DAISA DE LIMA PEREIRA

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Q-switched Nd:YAG laser on dental enamel with photoabsorber
2022 - CASTRO, PEDRO; PEREIRA, DAISA; ANA, PATRICIA; MATOS, CHRISTIANO; ZEZELL, DENISE
Nd:YAG lasers emitting λ=1064 nm at microsecond and nanosecond pulses are alternatives to prevent dental caries and erosion in clinics.This wavelength allows most of photons to penetrate deep in the hard tissue due to low absorption of hydroxyapatite in the region. It is necessary to use photoabsorbers so most of photons are absorbed in the surface of the tissue preventing dental pulp necrosis. Currently the coal paste is used as a photoabsorber but the irradiated tissue turns darker what implies in the patients low adherence to the treatment due to aesthetic reasons. [1,2]. Confocal Raman spectroscopy is a non-destructive optical method to obtain detailed information about molecular composition of biological structures in depth. The most prominent feature of Confocal Raman spectroscopy is the reliable capability to provide the biomolecular data with no use of ionizing radiation to penetrate in the sample. This work aims to characterize the dental enamel irradiated with Nd:YAG laser with nanoseconds pulses, in order to describe the depth related changes promoted in the enamel, by the heat generated due to laser irradiation. For these measurements, 30bovine enamel blocks of 8 mm2, were randomized into 3 groups: G1 – enamel untreated; G2 – enamel irradiated with Nd:YAG nanopulsed laser (1064 nm, 4 W; 1,05 J/cm2; 5 ns 20 Hz, Brilliant, Quantel Laser) using a coal paste as photoabsorber; G3 -enamel irradiated with Nd:YAG nanopulsed laser ( same parameters as G2) using squid ink as photoabsorber. The assessments of three different depth regions of the cubic shaped samples were: region A- left corner above of the sample, region B- middle of the sample and Region C- right corner below of the sample. The intensity map of phosphate (950 cm-1)regarding the position, were calculated [3,4] as shown in the Figure 01. The comparative results in the Fig.1 demonstrated that application of coal paste associated with Nd:YAG (G2) can preserve the inorganic content better than the squid ink group (G3). These findings have crucial clinical implications in the laser protocol development and itwas possible to correlate the heat penetration depth of the laser irradiation with photoabsorber using the images obtained bythe confocal Raman.
Caracterização óptica de tecidos duros dentais irradiados com lasers de Nd:YAG
2019 - PEREIRA, DAISA de L.
Os métodos de diagnóstico óptico são muito utilizados na odontologia e se baseiam nas propriedades ópticas dos tecidos duros dentais esmalte e dentina. Estes, podem detectar doenças da cavidade oral precocemente possibilitando uma intervenção mais rápida e eficaz. O laser Nd:YAG (λ=1064nm) é bastante difundido na clínica para a prevenção e tratamento de cárie e erosão dentária. Após a irradiação dos tecidos duros com Nd:YAG, suas propriedades ópticas são modificadas, há alta penetração de fótons deste comprimento de onda e baixa absorção, assim é necessário o uso de fotoabsorvedores para que os fótons sejam absorvidos na superfície e se evite a necrose da polpa dental. Atualmente a pasta de carvão, usada como fotoabsorvedor, causa escurecimento no tecido irradiado implicando na baixa adesão ao tratamento por questões estéticas. O objetivo deste estudo in vitro foi caracterizar os tecidos duros dentais quanto à irradiação com laser de Nd:YAG com pulsos na ordem de microssegundos e nanossegundos, descrever as alterações promovidas pela irradiação e se essas interferem nos métodos de diagnóstico e também como o uso de um fotoabsorvedor alternativo, como a tinta de lula, influencia nas propriedades ópticas dos tecidos. Esses lasers também são propostos como alternativa de prevenção de lesões de erosão dentária. Foram determinados os protocolos de irradiação eficiente e seguros para o laser de Nd:YAG (0,6W;84,9J/cm2;120μs) e também para o Q-Switched Nd:YAG (4W;1,05J/cm2;5ns) baseados na medida da temperatura intrapulpar com termopares de resposta rápida e superficial com termografia no infravermelho durante a irradiação de dentes humanos; concentração