Evaluation of cutting efficiency and thermal damage during soft tissue surgery with 940 nm-diode laser: An ex vivo study.

OBJECTIVES: To investigate quantitatively the cutting efficiency and the thermal effects in the surrounding soft tissues of incisions that are induced by a 940 nm-diode laser with different power settings. MATERIALS AND METHODS: Fifty-four gingival samples were prepared from the lower jaws of freshly slaughtered German-land race pigs and were randomly divided into 9 groups (n = 6) according to the adjusted output power (1, 1.5, 2, 2.5, 3, 3.5, 4, 5 and 6 W). Five incisions were implemented for each sample using a diode laser (940 nm) in continuous wave with an initiated tip resulting in 30 incisions for each experimental group utilizing a three-dimensional computer-controlled micropositioner. The samples were prepared for histometric evaluation using a transmitted light microscope. The cutting depth and width and the thermal damage were recorded for each sample and the efficiency factor γ was calculated. RESULTS: The highest cutting efficiency (γz = 0.81 ± 0.03) exhibited the group with 5 W output power (p < 0.05), while the lowest (γz = 0.45 ± 0.11) showed the 1-W group (p < 0.05). Over 3.5 W there was a rapid increase in the size of thermal damage of the incisions, especially for 6 W, which presented the largest. CONCLUSIONS: The most effective power parameters of diode laser (940 nm) for soft tissue surgery were from 3 to 5 W. The outcomes of the current study may help to establish clinical protocols for the use of diode lasers (940 nm) in soft tissue surgery in contact mode assisting dental professionals to achieve optimal clinical results and avoid complications.

Quantitative determination of cut efficiency during soft tissue surgery using diode lasers in the wavelength range between 400 and 1500 nm.

Within the scope of this ex vivo study, the cut efficiency was investigated with eight diode laser wavelengths in the range from 400 to 1500 nm. Incisions on porcine gingiva samples were generated in CW-mode at a power range of 0.5-4 W using a bare fiber (∅ = 320 µm) in contact and non-contact mode at a cut speed of 2 mm/s. Cut depths, cut widths, and thermal damages were recorded based on histological sections and were evaluated via measurement masks. Moreover, with respect to the controllability of a therapeutic measure, an efficiency factor was defined. At powers above 2 W, for 445 nm, the maximum cut depth was 820 µm and 344 µm for 810 nm, respectively. At all wavelength and power ranges, the cut width averaged 125 µm. At minimum output power (0.5 W), the spatial expansion of the thermal damage in the tissue surface layer corresponds in the blue/green wavelength range from the very beginning of the laser impact to the fiber core diameter. It could be shown that increases in the diode laser power output do not correlate to the same extent with the incision depth nor with thermal damage to tissue.

Laser-assisted prevention of enamel caries: a 10-year review of the literature.

Since the invention of lasers in dentistry, investigations in caries prevention by the use of laser radiation have been proposed. There are several mechanisms stated for this purpose such as photothermal and/or photochemical interaction processes with the enamel. Alone or in conjugation with topical fluoride application, this treatment modality may improve enamel acid resistance in high-caries-risk populations. Data collection was done by searching the keywords caries, prevention, and laser in PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar. Lasing protocols of the collected literature and their effectiveness as well as examination methods used to verify treatment outcomes have been evaluated. One hundred eighteen publications were found for the last 10 years. The wavelengths investigated for caries prevention are mainly located in the near and the mid-infrared spectral range. In the evaluated period of time, investigations using CO2; Er:YAG; Er,Cr:YSGG; Er:YLF; fundamental, second, and third harmonic generations of Nd:YAG; diodes; and argon ion lasers were found in the databases. Accounting for 39% of the literature, CO2 laser was the most examined system for this purpose. Reviewing the literature in this narrative review showed that all laser systems presented a positive effect in varying degrees. Laser irradiation could be an alternative or synergistic to topical fluoridation for enamel caries prevention with longer lasting effect. Further research should be focused on selecting proper laser settings to avoid damage to enamel and developing effective evidence-based clinical protocols.

Effectiveness of photopolymerization in composite resins using a novel 445-nm diode laser in comparison to LED and halogen bulb technology.

