Dental enamel irradiated with infrared diode laser and photo-absorbing cream: part 2--EDX study.

OBJECTIVE: The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (micro-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). BACKGROUND DATA: Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive micro-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. MATERIALS AND METHODS: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (lambda = 810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using micro-EDX after two sets of treatments and pH cycling cariogenic challenges. RESULTS: The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. CONCLUSION: micro-EDX may be able to detect compositional changes in mineral phases of lased enamel under cariogenic challenge. Our results suggest that with a combined laser and photo-absorbing agent (CL) treatment, there was a possible disorganization of organic content in the tooth enamel with hydroxyapatite crystal reordering and reorganization.

Dental enamel irradiated with infrared diode laser and photoabsorbing cream: Part 1 -- FT-Raman Study.

OBJECTIVE: The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. BACKGROUND DATA: Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. MATERIALS AND METHODS: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm(2) for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. RESULTS: There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). CONCLUSION: The FT-Raman technique may be suitable for detecting compositional and structural changes occurring in mineral phases and organic phases of lased enamel under cariogenic challenge.

Surface morphology of sound deciduous tooth enamel after application of a photo-absorbing cream and infrared low-level laser irradiation: an in vitro scanning electron microscopy study.

OBJECTIVES: The purpose of this descriptive scanning electron microscopic study was to characterize surface alterations in deciduous tooth enamel after in vitro infrared diode laser irradiation, using a photo-absorbing agent alone and also combined with fluoride, before and after laser irradiation. BACKGROUND DATA: Previous investigations have demonstrated increased enamel caries resistance after laser irradiation. METHODS: Seven extracted or exfoliated primary molar teeth underwent soft tissue débridement and fluoride-free prophylaxis. Buccal surfaces were determined to be caries free by macroscopic examination. Sample groups were divided into: (1) control (no treatment); (2) infrared diode laser irradiation (lambda = 810 nm, 68 nm, 60 mW/mm(2), 30 W) using the photo-absorbing agent alone (IRDL + PA; 500 J/cm(2)); and (3) infrared diode laser irradiation using a photo-absorbing agent combined with 2% fluoride (IRDL + PFA; 500 J/cm(2)). Buccal surfaces were evaluated following standard scanning electron microscopy preparation techniques. Control samples of enamel surfaces were relatively smooth but presented occasional enamel prism ends. There were no areas with cavitations or surface defects. RESULTS: After the IRDL + PA treatment, irradiated surfaces became rough and mildly to moderately irregular with scarce enamel cavitations and without exposure of enamel prism ends. The surfaces had adherent granules and only occasional fine cracks and porosities in surface coatings were noted. After the IRDL + PFA treatment, there was a homogenous confluent surface that masked typical enamel surface markings. The surfaces had well-defined globules resulting from the IRDL + PFA treatment, that were not seen after IRDL + PA treatment. CONCLUSIONS: Treatment of deciduous tooth enamel with infrared diode laser irradiation using a photo-absorbing agent and a photo-absorbing agent combined with 2% fluoride created surface coatings that may act as reservoirs for mineral phases during cariogenic activity on enamel, and also provide a certain degree of protection against cariogenic challenge.