Potential mechanism for the laser-fluoride effect on enamel demineralization.

Laser-induced prevention of dental caries has been studied extensively. However, the cariostatic mechanisms of a combined fluoride-laser treatment are not well-understood. Using micro- computed tomography (micro-CT), we quantified the effect of fluoride and/or Er:YAG laser treatment on enamel demineralization. The mean mineral loss (%/V) for each group was 4,870 ± 1,434 (fluoride followed by laser treatment), 6,341 ± 2,204 (laser treatment), 7,669 ± 2,255 (fluoride treatment), and 10,779 ± 2,936 (control). The preventive effect of the laser (p < 0.001) and fluoride (p = 0.010) treatment was statistically significant. Characterized by micro-x-ray diffraction (XRD) analysis, the significant contraction in the a-axis after both laser and combined laser/fluoride treatment was revealed (both p < 0.05). In conclusion, subablative low-energy Er:YAG laser irradiation following fluoride treatment may instantaneously transform enamel hydroxyapatite into fluoridated hydroxyapatite to reduce enamel solubility as a preventive treatment for enamel demineralization.

Screening of CO(2) laser (10.6 µm) parameters for prevention of enamel erosion.

OBJECTIVE: The aim of this study was to screen CO(2) laser (10.6 µm) parameters to increase enamel resistance to a continuous-flow erosive challenge. BACKGROUND DATA: A new clinical CO(2) laser providing pulses of hundreds of microseconds, a range known to increase tooth acid-resistance, has been introduced in the market. METHODS: Different laser parameters were tested in 12 groups (n=20) with varying fluences from 0.1 to 0.9 J/cm(2), pulse durations from 80 to 400 µs and repetition rates from 180 to 700 Hz. Non-lased samples (n=30) served as controls. All samples were eroded by exposure to hydrochloric acid (pH 2.6) under continuous acid flow (60 µL/min). Calcium and phosphate release into acid was monitored colorimetrically at 30 sec intervals up to 5 min and at 1 min intervals up to a total erosion time of 15 min. Scanning electron microscopic (SEM) analysis was performed in lased samples (n=3). Data were statistically analysed by one-way ANOVA (p<0.05) and Dunnett's post-hoc tests. RESULTS: Calcium and phosphate release were significantly reduced by a maximum of 20% over time in samples irradiated with 0.4 J/cm(2) (200µs) at 450 Hz. Short-time reduction of calcium loss (≤1.5 min) could be also achieved by irradiation with 0.7 J/cm(2) (300µs) at 200 and 300 Hz. Both parameters revealed surface modification. CONCLUSIONS: A set of CO(2) laser parameters was found that could significantly reduce enamel mineral loss (20%) under in vitro erosive conditions. However, as all parameters also caused surface cracking, they are not recommended for clinical use.

Prevention of toothbrushing abrasion of acid-softened enamel by CO(2) laser irradiation.

OBJECTIVE: The aim of the present study was to evaluate the effect of CO(2) laser irradiation (10.6µm) at 0.3J/cm(2) (0.5µs; 226Hz) on the resistance of softened enamel to toothbrushing abrasion, in vitro. METHODS: Sixty human enamel samples were obtained, polished with silicon carbide papers and randomly divided into five groups (n=12), receiving 5 different surface treatments: laser irradiation (L), fluoride (AmF/NaF gel) application (F), laser prior to fluoride (LF), fluoride prior to laser (FL), non-treated control (C). After surface treatment they were submitted to a 25-day erosive-abrasive cycle in 100ml sprite light (90s) and brushed twice daily with an electric toothbrush. Between the demineralization periods samples were immersed in supersaturated mineral solution. At the end of the experiments enamel surface loss was determined using a contact profilometer and morphological analysis was performed using scanning electron microscopy (SEM). For SEM analysis of demineralization pattern, cross-sectional cuts of cycled samples were prepared. The data were statistically analysed by one-way ANOVA model with subsequent pairwise comparison of treatments. RESULTS: Abrasive surface loss was significantly lower in all laser groups compared to both control and fluoride groups (p<0.0001 in all cases). Amongst the laser groups no significant difference was observed. Softened enamel layer underneath lesions was less pronounced in laser-irradiated samples. CONCLUSION: Irradiation of dental enamel with a CO(2) laser at 0.3J/cm(2) (5µs, 226Hz) either alone or in combination with amine fluoride gel significantly decreases toothbrushing abrasion of softened-enamel, in vitro.

Influence of the irradiation distance and the use of cooling to increase enamel-acid resistance with Er:YAG laser.

OBJECTIVES: The aim of this study was to assess the influence of irradiation distance and the use of cooling in the Er:YAG laser efficacy in preventing enamel demineralization. METHODS: 84 enamel blocks were randomly assigned to seven groups (n=12): G1: control group - no treatment, G2-G7: experimental groups treated with Er:YAG laser (80mJ/2Hz) at different irradiation distances with or without cooling: G2: 4mm/2mL; G3: 4mm/no cooling; G4: 8mm/2mL; G5: 8mm/no cooling; G6: 16mm/2mL; G7: 16mm/no cooling. The samples were submitted to an in vitro pH cycles for 14 days. Next, the specimens were sectioned in sections of 80-100microm in thickness and the demineralization patterns of prepared slices were assessed using a polarized light microscope. Three samples from each group were analyzed with scanning electronic microscopy. Analysis of variance and the Fisher test were performed for the statistical analysis of the data obtained from the caries-lesion-depth measurements (CLDM) (alpha=5%). RESULTS: The control group (CLDM=0.67mm) was statistically different from group 2 (CLDM=0.42mm), which presented a smaller lesion depth, and group 6 (0.91mm), which presented a greater lesion depth. The results of groups 3 (CLDM=0.74mm), 4 (CLDM=0.70mm), 5 (CLDM=0.67mm) and 7 (CLDM=0.89mm) presented statistical similarity. The scanning electronic microscopy analysis showed ablation areas in the samples from groups 4, 5, 6 and 7, and a slightly demineralized area in group 2. CONCLUSIONS: It was possible to conclude that Er:YAG laser was efficient in preventing enamel demineralization at a 4-mm irradiation distance using cooling.