Challenges especially in the minimal invasive restorative treatment of teeth require further developments of composite polymerization techniques. These include, among others, the securing of a complete polymerization with moderate thermal stress for the pulp. The aim of this study is to compare current light curing sources with a blue diode laser regarding curing depth and heat generation during the polymerization process. A diode laser (445 nm), a LED, and a halogen lamp were used for polymerizing composite resins. The curing depth was determined according to the norm ISO 4049. Laser output powers of 0.1, 0.5, 1, and 2 W were chosen. The laser beam diameter was adapted to the glass rod of the LED and the halogen lamp (8 mm). The irradiation time was fixed at 40 s. To ascertain ΔT values, the surface and ground area temperatures of the cavities were simultaneously determined during the curing via a thermography camera and a thermocouple. The curing depths for the LED (3.3 mm), halogen lamp (3.1 mm) and laser(0.5/1 W) (3/3.3 mm) showed no significant differences (p < 0.05). The values of ΔTsurface as well as ΔTground also showed no significant differences among LED, halogen lamp, and laser(1 W). The ΔTsurface values were 4.1LED, 4.3halogen lamp, and 4.5 °C for the laser while the ΔTground values were 2.7LED, 2.6halogen lamp, and 2.9 °C for the laser. The results indicate that the blue diode laser (445 nm) is a feasible alternative for photopolymerization of complex composite resin restorations in dentistry by the use of selected laser parameters.

A novel blue light laser system for surgical applications in dentistry: evaluation of specific laser-tissue interactions in monolayer cultures.

OBJECTIVES: The objective of this study was to examine a new blue light diode laser system (445 nm) for dental soft tissue surgery on cellular level. MATERIALS AND METHODS: An in vitro cell culture model was established to evaluate the effects of the 445-nm diode laser in comparison to an established infrared diode laser (IR). Monolayer cell cultures were irradiated and wound healing was morphometrically measured. Fluorescence staining was used for proof of potential DNA double-strand breaks as well as cytoskeleton alterations. Cellular live/dead discrimination was performed and temperature development during laser irradiation was measured with a thermographic infrared camera. RESULTS: A characteristic zone formation was detected after irradiation with both wavelengths. Despite a larger wound area after irradiation with 445 nm, due to its higher temperature development, this laser system showed a faster wound healing in comparison to the IR laser. No increase of devitalized cells was documented with higher distances between laser tip and cell layer and thus without thermal interaction. Neither cytoskeleton alteration nor DNA double-strand breaks could be recorded after irradiation in non-contact mode. CONCLUSIONS: The blue diode laser system demonstrated an excellent direct thermal coupling to cells and tissues without side effects even by reduced power settings. CLINICAL RELEVANCE: The blue diode laser seems to be a promising technology for clinical application due to high absorption of blue light without major side effects in adjacent tissues even by reduced power settings.

Imaging of Dental Hard Tissue Surfaces Prepared by an Ultrashort Pulsed Laser System (USPL).

The aim of this study was to compare surface structures of laser-irradiated dental hard tissues using confocal (CFM), atomic force (AFM), and scanning electron microscopy (SEM). The general potential of the AFM in analyzing laser-irradiated surfaces was determined in this context. Specimens of human enamel and dentin were irradiated using an 8.6 W Nd:YVO4 laser with a pulse duration of 8 ps, λ Center=1,064 nm, and a pulse repetition rate of 500 kHz. Surface topology of irradiated areas (1 mm2) was investigated using AFM, CFM, and SEM. Surface roughness R z was measured only with the AFM and the CFM. For non-irradiated enamel and dentin surfaces, roughnesses for CFM and AFM are in the nanometer range. However, major differences in roughness were determined for laser-prepared surfaces. For enamel, R z (CFM)=2.33 µm is much higher compared with R z (AFM)=0.09 µm; in the case of dentin, R z (CFM)=5.35 µm is also much higher compared with R z (AFM)=0.093 µm. Information regarding structural properties of surfaces needs real dimensions, particularly for use in dentistry. In this respect, AFM technology provides no additional results that lead to a significant improvement.