de flúor nos fotoabsorvedores; mudança de cor de acordo com o fotoabsorvedor e também na análise da morfologia superficial por microscopia eletrônica de varredura após a irradiação de dentes bovinos. Após a determinação dos protocolos, foram calculados o índice de refração, coeficiente de atenuação óptica para determinar se o protocolo foi eficiente na prevenção de lesões de erosão e também foram utilizados neste cálculo os índices refração calculados anteriormente. Ambos protocolos apresentaram aumento menor do que 5,5ºC da temperatura intrapulpar, indicando que estão na faixa de manutenção da vitalidade pulpar. A temperatura superficial durante a irradiação foi maior do que 200ºC. A concentração de flúor na pasta de carvão é 0,03±0,01μgF/mL e na tinta de lula é 3,92±0,32μgF/mL. A tinta de lula promoveu menor escurecimento. As eletromicrografias mostraram que os lasers promoveram fusão nas superfícies dos tecidos exceto a dentina irradiada com o Nd:YAG Q-Switched. Não houve diferença estatística significante entre os índices de refração calculados, porém, o cálculo do coeficiente de atenuação óptica mostrou diferenças significativas e os protocolos que se utilizaram da tinta de lula se mostraram mais eficientes na prevenção das lesões de erosão. A composição química em profundidade foi determinada utilizando-se a espectroscopia Raman confocal. Lasers de Nd:YAG são eficientes para a prevenção de lesões de erosão dentária independente da largura de pulso, a tinta de Lula se mostrou eficaz e viável esteticamente. Os protocolos são seguros para aplicação clínica e alteram os tecidos duros dentais química e opticamente influenciando no diagnóstico por técnicas ópticas, por exemplo OCT.
Assessment of the preventive effects of Nd:YAG laser associated with fluoride on enamel caries using optical coherence tomography and FTIR spectroscopy
2021 - DIAS-MORAES, MARCIA C.; CASTRO, PEDRO A.A.; PEREIRA, DAISA L.; ANA, PATRICIA A.; FREITAS, ANDERSON Z.; ZEZELL, DENISE M.
Objective This in vitro study characterized and monitored, by Optical Coherence Tomography (OCT) and Fourier Transformed Infrared Spectroscopy (FTIR), the effects of the association of acidulated phosphate fluoride gel (APF-gel) and Nd:YAG (neodymiun:yttrium-aluminum-garnet) laser, as sequencial treatments, in the prevention of incipient enamel caries lesions. Methods 120 human enamel samples were randomized into 3 groups (n = 40): APF-gel (1.23% F-, 4 min.); Laser+APF (Nd:YAG laser irradiation—0.6W, 84.9J/cm2, 10Hz, followed by APF-gel); and APF+Laser (APF-gel followed by laser irradiation). The samples were subjected to a 15-day pH-cycling, evaluated by OCT (quantification of optical attenuation coefficient–OAC) and FTIR (analysis of carbonate and phosphate content) before treatments, after treatments, and on the 5th, 10th and 15th days of pH-cycling. The statistical analysis was performed (α = 5%). Results The Optical Attenuation Coefficient (OAC) assessed by OCT increases with the progression of demineralization, and the Laser+APF presented the highest values of OAC in 10th and 15th days of pH-cycling. Nd:YAG decreased the carbonate content after treatment regardless of the application order of the APF-gel, while APF-gel did not interfere in the composition of enamel. The carbonate content was also changed in the first 5 days of the pH-cycling in all groups. Conclusion Nd:YAG laser irradiation before or after the application of APF-gel did not influence the appearance of incipient caries lesions, showing no synergistic effect. Regardless of the application order of the APF-gel, laser irradiation reduces the carbonate content of the enamel, which also changes during the demineralization process. However, irradiation before the application of APF-gel increased the speed of progression of the lesions, which positively impacts public health as it can prevent caries disease, even in high risk individuals. OCT and FTIR are suitable for assessing this effect.
The lingual enamel morphology and bracket shear bond strength influenced by Nd:YAG laser and aluminum oxide sandblasting preconditioning
2021 - LOPES, MONICA S.; PEREIRA, DAISA L.; MOTA, CLAUDIA C.B. de O.; AMARAL, MARCELLO M.; ZEZELL, DENISE M.; GOMES, ANDERSON S.L.