The caries-preventive potential of subablative Er:YAG and Er:YSGG laser radiation in an intraoral model: a pilot study.

OBJECTIVE: The aim of the present study was to investigate the effect of sub-ablative Er:YAG and Er:YSGG laser radiation on the demineralization of human dental enamel in situ. METHODS: Eighteen enamel specimens were prepared to this end, nine of which were irradiated at 8 J/cm(2) with the Er:YSGG laser and nine at 6 J/cm(2) with the Er:YAG laser (125 pulses per surface). Each test surface was assigned a control surface on the same specimen. Three healthy volunteers from each group subsequently wore three enamel specimens in situ for a period of 1 week. The demineralization was assessed by determining the surface microhardness according to Knoop (KH) before and after wearing. RESULTS: Before wearing, the mean surface hardness measured on the control surfaces was 233 (SD 99) KH (CYSGG) and 162 (SD 59) KH (CYAG). After sub-ablative laser irradiation, the surface hardness values measured were already found to be lower compared to the untreated control surfaces (YSGG: 195 [SD 110] KH/YAG: 112 [SD 72] KH). Marked demineralization was observed on the control surfaces after 1 week of wearing in situ (CYSGG*: 60 [SD 57] KH; CYAG*: 53 [SD 9] KH). After wearing, the hardness on the irradiated test surfaces was ErYSGG*: 133 [SD 58] KH and ErYAG*: 89 [SD 28] KH, and was thus higher than on the control surfaces. CONCLUSIONS: The results indicate a tendency towards increased caries resistance following sub-ablative erbium laser irradiation. However, in an analysis of variance model with repeated measures, the tendency in this study failed to reach statistical significance (alpha = 0.05).

Nd:YAG laser ablation and acid resistance of enamel.

The acid resistance of Nd:YAG laser-ablated enamel surfaces was studied by evaluating crystal structure, mineral distribution, and fluorescence radiance and image in the present study. For comparison, 37% phosphoric acid etching was performed. The formation of beta-tricalcium phosphate (beta-TCP) was confirmed in the laser-ablated surface. The Ca/P ratio increased after ablation due to mineral re-distribution. In contrast, the Ca/P ratio decreased after acid etching due to mineral loss. The laser-ablated enamels showed a smaller increase of fluorescence radiances and less clear laser confocal scanning microscope images than those observed in the acid-etched enamels. The former suggests a minimized mineral loss. The Nd:YAG laser irradiation will enhance the acid resistance and retard the carious progression in enamel.

Influencia de la radiación láser sobre la inducción de caries / Influence of caries radiation in laser induction

En el presenta trabajo se estudia la acción de la radiación láser de 10,6 mum sobre la solubilización del esmalte provocada por solución amortiguadora de acetato y lactato. Los resultados del trabajo indican que hay una influencia de la radiación láser sobre el proceso de solubilización mientras participa en el mismo sóla la superficie del esmalte y que este efecto se pierde cuando participa todo su volumen (AU)

Influencia de la radiación láser sobre la inducción de caries / Influence of caries radiation in laser induction

En el presenta trabajo se estudia la acción de la radiación láser de 10,6 mum sobre la solubilización del esmalte provocada por solución amortiguadora de acetato y lactato. Los resultados del trabajo indican que hay una influencia de la radiación láser sobre el proceso de solubilización mientras participa en el mismo sóla la superficie del esmalte y que este efecto se pierde cuando participa todo su volumen

The effect of normal pulsed Nd-YAG laser irradiation on pits and fissures in human teeth.

The effects of normal pulsed Nd-YAG laser irradiation on the acid resistance of human dental enamel of pits and fissures, the cleaning of the pit and fissure contents and fluoride uptake into deep pits and fissures were examined. The acid resistance of the pit and fissure enamel was evaluated by the amount of dissolved calcium per square millimeter of the surface area. The pit and fissure enamel treated with laser irradiation obtained an acid resistance 30% higher than that of the unlased controls. The cleaning effect of laser irradiation on the pit and fissure contents was compared with chemicomechanical and mechanical methods. The laser irradiation was found to clean the pits and fissures to a greater depth without alterating the shape of pits and fissures, compared with the other two methods. The distribution of calcium, phosphorus and fluoride in the enamel of the pits and fissures was then measured by electron probe microanalyzer. At the entrance and in the deep part of the pits and fissures, the fluoride content of the enamel treated with acidulated phosphate fluoride after laser irradiation was higher than that of the enamel treated with acidulated phosphate fluoride alone. These results thus suggest that Nd-YAG laser irradiation might be effective in increasing the acid resistance of the pit and fissure enamel, while removing the pit and fissure debris contents and increasing the fluoride uptake into the pit and fissure enamel.

[The effect of the light from a helium-neon laser on normal dental enamel solubility and in caries]. / Vliianie sveta gelii-neonovogo lazera na rastvorimost' émali zubov v norme i pri kariese.

Effects of He-Ne laser radiation at a wavelength 0.63 micron for 90 sec on dental enamel mineral metabolism were studied from Ca, P levels and Ca/P ratio in 67 children aged 3 to 7. Ca and P solubility in surface enamel layers was found reduced after He-Ne laser irradiation in both healthy children and those with caries. Laser was found to normalize the oral fluid mineral composition.