Ablation of porcine bone tissue with an ultrashort pulsed laser (USPL) system.

Ultrashort pulsed lasers (USPLs) represent a new generation of laser systems in the field of biophotonical applications. In terms of a pilot project, the study was carried out to evaluate the ablation parameters of bone tissue regarding the medical use of such a laser technology in dentistry. Specimens from ribs of freshly slaughtered pigs were assembled and irradiated with an USP Nd:YVO4 laser (pulse duration 8 ps at 1,064 nm with repetition rates between 50 and 500 kHz) using eligible average output powers in the range of 3.5-9 W and fluences between 1 and 2.5 J/cm(2). Square-shaped cavities of 1-mm edge length in the bone compacta were created employing a scanner system. Cavities were analyzed with an optical profilometer to determine the ablated volume. Ablation rate was calculated by the ablated volume and the recorded irradiation time by the scanner software. Additionally, samples were examined histologically to investigate side effects of the surrounding tissue. Formed cavities showed a precise and sharp-edged appearance in bone compacta. Optimized ablation rate of 5.2 mm(3)/min without any accompanying side effects was obtained with an average output power of 9 W, a pulse repetition rate of 500 kHz, and an applied fluence of 2.5 J/cm(2). Provided that the used laser system will be advanced and adjusted for clinical applications, the outcome of this study shows auspicious possibilities for the use of USPL systems in the preparation of bone tissue.

Ablation of carious dental tissue using an ultrashort pulsed laser (USPL) system.

The aim of the study was to investigate the efficiency of caries removal employing an ultrashort pulsed laser (USPL) and to compare the results regarding to the ablation rate of sound enamel and dentin including surface texture. The study was performed with 59 freshly extracted carious human teeth. Two cavities with an edge length of 1 × 1 mm per tooth were created: one in the dental decay and one in sound hard tissue. For this purpose a 9-W Nd:YVO4 laser with a center wavelength of 1,064 nm and a pulse duration of 8 ps at a repetition rate of 500 kHz was used. A scanner system moved the laser beam across the surface with a scan speed of 2,000 mm/s. Ablated volume and roughness R z of the cavity ground were measured using an optical profilometer. Subsequently, the specimens were cut to undecalcified sections for histological investigations. The removal of dental decay (dentin, 14.9 mm(3)/min; enamel, 12.8 mm(3)/min) was significantly higher (p < 0.05) compared to the removal of sound tissues (dentin, 4.2 mm(3)/min; enamel, 3.8 mm(3)/min). The arithmetic means of the surface roughness R z were 8.5 µm in carious enamel, 15.43 µm in carious dentin, 4.83 µm in sound enamel and 5.52 µm in sound dentin. Light microscopic investigations did not indicate any side effects in the surrounding tissues. Regarding the ablation rate of dental decay using the USPL system, caries removal seems to be much more efficient for cavity preparation.

Ultrashort pulsed laser (USPL) application in dentistry: basic investigations of ablation rates and thresholds on oral hard tissue and restorative materials.

Modern ultrashort pulse lasers with scanning systems provide a huge set of parameters affecting the suitability for dental applications. The present study investigates thresholds and ablation rates of oral hard tissues and restorative materials with a view towards a clinical application system. The functional system consists of a 10 W Nd:YVO4 laser emitting pulses with a duration of 8 ps at 1,064 nm. Measurements were performed on dentin, enamel, ceramic, composite, and mammoth ivory at a repetition rate of 500 kHz. By employing a scanning system, square-shaped cavities with an edge length of 1 mm were created. Ablation threshold and rate measurements were assessed by variation of the applied fluence. Examinations were carried out employing a scanning electron microscope and optical profilometer. Irradiation time was recorded by the scanner software in order to calculate the overall ablated volume per time. First high power ablation rate measurements were performed employing a laser source with up to 50 W. Threshold values in the range of 0.45 J/cm(2) (composite) to 1.54 J/cm(2) (enamel) were observed. Differences between any two materials are statistically significant (p < 0.05). Preparation speeds up to 37.53 mm(3)/min (composite) were achieved with the 10 W laser source and differed statistically significant for any two materials (p < 0.05) with the exception of dentin and mammoth ivory (p > 0.05). By employing the 50 W laser source, increased rates up to ∼50 mm(3)/min for dentin were obtained. The results indicate that modern USPL systems provide sufficient ablation rates to be seen as a promising technology for dental applications.