Objectives This study aimed to investigate the influence of Nd:YAG laser and aluminum oxide sandblasting on the shear bond strength (SBS) of lingual brackets and to optically analyze the behavior of the enamel morphology. Materials and methods Thirty-five bovines’ incisors teeth were divided into 5 groups (n = 7), according to the surface preconditioning: G1, control group; G2, Nd:YAG laser; G3, laser + aluminum oxide sandblasting (Al2O3); G4, Al2O3; and G5, Al2O3 + laser. All groups had lingual brackets bonded and shear debonded after 72 h. SBS values were analyzed, and the enamel morphology was evaluated by optical coherence tomography (OCT) and scanning electron microscope (SEM), before and after preconditioning surface. The optical attenuation coefficient (α) analysis was obtained from OCT images. Data analysis used the ANOVA test, followed by post hoc Tukey, Kruskal Wallis, and post hoc Dunn tests (significance of 5%). Results The SBS values presented similarly among groups, but the value of α showed statistical difference (p-value = 0.0124) between G3 and G5 with the others. Optical analyses indicated a melting on the enamel that suffered laser irradiation for G2 and G5 and crystal surface disorganization for G4. Sandblasting partially removes the melting of the laser effect (G3). Conclusion The sandblasting is a dispensable step for bonding lingual brackets, and the melting of the enamel after laser irradiation does not compromise the bracket adhesive resistance. Clinical relevance The Nd:YAG laser became an interesting tool to prevent caries and decrease prevalence of white spot lesions in orthodontic treatments, without systemic effects in patients with genetic high risks of caries.
Surface evaluation of enamel etched by Er,Cr:YSGG laser for orthodontic purpose
2020 - LOPES, DANIELA S.; PEREIRA, DAISA L.; MOTA, CLAUDIA C.B.O.; MELO, LUCIANA S.A.; ANA, PATRICIA A.; ZEZELL, DENISE M.; GOMES, ANDERSON S.L.
Aim: To compare the effect of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser at different irradiation parameters and acid etching on the shear bond strength (SBS) of orthodontic brackets to enamel. Materials and methods: Forty bovine incisors were randomly distributed into groups (n = 10): GI: 37% phosphoric acid etching; GII: Er,Cr:YSGG laser etching 19.1 J/cm2; GIII: Er,Cr:YSGG, 29.3 J/cm2; and GIV: Er,Cr:YSGG, 42.4 J/cm2. After treatments, metallic brackets were bonded using Transbond XT adhesive system. After light curing, the samples were subjected to 500 thermal cycles, debonded with a universal testing machine, and the SBS values were recorded. After debonding, surface morphology was evaluated using scanning electron microscopy (SEM) and optical coherence tomography (OCT). The values of SBS testing were analyzed by one-way analysis of variance (ANOVA) and Tukey post hoc test, at 5% significance level. Results: The mean SBS values of GI, GII, GIII, and GIV groups were 6.2 ± 1.7 MPa, 4.6 ± 2.5 MPa, 7.0 ± 2.2 MPa, and 8.0 ± 3.6 MPa, respectively. Laser irradiation promoted rough surfaces in all parameters used, and the OCT analysis revealed higher optical changes on lased groups when compared with phosphoric acid. Conclusion: Er,Cr:YSGG laser irradiation operated at 42.4 J/cm2 and 29.3 J/cm2 is a better alternative for etching enamel prior to the orthodontic treatment than the phosphoric acid. Clinical significance: Er,Cr:YSGG laser irradiation is better than the phosphoric acid for etching enamel prior to the orthodontic treatment because laser irradiation promotes similar SBSs and preventing demineralization around orthodontic brackets.
Effect of Nd:YAG laser and aluminum oxide sandblasting preconditioning on lingual enamel
2019 - LOPES, MONICA S.; MOTA, CLAUDIA C.B.O.; PEREIRA, DAISA L.; AMARAL, MARCELLO M.; ZEZELL, DENISE M.; GOMES, ANDERSON S.L.
