THAIS FREITAS RABELO

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Analysis of ceramic laminates removal with Er,Cr:YSGG laser by optical coherence tomography
2019 - ZANINI, NATHALIA; ZAMATARO, CLAUDIA B.; RABELO, THAIS F.; JUVINO, AMANDA C.; KUCHAR, NIELSEN G.; CASTRO, PEDRO; ANA, PATRICIA da; ZEZELL, DENISE
Porcelain laminated veneers have been widely used. For wear of hard tissue such as enamel and dentin, the diamond rotary instrument is the most traditional, but the laser has become recently used to remove aesthetic facets. Optical coherence tomography (OCT) used as an optical biopsy, is important for morphological analysis and attenuation coefficient is related to the property of the photons to be scattered by the samples. After approval by the Ethics Committee, the present study investigated the detachment of 30 ceramic E-max fragments cemented in human dental enamel of dimensions 3mm x 3mm x 0.7mm with 3 types of resin cements, RelxY Veneer, Relx U200 and Variolink Veneer. The samples (Enamel + Ceramic Fragment) were randomly distributed in the 3 groups and cemented according to the manufacturer. After that, they were prepared for irradiation with the Er,Cr: YSSG laser under predetermined conditions (3.5 and 3W, 20Hz, 60% water and 40% air flow). OCT analysis was done before and after irradiation. We observed that themorphological changes of the enamel surface showed an increased surface area due to the cement remaining in the enamel.We concluded that the Er, Cr: YSGG laser, when used in the irradiation protocol tested, seems to be a safe tool for the removal of laminates.
Removal of laminates with Er,Cr:YSGG laser from dental enamel submitted to gamma radiation
2019 - RABELO, THAIS F.; ZAMATARO, CLAUDIA B.; ZANINI, NATHALIA; JUVINO, AMANDA C.; KUCHAR, NIELSEN G.; CASTRO, PEDRO A.A.; ZEZELL, DENISE M.
Background: Modern Dentistry is characterized by the search for aesthetic perfection in the smile. Many efforts are made regarding procedures related to manufacturing, cementing, maintenance and removal of ceramic laminates. The laser removal of laminates has become more frequent when the aesthetical procedures needs to be replaced. On the other hand, the head and neck cancer treatment causes comorbidities in the buccal environment when laminates are in place. Objective: To evaluate in vitro the removal of ceramic fragments by means of Er,Cr:YSGG laser irradiation, after gamma radiation. Methods: 20 Lithium disilicate veneers were cemented with Variolink to human dental enamel and then samples were irradiated with 0.07 kGy. After gamma irradiation, the laminates removal with Er,Cr:YSGG laser was performed. The control group was not subjected to gamma radiation. Dental enamel samples were analyzed by Scanning Electron Microscopy (SEM), Fourier Transformed Infrared Spectroscopy (FTIR) and Surface Microhardness Loss (SMH). Results: SEM has shown that less cement was found after removal of the facets in gamma irradiated group when compared to the control. For both groups there was alteration of the SMH possibly due to the use of the adhesive system. When performed intra group analysis, the sample being its own control of baseline in the FTIR analysis, there were no band shifts or formation of new compounds on the surface of human dental enamel. Conclusions: The Er,Cr:YSGG laser is an effective alternative for laminates removal in human dental enamel even when it is subjected to gamma radiation.
Calcium analysis of gamma sterilized human dentin submmited to Er,Cr:YSGG laser irradiation
2019 - KUCHAR, NIELSEN G.; ZAMATARO, CLAUDIA B.; RABELO, THAIS; JUVINO, AMANDA; ZANINI, NATHALIA; CASTRO, PEDRO; ZEZELL, DENISE M.
