney, P < .005). ConclusionsDental burs used with the purpose of removing pulpal floor dentin cracks induced new small cracks and extended existing cracks, and the volume of removed dentin depended on the shape and size of the bur. Air particle abrasion induced the fewest new cracks despite removing larger dentin volume.

Effects of dentin surface preparations on bonding of self-etching adhesives under simulated pulpal pressure.

ObjectivesThis study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure.Materials and MethodsHuman third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH2O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests.ResultsOnly the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives.ConclusionsSuperfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

Comparative assessment of corticotomy facilitated rapid canine retraction using piezo versus bur: A randomized clinical study

PurposeThe leading concern of orthodontic patients is prolonged treatment with fixed appliances and demand speedy treatment from the orthodontists. Piezocision is a relatively innovative, safe and reliable technique of corticotomy in the domain of surgically-accelerated orthodontic treatment. Our aim was to compare the efficiency of piezo corticotomy (piezocision) and conventional bur in rapid orthodontic tooth movement (OTM). Subjects and methodThe study employed a randomized, double-blind, split-mouth design. 24 subjects with Class II div 1 malocclusion were randomly assigned to the two interventions, viz; piezo and bur group. The primary parameters evaluated were the rate and amount of tooth movement and total treatment time required for canine retraction. Additionally, the duration of surgery and postoperative complications were also evaluated. Observations and resultsRate and amount of tooth movement were significantly higher with reduction in total treatment time in piezo compared to bur group. The duration of surgery was significantly longer in piezo group with no significant difference observed in post-operative complications. ConclusionPiezo-guided corticotomy was effective in providing rapid OTM with profound reduction in total treatment time and may be proposed as a suitable adjuvant to conventional corticotomy having comparable post-operative complications.

Clinical and Microbiological Assessment of Carisolv and Polymer Bur for Selective Caries Removal in Primary Molars.

Aim and objectiveTo assess the efficacy of the new Carisolv system and Polymer bur (SmartbursII®) for selective caries removal in primary molars clinically and microbiologically, compared with the conventional mechanical method.Materials and methodsSixty children with class I active carious lesions were selected. The children were randomly allocated to three groups (n = 20) according to the caries removal method. Under rubber dam isolation, dentin samples were taken before and after caries removal for microbial culture. Time spent in each technique was recorded. The clinical efficacy of caries removal was verified using caries detector dye. Patient satisfaction toward the treatment was evaluated using a facial image scale.ResultsThe median of caries detector dye scores was significantly lower in the conventional group compared to others (p value < 0.05). The mean time for caries removal was the longest with Carisolv (p value < 0.05). The median of facial image scale scores was significantly higher in the conventional group compared with others (p value < 0.05). The mean total viable bacterial count after caries removal was significantly higher in polymer bur group compared with others (p value < 0.05). While, there was no significant difference between Carisolv and conventional groups (p value > 0.05).ConclusionThe clinical efficacy of caries removal was highest with the mechanical method. Carisolv took the longest time for caries removal. Patient satisfaction was higher with Carisolv and polymer bur than the mechanical method. The antimicrobial efficacy of Carisolv and the mechanical method was higher than the polymer bur.Clinical significanceCarisolv is a viable alternative to the mechanical method in the management of dental caries, especially in children. Further studies are needed to assess the efficacy of caries removal by SmartbursII®.How to cite this articleAsal MA, Abdellatif AM, Hammouda HE. Clinical and Microbiological Assessment of Carisolv and Polymer Bur for Selective Caries Removal in Primary Molars. Int J Clin Pediatr Dent 2021;14(3):357–363.

COMPARISON OF TWO AEROSOL-FREE CARIES REMOVAL METHODS - A SPLIT MOUTH RANDOMIZED CLINICAL TRIAL

Objectives: The management of deep caries lesions in immature permanent molars might be challenging in clinical practice. Minimally invasive caries removal methods can maintain apexogenesis by preventing extensive tissue loss. Here we compare the chemo-mechanical caries removal (CMCR) gel and the polymer bur in terms of time spent on caries removal, patient acceptability, and clinical success. Materials and Methods: The teeth of 30 children were randomly divided into two groups. The duration of each method, the level of cooperation during each method, and the child’s choice of caries removal method were recorded. Patients were followed at 6-month intervals for at least 2 years. Results: The difference between the patients’ preferences was not statistically significant, while the average caries removal time of the polymer bur method was significantly shorter (p &amp;lt; 0.05). The rates of apical closure without pathology in CMCR and polymer bur groups were 63.2% and 73.7%, respectively, whereas 10% of each group underwent further treatments due to the clinical and/or radiographic pathology. Conclusions: These methods were thought to serve as an interim treatment in managing immature permanent teeth with deep caries. Furthermore, these methods, which do not involve water cooling, can also minimize the risk of contamination and cross-infection.