Influence of Cementation on the Aesthetical Appearance of Full-Ceramic Restorations.

The use of dental ceramics as restorative materials requires corresponding luting materials (cements) that, in turn, influence the visual appearance of the restoration. Due to the high light transmission through the ceramics, the cements can affect the color perception of the dental restoration. This study aims to investigate the optical effects of various cements on the visual appearance of full-ceramic restorations. Three fixing polymer resins (Bifix SE (VOCO GmbH, Cuxhafen, Germany), BreezeTM (Pentron Clinical, West Collins Orange, CA, USA), and PanaviaTM F. 2.0 (Kuraray, Noritake, Osaka, Japan)), with layer thicknesses of 50, 100, 200, and 250 µm, were applied onto a ceramic base model (0.4 mm thick), and irradiated with laser light of wavelengths 532, 632.8, and 1064 nm. Light intensities and scattering effects of light of various wavelengths were angle-dependent, analyzed using a goniophotometer with perpendicular light incidence on the sample specimen (base model plus luting material). In addition, the transmitted power of the light through the sample specimen was determined as a function of the layer thickness. With increasing layer thickness, power losses of respectively 30% for Bifix SE and BreezeTM in the visible spectral range were comparable, whereas PanaviaTM F. 2.0 showed a power loss of ca. 44% here. For the near-infrared range, the power losses for all cements were 25%. This could be confirmed by the interpretation of the line widths. Moreover, the line widths for thin cement layer thicknesses (50 and 100 µm) in the visible spectral range displayed only a redistribution of light by scattering, which does not affect color perception at all. In addition, at 200 and 250 µm, absorption occurred which causes a change in color perception. Within the scope of this study, it could be shown that for thin-layer thicknesses of the cement applied here, there is no adverse optical effect on the aesthetic visual appearance of the restoration.

Comparative evaluation of different debonding and reconditioning methods for orthodontic ceramic brackets regarding effectiveness for reuse : An in vitro study.

PURPOSE: To investigate the reusability of ceramic brackets in terms of shear bond strength, friction behavior, slot dimension, fracture strength, and color stability. METHODS: A total of 90 conventionally debonded and 30 by an Er:YAG laser debonded ceramic brackets were collected. All the used brackets were inspected under a stereomicroscope at 18 נmagnification and sorted according to their adhesive remnant index (ARI). Five groups were formed (n = 10): (1) new brackets as a control group, (2) flamed and sandblasted, (3) flamed and acid bathed, (4) laser-reconditioned, and (5) laser-debonded brackets. The bracket groups were tested regarding different properties such as shear bond strength, friction behavior, slot size, fracture strength, and color stability. Analysis of variance (ANOVA) and nonparametric Kruskal-Wallis tests were used for statistical analysis (significance level: p < 0.05). RESULTS: Shear bond strength values of the acid reconditioned brackets were significantly lower (8.0 ± 3.1 MPa) compared to the control group (12.9 ± 2.9 MPa). Laser-reconditioned (32.8 ± 2.7%) and laser-debonded (30.9 ± 2.4%) brackets showed the lowest force loss due to friction (control group 38.3 ± 3.0%). No significant differences were observed between groups regarding slot size and fracture strength. All groups had color differences of [Formula: see text]< 10. Scanning electron microscope images and ARI scores indicated that most of the residues on the bracket bases were removed. CONCLUSION: All reconditioning methods yielded adequate results regarding bracket properties. Yet, focusing on the need to protect the enamel and the bracket base, laser debonding seems to be the most suitable method for reconditioning ceramic brackets.

A Comparative Histological Study of Gingival Depigmentation by 808 and 445 nm Diode Lasers.