Studies report that gamma radiation changes the oral cavity of patients submitted to radiotherapy. These changes include xerostomia, resulting in an unsaturation of calciumand phosphate in the oral cavity. However, human enamel samples isolated from the altered oral environmentwhen irradiatedwithgamma radiation at doses of up to 25kGy (much higher than radiotherapy doses) were shown to have undergone no changes in molecular hardness or micro surface. After approval of the Research Ethics Committee, 20 human dentin samples were evaluated before and after irradiation, split randomly into control group (n = 10) and irradiated group (n = 10) treated with 25.0 kGy at the Co60 multipurpose irradiator and irradiated with Er,Cr:YSGG laser in the parameters: 8.5 J/cm2 in the Fourier Transform Infrared Spectroscopy (FTIR), % surface Microhardness loss and Scanning Electron Microscopy (SEM). At the end, acidic biopsies were performed to quantify the concentration of calcium present in the samples. In the results of FTIR analysis differences were found only in the bands of organic content and in the inorganic content, difference were not found between before and after irradiations. The EDS and % Surface Microhardness loss analysis corroborates these findings, as well as no significant loss of the Calcium content before and after their radiation with Co60 at 25 kGy and with the Er,Cr:YSGG laser. These findings lead us to a new hypothesis of behavior of the hydroxyapatite crystal submitted to the gamma irradiation.
Er,Cr:YSGG laser irradiation associated to fluoride for in situ model using gamma sterilized dentin and enamel
2019 - ZAMATARO, CLAUDIA B.; RABELO, THAIS F.; ZANINI, NATHALIA; JUVINO, AMANDA C.; KUCHAR, NIELSEN G.; CASTRO, PEDRO A.L.; ANA, PATRICIA A. da; ZEZELL, DENISE M.
The in situ intraoral model uses human dental enamel samples (HDE) in order to analyse the de-remineralization processes using the buccal environment without interfering into the patients’ natural dentition. The main ethical concern from this model is the biosafety. Gamma radiation is a very efficient sterilization method that is not expected to alter the mineral content of the hard tissues, avoiding biases in the results. Thus 40 HDE samples were irradiated through a source of 60Co multipurpose irradiator aiming complete sterilization (25 KGy/h) with the purpose of accumulating the native plaque on them at an in situ study. An Er,Cr:YSGG laser was used alone and in combination with the topical applications of: 1-dentifrice (1,100 lg F-/g) or 2-APF (12,300 lg F-/g). Morphological analyses were performed by scanning electron microscopy (SEM), determination of alkali-soluble fluoride concentration by specific ion electrode and microhardness determination. Then, the 15 volunteers used palatal devices containing previously treated HDE samples and remained using F dentifrice. The FTIR findings established that gamma radiation could be used aiming HDE sterilization. The Knoop hardness number was within the range of that of natural dentin of human origin. X-ray fluorescence shows that irradiated dentin has great similarity with natural dentin from the point of view of chemical composition. SEM analyses showed that there was no thermal damage or interprismatic morphological changes in the hydroxyapatite structure of human dental dentin outside the buccal environment when using doses of gamma irradiation up to 25 kGy.
In vitro determination of the critical pH demineralization of human dental enamel irradiated with Nd:YAG laser associated with fluoridated product
2019 - JUVINO, AMANDA C.; ZAMATARO, CLAUDIA B.; RABELO, THAIS F.; KUCHAR, NIELSEN G.; ZANINI, NATHALIA; CASTRO, PEDRO; ZEZELL, DENISE
The use of fluoride products associated with high intensity laser irradiation are beneficial for dental caries prevention because it increases the surface area, improving the formation of fluorapatite (FA), which gives greater acid-resistance of enamel against bacterial acids. The objective of this study is to determine the critical pH of dental enamel treated with acid fluoride phosphate 12,300 lF-/g (APF) and Nd:YAG laser 84 J/cm2, as there is no precedent to determine this pH. The study consisted of 4 groups (n = 15): G1: Negative Control; G2: APF; G3: Nd:YAG; G4: APF + Nd:YAG. Each group was randomized into three subgroups (n = 5) for pH cycling. The cycling was designed to simulate three conditions: below critical pH of enamel hydroxyapatite (pH 5.0); pH below critical for hydroxyapatite and fluorapatite (pH 4.5); condition further below the critical situation to investigate extent of acid resistance of the enamel (pH 4.0). The samples were analyzed by scanning electron microscopy (SEM), Fourier infrared spectroscopy (FTIR) and solutions were quantified fluoride (specific ion electrode) and phosphate (colorimetric method). In SEM and FTIR (phosphate band) at pH 5, only the APF and APF + Nd:YAG groups did not present demineralization. At pH 4.5, only the APF + Nd:YAG group was integrated. At pH 4, APF + Nd:YAG showed signs of mild demineralization while the other groups showed aggressive signals. It is concluded that the irradiated fluorapatite has critical dissolution pH different from fluorapatite formed only with the application of fluorine.
