Effect of CO2 laser on root caries inhibition around composite restorations: an in vitro study.

The aim of the present study was to investigate the in vitro effect of CO2 laser on the inhibition of root surface demineralization around composite resin restorations. For this purpose, 30 blocks obtained from human molar roots were divided into three groups: group 1 (negative control), cavity prepared with cylindrical diamond bur + acid etching + adhesive + composite resin restoration; group 2, cavity prepared with cylindrical diamond bur + CO2 laser (5.0 J/cm(2)) + acid etching + adhesive + composite resin; and group 3, cavity prepared with cylindrical diamond bur + CO2 laser (6.0 J/cm(2)) + acid etching + adhesive + composite resin. After this procedure, the blocks were submitted to thermal and pH cycling. Root surface demineralization around the restorations was measured by microhardness analysis. The hardness results of the longitudinally sectioned root surface were converted into percentage of mineral volume, which was used to calculate the mineral loss delta Z (ΔZ). The percentage of mineral volume, ΔZ, and the percentage of demineralization inhibition of the groups were statistically analyzed by using analysis of variance and Tukey-Kramer test. The percentage of mineral volume was higher in the irradiated groups up to 80 µm deep. The ΔZ was significantly lower in the irradiated groups than in the control group. The percentage of reduction in demineralization ranged from 19.73 to 29.21 in position 1 (50 µm), and from 24.76 to 26.73 in position 2 (100 µm), when using 6 and 5 J/cm(2), respectively. The CO2 laser was effective in inhibiting root demineralization around composite resin restorations.

CO2 laser inhibitor of artificial caries-like lesion progression in dental enamel.

Several studies during the last 30 years have demonstrated the potential of laser pre-treatment of enamel or tooth roots to inhibit subsequent acid-induced dissolution or artificial caries-like challenge in the laboratory. The overall objective of ongoing studies in our laboratories is to determine, systematically, the optimum sets of parameters for carbon dioxide laser irradiation that will potentially effectively inhibit dental caries in enamel and tooth roots. The aim of the present study was to examine the roles of wavelength and fluence in the prevention of caries progression in vitro in enamel by means of a pH-cycling model. The hypothesis to be tested was that the highly absorbed 9.3- and 9.6-microm wavelengths would be efficiently converted to heat, creating a temperature sufficiently high to reduce the acid-reactivity of the mineral and inhibit caries-like lesion progression in dental enamel. One hundred and sixty caries-free tooth crowns were cleaned and varnished with acid-resistant varnish, leaving one exposed window of enamel. Twelve groups of 10 enamel samples were irradiated in their individual windows by one of the four wavelengths (9.3, 9.6, 10.3, or 10.6 microm) of a tunable CO2 laser. Energy per pulse was 25, 50, 100, 200, or 250 mJ (25 pulses). Repetition rate was 10 Hz, and beam diameter was 1.6 mm. Fluence conditions of 1 to 12.5 J/cm2 per pulse were produced. All teeth, including 40 non-irradiated controls, were subjected to pH-cycling to produce artificial caries-like lesions. Results were assessed by cross-sectional microhardness testing. Inhibition of caries progression of from 40% to 85% was achieved over the range of laser conditions tested. At 9.3 and 9.6 microm, 25 pulses at absorbed fluences of 1 to 3 J/cm2 produced inhibition on the order of 70% with minimal subsurface temperature elevation (< 1 degree C at 2 mm depth), comparable with inhibition produced in this model with daily fluoride dentifrice treatments. Safety and efficacy studies will be required in animals and humans before these promising laboratory results can be applied in clinical practice.

Comparison between Er:YAG laser and conventional technique for root caries treatment in vitro.

Effective ablation of dental hard tissues by means of the erbium-doped:yttrium-aluminum garnet (Er:YAG) laser has been reported recently, and its application to caries removal and cavity preparation has been expected. However, few studies have investigated the capability of the Er:YAG laser to treat caries. In the present study, the effectiveness of caries removal by using an Er:YAG laser in vitro was compared with that of conventional mechanical treatment. Thirty-one extracted human teeth with root caries were used. Half of the caries in each tooth was treated with the Er:YAG laser, and the other was removed with a conventional bur or was left untreated as a control. Laser treatment was performed by means of a combination of contact and non-contact irradiation modes with cooling water spray, with a new fiber delivery and contact probe system. Conventional bur treatment was conducted by means of a low-speed micromotor. Measurements of the time required for caries removal, histopathological observations of decalcified serial sections, scanning electron microscope (SEM) observations, and hardness measurements of the treated cavity-floor dentin were performed for each treatment. Due to the careful irradiation technique, a longer treatment time was required for the complete removal of carious dentin by the Er:YAG laser. However, the Er:YAG laser ablated carious dentin effectively with minimal thermal damage to the surrounding intact dentin, and removed infected and softened carious dentin to the same degree as the bur treatment. In addition, a lower degree of vibration was noted with the Er:YAG laser treatment. The SEM examination revealed characteristic micro-irregularities of the lased dentin surface. Our results show that the Er:YAG laser system is promising as a new technical modality for caries treatment.