Introduction: Using lasers in melanin depigmentation is one of the main fields of interest for dental practitioners and patients. However, it is important to know what would happen inside the tissue and how the cells would interact inside the tissue with a laser. Methods: In this study, we used both wavelengths of 445 nm and 808 nm on sheep gingiva to find out the effects and side effects of these diode lasers while using them for gingival depigmentation. Results: After microscopic evaluation, we concluded that 808 nm and 445 nm lasers with a power of 1 W are safe enough to use in the depigmentation of gingiva, and both lasers are highly effective in melanin pigments which are located in basal membrane. Conclusion: The 445 nm blue laser produced a less thermal effect, which means it is safer to be used in gingival hyperpigmentation than a diode laser.

Comparison of the Diode Laser Wavelengths 445 nm and 810 nm in Gingival Depigmentation - A Clinical Evaluation.

Introduction: Nowadays, esthetic appearance plays an important role in the field of dentistry. Discolorations and pigmentations of the gingiva reduce the appearance of a healthy-looking smile. On this occasion, the use of lasers shows a promising approach for a fast and non-aggressive treatment in this field. Different laser wavelengths are being used for gingival depigmentation this clinical study aimed to investigate the effect of the novel laser wavelength (445 nm) in this field and compare it with an 810 nm diode laser. Methods: Two diode laser wavelengths (445 nm and 810 nm) were used for depigmentation. The laser output power chosen was 1 W. An optical fiber with a diameter of 400 µm was used. 21 patients with pigmented gingiva were selected. Depigmentation was carried out in a split-mouth design for a direct comparison of the clinical effect. Outcomes were documented by photograph after one month and six months of follow-up. Results: For each wavelength, 21 volunteers evaluated 21 clinical cases of depigmentation, which means that 441 comparisons were carried out in total regarding the color change from brownish to pinkish. A 100% clarification was achieved for 445 nm. In the 810 nm group, the color change in 44 of 441 cases (10%) could not be clearly identified. No statistically significant difference in pain experience was reported for both laser treatments. Conclusion: The clinical evaluation showed that within the limitations of this study, most of the clinical outcome parameters were highly acceptable by the patients due to mild pain and discomfort for both laser systems.

Transmission of 940 nm diode laser to the radicular area during its application as root canal disinfectant.

To measure the transmitted laser power in the coronal, middle and apical root thirds during vertical and horizontal irradiation of laser. 14 mm length whole roots and longitudinal root sections were irradiated using a 940 nm diode laser with 0.5 W in continuous mode for 5 s. A power detector was placed in front of the root apex for the vertical transmitted power measurement and placed laterally to root surface for the horizontal transmission experiment. The transmitted power from the root apex vertically was 53% of the irradiated power, while for the horizontal transmission experiment for the coronal, middle and apical root thirds were 25.6%, 40.4% and 41.3%, respectively. Irradiation of root canals with 940 nm laser power can be transmitted during vertical irradiation in more than 50% of the samples, whereas less transmission happens with horizontal irradiation at apical and middle root third than coronal.

Bactericidal effect of a Nd:YAG laser on Enterococcus faecalis at pulse durations of 15 and 25 ms in dentine depths of 500 and 1,000 µm.

The success of endodontic treatment depends on the effective elimination of microorganisms from the root canal, and lasers provide more effective disinfection than conventional treatment using rinsing solutions. The objective of this in vitro study was to determine the bactericidal effect of laser irradiation in dentine of various depths at a wavelength of 1,064 nm and pulse durations of 15 and 25 ms. A total of 90 dentine slices were cut from bovine incisors and divided into two groups (45 slices each) of thickness 500 and 1,000 µm. All were inoculated with a suspension of Enterococcus faecalis (5.07 × 10(9) bacteria/ml). Based on the clinically accepted dose (approximately 300 J/cm(2)), the following laser settings were chosen for this study: 1.75 W, 0.7 Hz for 4 s, three repetitions. The two groups were divided into two subgroups of 15 slices each to be irradiated with pulse durations of 15 and 25 ms. The remaining 15 slices per group were not irradiated to serve as a control. After irradiation, the colony-forming units (CFU) were counted and evaluated. To determine the bactericidal effect of irradiation with different pulse durations, the results in the different groups were compared statistically. For all irradiated subgroups a bactericidal effect was observed at pulse durations of 15 and 25 ms (p=0.0085 and p<0.0001). The corresponding average log kills were 0.29 (15 ms) and 0.52 (25 ms) for 500 µm and 0.15 and 0.3 for 1,000 µm, respectively. The results of this in vitro study showed that Nd:YAG laser irradiation with a pulse duration of 15 ms eliminated an average of 49% and 29% of E. faecalis at dentine depths of 500 µm and 1,000 µm, respectively, and irradiation with a pulse duration of 25 ms eliminated 70% (500 µm) and 50% (1,000 µm). However, these values are lower than those achieved with the established protocol using microsecond pulses.