Comportamento da hidroxiapatita do esmalte e da dentina frente à radiação ionizante in vivo e in vitro
2019 - KUCHAR, NIELSEN G.; ZAMATARO, CLAUDIA B.; ZANINI, NATHALIA; RABELO, THAIS F.; JUVINO, AMANDA C.; SOGLIA, VICTOR; CASTRO, PEDRO A.A.; ZEZELL, DENISE
Human dental enamel evaluation after radiotherapy simulation and laminates debonding with Er,Cr:YSGG using SEM and EDS
2019 - RABELO, THAIS F.; ZAMATARO, CLAUDIA B.; KUCHAR, NIELSEN G.; ZANINI, NATHALIA; JUVINO, AMANDA C.; DEL-VALLE, MATHEUS; CASTRO, PEDRO A.A.; SANTOS, MOISES O.; ZEZELL, DENISE M.
The pursuit of perfection makes younger people undergo aesthetic procedures without formal indication. However, young patients may be susceptible to a disease such as head and neck cancer which treatment can compromise the adhesion of these indirect mate-rials. Here, we present an analyze, of the gamma radiation effects on crystallographic morphology of human dental enamel after laminate veneer debonding with Er,Cr:YSGG laser. Thus, human dental enamel samples were prepared and randomized into 2 groups (n=10): Laser Irradiation (L) and Gamma + Laser Irradiation (GL) group. Scanning elec-tron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were performed before bonding and after debonding using Er,Cr:YSGG. Only Gamma + Laser Irradia-tion group received a cumulative dose of 70 Gy gamma radiation used in head and neck cancer radiotherapy. SEM images showed that both GL and L groups presented altered morphology. EDS showed an decrease in Ca and P intensities after laser debonding of laminates veneers in both group. Therefore, a proper laser facet removal protocol should be established for healthy patients and patients who have been exposed to radiotherapy for head and neck cancer.
Effect of Er,Cr:YSSG laser on dental Veneers removal submitted to gamma radiation
2019 - ZANINI, NATHALIA; RABELO, THAIS F.; ZAMATARO, CLAUDIA B.; JUVINO, AMANDA C.; KUCHAR, NIELSEN G.; CASTRO, PEDRO A.A. de; ANA, PATRICIA A. da; ZEZELL, DENISE M.
The search for aesthetical rehabilitive treatment such as porcelain veneers is increasing over the past years. After CEP-FOUSP approval, the present study investigated the debonding of 20 ceramic fragments of lithium disilicate(5x5x1 mm) from human dental enamel bond with Variolink ® N. The samples were splitted in two groups: control (without gamma irradiation) and treatment (gamma irradiation: GL). EDS and FTIR was performed on enamel in both groups, before and after treatment. After cementation of the ceramic fragments the control group was only irradiated with Er, Cr: YSGG laser (λ = 2.78 nm) to remove the fragments, whereas the GL was gamma irradiated with 0.07 kGy followed by laser irradiation Er, Cr: YSGG for removal of laminates.The laser parameters were previously determined as follows: 3.5 W. The gamma and laser (GL) group was exposed to gamma radiation and the erbium laser was applied in both groups to remove lithium disilicate laminates from human dental enamel. Thus, the load required to remove the laminates after simulation of the radiotherapy treatment in the human dental enamel was analyzed by mechanical assay. In this assay, the GL group presented higher loads for the removal of the laminates compared to the control group. This indicates that the gamma radiation induces a water radiolysis by modifying the hybrid layer of the adhesive cement and increases the bond between the enamel and the resin cement, which hinders the laser debonding of the laminates.