It is known that Nd:YAG laser radiation on dental structure can increase enamel resistance to demineralization; however, few studies report its impact in orthodontics. This study aimed to verify the interaction of Nd:YAG laser and aluminum oxide sandblasting (Al2O3) as preconditioning treatment of lingual brackets bonding to quantify the shear bond strength (SBS) and to characterize the enamel after different surface preconditioning techniques. Thirty-five bovines’ incisors were divided in 5 groups (n=7), according to the preconditioning. All groups had the lingual brackets bonded with Transbond XT adhesive according to manufacturer’ protocol, and shear bonded after 72h. Samples were analyzed by Optical Coherence Tomography (OCT) and Scanning Eletronic Microscope (SEM) to verify enamel alterations. Optical attenuation coefficient (α) was measured before any preconditioning (T0) and after preconditioning surface (T1) for each group. Statistics analysis ANOVA-test was used, followed by Post Hoc Tukey for shear bond strength data, and Kruskal Wallis and post hoc Dunn test for α data. SEM and OCT qualitative analysis showed the melting effect with laser irradiation and enamel crystal surface disorganization with sandblasting in T1 and after shear bond. All groups were adequate for SBS and the statistical differences (p=0.0034) among groups showed better results for groups with techniques association (laser and Al2O3 used in this or in reverse order) and the highest SBS when laser was used after. The Al2O3 removes part of melting effect. The α had statistical difference (p= 0.0124) among groups, increasing with laser and Al2O3 isolated and decrease with techniques association.
Optical properties of bovine dentin when irradiated by Nd:YAG and a black dentifrice aimed at treating dentin erosion
2019 - PEREIRA, DAISA L.; DEL VALLE, MATHEUS; GOMES, GABRIELA V.; ZEZELL, DENISE M.; ANA, PATRICIA A.
Dental erosion has been extensively studied as a risk factor for tooth loss or injure, and the early diagnosis of lesions is essential for avoiding greater damages. Optical Coherence Tomography (OCT) is a potential tool for early diagnosis of demineralization. In this study, this technique was used to analyze the optical changes of dentin samples irradiated with Nd:YAG laser using a black dentifrice as photoabsorber, then submitted to an erosive cycling. 75 slabs of bovine root dentin were randomized into 5 groups: G1—untreated; G2—treated with acidulated phosphate fluoride gel (APF-gel, [F-] = 1.23%, pH = 3.3–3.9); G3—irradiated with Nd: YAG laser (100 μs, 1064 nm, 0.6 W, 10 Hz) without photoabsorber; G4—irradiated with Nd:YAG laser using a coal paste as photoabsorber; G5—irradiated with Nd: YAG laser using a black dentifrice as photoabsorber. All samples were submitted to a 3-day erosive demineralization (Citric acid 1%, pH = 3.6, 5 min, 2 /day) under agitation, and remineralization (artificial saliva, pH = 7, 120 min) cycling. The samples were evaluated by OCT before treatments (baseline), after treatments and after erosive cycling. Optical attenuation coefficient (μ) was calculated using a Matlab routine, and the statistical analysis was performed (a = 0.05). It was observed a significant decrease on μ values after all treatments. Also, the μ values decreased after erosive cycling, except for the groups G3 and G5. It was concluded that OCT technique is capable to distinguish among sound, treated and demineralized dentin. As well, the black paste was efficient to act as a photoabsorber, helping the Nd:YAG laser to decrease dentin erosion.
Advances in the prevention and monitoring of root dentin demineralization using lasers
2019 - ANA, PATRICIA A.; PEREIRA, DAISA de L.; FERREIRA, ELIZABETE dos S.; FIGUEREDO, DANIELA C.; DAGUANO, JULIANA K.F.B.; ZEZELL, DENISE M.
The increase in the life expectancy and the longer permanence of the teeth in the oral cavity also led to an augment in the prevalence of root caries lesions. These lesions require more attention because of their rapid progression and difficulty in early diagnosis and monitoring. In this context, the irradiation of the tissues with high intensity lasers has been shown as an important way for preventing lesion formation because lasers chemically modify the irradiated dental hard tissues and make them more resistant to acid challenge. In addition, the association with ceramic biomaterials may allow additional remineralizing results. Together with therapeutics, the effective early diagnosis of incipient lesions is indispensable. Techniques that use lasers, such as optical coherence tomography, have also been promising in this aspect because they allow the early diagnosis and monitoring of demineralizations with high resolution and in a non-detrimental way. This article aims to show the actions of high intensity laser therapies when associated or not with biomaterials, on the prevention and remineralization of root caries lesions, as well as the effectiveness of optical coherence tomography in the diagnosis and monitoring the effects of the treatments in these lesions.
