PEDRO ARTHUR AUGUSTO DE CASTRO

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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.
Nd:YAG laser on dental enamel in the reduction of artificial caries demineralization
2019 - ZEZELL, DENISE M.; SILVA, MATEUS R.; CASTRO, PEDRO A.A.; SILVA, TANIA M.; GONCALVES, SERGIO E.P.
Nd:YAG-laser associated to a photoabsorber, in the reduction of artificial caries in enamel was evaluated. Eighty bovine specimens with 6mm diameter and 2mm high were obtained and a half of the surface of each was protected as a control. Microdurometer and FTIR were performed initially and 8 groups (n=10) were obtained according to treatments: G1(- control): no-treatment; G2(+control): fluorophosphate; G3(Nd:YAG 60mJ/pulse, 10Hz, 48J/cm2, non-contact); G4(photoabsorber + Nd:YAG 60mJ); G5(Nd:YAG 80mJ/pulse, 10Hz, 64J/cm2); G6(photoabsorber + Nd:YAG 80mJ); G7(Nd:YAG 100mJ/pulse, 10Hz, 80J/cm2); G8(photoabsorber + Nd:YAG 100mJ). De-remineralization cycle were performed for induction of artificial caries and to interferometer, microdurometer and FTIR. Microhardness data were submitted to 2-way ANOVA and Tukey/Dunnett tests 5%. Statistically differences were obtained in the photoabsorberfactor individually and in the interaction between laser and photoabsorber. There was a lower percentage of microhardness loss in the groups with photoabsorber; G8 presented microhardness similar to G2. FTIR data were submitted to T-test 5%. Compared with G2, higher concentrations of carbonate were found in G4, G6 and G8; phosphate in G8; lower Amide-I concentration at G8 and higher Carbonate/Phosphate ratio at G4 and G6. The interferometry results were submitted to 3-way ANOVA of repeated measures 5%. There were statistically differences in the photoabsorber-factor individually and in the time-factor. Photoabsorber decreased the demineralization; Nd:YAG-laser without photoabsorber were less effective than fluoride; Nd:YAG-laser 100mJ with photoabsorber was as effective as fluoride and; the Nd:YAG-laser, associated or not to the photoabsorber, was no more effective than fluoride in the reduction of artificial decay.
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.
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.
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.