FTIR analysis of human dentin submitted to gamma radiation
2019 - KUCHAR, NIELSEN G.; ZAMATARO, CLAUDIA B.; CASTRO, PEDRO A.A. de; RABELO, THAIS F.; JUVINO, AMANDA C.; ZANINI, NATHALIA; ZEZELL, DENISE M.
Global data indicate that head and neck cancer express one of the sixth most common types of malignant cancers. In 2030, head and neck cancer predict 1,031,439 new cases per year around the world. Radiation therapy is used as a major therapy step in the treatment protocol for head and neck malignancies. Radiation caries consists in a side effect of xerostomia, ie a considerable reduction in the quantity and quality of saliva in the oral cavity, being defined as a type of cavity that advance severely with fast progression being able to injure the dental pulp. Gamma radiation effects can promote changes associated to modification in the enamel prismatic structure, the reduction in surface microhardness and biochemically alterations in the tooth composition. However, other studies where the human dental enamel using ionizing radiation present no differences found in the integrity of the dental enamel and there was no interference in the surface microhardness. In this study, 20 human dentin samples were evaluated, split randomly into the control group and irradiated group at 25 kGy, in the Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM). The FTIR shows that no significant changes were found in the Phosphate band representing the inorganic material. On the other hand, the Amide I band -chosen as the representative of the organic matrix composed mainly of collagen- showed a significant difference, suggesting a degradation of the organic content. These findings corroborate with SEM analysis after the gamma irradiation dose at 25 kGy.
Calcium analysis from gamma sterilized human dentin and enamel
2019 - ZAMATARO, CLAUDIA B.; KUCHAR, NIELSEN G.; SCAPIN, MARCOS A.; ZANINI, NATHALIA; CASTRO, PEDRO; RABELO, THAIS F.; JUVINO, AMANDA C.; ZEZELL, DENISE
Gamma radiation changes the patients0 oral cavity undergoing radiotherapy. Alterations cause an unsaturated environment of calcium and phosphate into the oral cavity. After approval of the Ethics Committee, 20 hu- man teeth were sectioned to obtain 20 human enamel and 20 dentin samples, polished plane. Samples were randomized in the irradiated group and control group (untreated). Then, the treatment group was irradiated with 25:0 kGy at the 60Co multipurpose irradiator. After the gamma irradiation, Fourier Transformed Infrared Spectroscopy (FTIR), percentage of surface microhardness loss (%SMHL) and Scanning Electron Microscopy (SEM) were performed. At the end, acidic biopsies were performed to quantify the concentration of calcium present in the samples. FTIR showed that the molecular structure of HA of the enamel is similar to the non- irradiated, with no formation or loss of molecular compounds occurring. X-ray °uorescence at enamel samples was performed. Microscopic morphological analysis did not shown signi¯cant di®erences. Surface microhardness is an indirect indicator of the mineral content of the samples. The mean obtained was 258:2 (38:8) KHN within the hardness spectrum of the healthy natural enamel. The compounds present in the samples and the values of the ratios of Calcium and Phosphate oxides and relation between the elements Calcium and Phosphorus. The ratio of the most stable oxides shows a variation with linear correlation. In the enamel, the ratio (Ca/P) shows a change in the elemental content with linear correlation (R2 = 1). These ¯ndings lead us to a new hypothesis of behaviour of the HA crystal versus gamma irradiation. On the other hand for the irradiated dentin, the Knoop hardness number was within the range of the spectrum similar to that of natural dentin of human origin. X-ray °uorescence shows that irradiated dentin has great similarity with natural dentin from the point of view of chemical composition. SEM analyses showed that there was no thermal damage or interprismatic morpho- logical changes in the hydroxyapatite structure of human dental dentin outside the buccal environment when using doses of gamma irradiation up to 25 kGy.

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