Heat-induced depth of Nd:YAG laser irradiation in biological hard tissues
2019 - PEREIRA, DAISA L.; CASTRO, PEDRO A.A.; GOMES, GABRIELA V.; ZAMATARO, CLAUDIA B.; ZEZELL, DENISE M.; RIBEIRO, HENRIQUE B.; MATOS, CHRISTIANO J.S.; ANA, PATRICIA A.
Confocal Raman spectroscopy is a non-destructive and non-invasive technique which provides surface Raman spectra and depth images of biological structures contactless with the sample, with no use of ionizing radiation to penetrate in the sample under analysis. These characteristics allow its experimental use without any side e®ects to the sample. The depth images are obtained by Raman microscopy and are related to the characteristics of the tissues. This study aims to characterize irradiated hard tissues and correlate the depth reached by the heat of the laser irradiation with the obtained images. For this, thirty 8 mm2 blocks of bovine enamel and bovine root dentin, were randomized into 6 groups: G1- enamel untreated; G2- enamel irradiated with Nd:YAG micropulsed laser (1064 nm, 10 Hz- Lares Research R°) using a coal paste as photoabsorber; G3- enamel irradiated with Nd:YAG nanopulsed laser (1064 nm, 20 Hz, Brilliant, Quantel Laser) using a coal paste as photoabsorber; G4-G6 (bovine root dentin in the same conditions of treatment of G1-G3). The measurements were performed in three di®erent depth regions of the cubic shaped samples: region A- left corner above of the sample, region B- middle of the sample and Region C- right corner below of the sample. The area under the phosphate, carbonate, amide I, II, and III bands were calculated. The Raman spectra of the Nd:YAG irradiated samples detected a reduction in all the organic components of the enamel after laser irradiation. Previous studies of our group demonstrated that di®erences in carbonate substitution in the apatite lattice are related to the apatite instability and demineralization susceptibility. Considering that carbonate free apatite is less susceptible to acid attack, the results of this study suggest that Nd:YAG lased enamel can be more resistant to caries, in a direct correlation to the thickness of the treated area. It was found that for micropulsed Nd:YAG laser, the heat induced depth was 10 § 2 ¹m and for nanopulsed laser the heat induced depth was 8 § 3 ¹m. So, it is possible to correlate the heat penetration depth of the laser irradiation with the images obtained by the confocal Raman.
Optical coherence tomography provides the optical attenuation coefficient of bovine dentin irradiated by Nd:YAG
2018 - PEREIRA, DAISA L.; GOMES, GABRIELA V.; ZEZELL, DENISE M.; DEL VALLE, MATHEUS; ANA, PATRICIA A.
Optical Coherence Tomography (OCT) is a non-destructive and non-invasive technique which provides transverse images of biological structures contactless with the sample, with no use of ionizing radiation to penetrate in the sample under analysis. These characteristics allow its clinical use without any side eÆects to the patient. The optical attenuation coe±cient (OAC) is obtained by OCT and is related to the characteristics of the tissues. This study aims to analyze the OAC from the OCT signal in bovine dentin to distinguish sound from demineralized dentin. For this, sixty 8mm2 blocks of bovine root dentin, were randomized into 4 groups: G1- untreated; G2- treated with acidulated phosphate fluoride (APF, [F]=1.23%, pH=3.3 to 3.9); G3- irradiated with Nd:YAG laser (1064nm, 0.6W, 10Hz- Lares Research R∞) without photoabsorber; G4- irradiated with Nd:YAG laser (1064 nm, 0.6W, 10 Hz- Lares Research R∞) using a coal paste as photoabsorber. All samples were submitted to a 3-day erosive demineralization protocol (Citric acid 1%, pH=3.6, 5 min, 2x/day) under agitation, and remineralization (artificial saliva, pH=7, 120 min) cycling. In this study, it was noticed that the values of optical attenuation coe±cient of all samples decreased after the erosive cycling. This finding indicates that the demineralization promoted by acids, such as the citric acid creates empty spaces in the structure of dentin that increases the number of interfaces and, as a consequence, increases the scattering of light and decreases the values of optical attenuation coe±cients. It is possible to conclude that the optical attenuation coe±cient, calculated from the OCT signal, is able to distinguish sound from demineralized bovine dentin. This quantitative parameter can be used for diagnosis and to monitor the evolution of mineral loss in patients in near future.