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.
Q-switched Nd:YAG laser on dental enamel with photoabsorber
2020 - CASTRO, P.; PEREIRA, D.; ANA, P.; MATOS, C.; ZEZELL, D.
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, 30 bovine 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 it was possible to correlate the heat penetration depth of the laser irradiation with photoabsorber using the images obtained by the confocal Raman.
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.
Optical attenuation coefficients obtained through OCT correlates to microhardness in dental human enamel irradiated with Nd: YAG and submitted to demineralization in vitro
2019 - MORAES, MARCIA C.D.; PEREIRA, DAISA L.; ANA, PATRICIA A. da; FREITAS, ANDERSON Z. de; ZEZELL, DENISE M.
This work aims was to correlate the changes in the optical attenuation coefficients obtained through the OCT technique with the values obtained in Knoop sectional microhardness tests over time in dental human enamel samples irradiated with the Nd: YAG laser and Acid Phosphate Fluoride (APF), aiming the prevention of caries lesions in vitro. After Ethical Committee approval, 160 enamel samples, obtained from 40 human tooth molars, were divided into 4 groups: Control group (where no treatment was performed); Fluoride group (APF - fluoride phosphate acidulated for 4 minutes); Fluoride-Laser group: APF followed by irradiation with Nd:YAG laser (DE = 84.9 J/cm2, contact mode, with the use of carbon paste as photoabsorver); Laser-fluoride group (irradiation with Nd:YAG laser followed by APF). The samples of all groups were subjected to pH cycling during 20 days. On days 5, 10, 15 and 20, 10 samples from each group were removed from the cycling for the Knoop sectional microhardness test. Two samples of each group, at each time, were randomly selected for the analysis with FTIR-ATR (Fourier transform infrared spectroscopy associated with attenuated total reflection technique). The analysis by ATR-FTIR showed changes in the chemical composition of the samples of the irradiated groups in relation to Control and Fluoride group. There was correlation between the values of sectional microhardness tests and the measured optical attenuation coefficient by OCT in irradiated dental enamel, showing that the association between fluoride application and Nd:YAG laser irradiation is an important tool for the prevention of tooth enamel demineralization.
Estudo in vitro de um novo fotoabsorvedor para a irradiação de laser Nd:YAG na prevenção de erosão em esmalte
2018 - GOMES, GABRIELA V.; PEREIRA, DAISA de L.; ZEZELL, DENISE M.