Laser-assisted in-office bleaching using a neodymium:yttrium-aluminum-garnet laser: an in vivo study.

The desire for perfect and white teeth can be accomplished in aesthetical dentistry by modern tooth bleaching methods. Within the scope of a clinical study, laser assisted in-office bleaching was applied to the teeth of 20 individual patients with a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (lambda = 1.064 microm, average power 4 W, pulse repetition rate 10 Hz, pulse duration 320 micros). The treatment was carried out in a split-mouth design, each patient having two appointments with 1 week in between. Laser activation of the bleaching agent was performed on teeth 14-11 and 34-31 per session, with a total irradiation time of 30 s per tooth. The initial and the final color of the teeth were ascertained by VITA Colorsticks and the dental chromatometer ShadeEye NCC. Whitening was detected in the laser-activated and in the non-activated quadrants. Statistical evaluation showed that the additional activation of the bleaching agent by the Nd:YAG laser had produced no significant influence on the whitening (P > 0.05). The results achieved in this study should be scrutinized critically. They give cause for one to reconsider the treatment conditions or the laser parameters used, or even to query the application of the Nd:YAG laser in general during in-office bleaching.

First clinical application of a liquid-core light guide connected to an Er:YAG laser for oral treatment of leukoplakia.

For medical applications, erbium lasers are usually equipped with articulated mirror arms or special glass fibers. However, only with mirror arms is it so far possible to transmit high average powers or pulse energies in the region of 1 J to achieve suitable energy densities for fast tissue preparation. An alternative to the glass fiber systems mentioned above are liquid-core light guides. An extremely flexible liquid-core light guide was used to connect a dental Er:YAG laser system to an especially adapted dental laser applicator. The core liquid was continuously circulated during laser irradiation to transmit pulse energies up to 1.1 J. A modified laser handpiece was used for exemplary clinical treatment. The experimental setup with the highly flexible light guide was completed successfully, and its ease of handling for a dental surgeon was demonstrated in the clinical treatment of leukoplakia of the oral cheek mucosa. Complete ablation of the epithelium with the laser was performed. One year postoperatively, the patient remains disease-free. This article describes the technical realization of a liquid-core light guide system for medical applications. We report about the first successful clinical treatment of oral hyperkeratosis using this new light guide technology.

Cavity Disinfection With a 445 nm Diode Laser Within the Scope of Restorative Therapy - A Pilot Study.

Introduction: Cavity disinfection is necessary to prevent a progressive infection of the crown dentin and pulp. Increasing intolerance and resistance to antiseptics and antibiotics as well as the controversy over the effects of those on the dental hard tissue and composite have prompted the investigation of alternative treatment options. The objective of this pilot study is to evaluate the antibacterial potential of a diode laser with a wavelength of 445 nm in the cavity preparation using the bacterium Streptococcus salivarius associated with caries in conjunction with the characteristics and influences of dentin on light transmission. Methods: The bactericidal effect of the laser irradiation was determined in culture experiments by using caries-free human dentin samples on bacteria-inoculated agar. For this, dentin discs (horizontally cut coronal dentin) of 500 µm and 1000 µm thicknesses were produced and irradiated with the laser with irradiation parameters of 0.7-1 W in a cw-mode and exposure times of between 5-30 s. Based on the different sample thicknesses, the penetration depth effect of the irradiation was ascertained after the subsequent incubation of the bacteria-inoculated agar. Additional influential parameters on the irradiation transmission were investigated, including surface moisture, tooth color as well as the presence of a smear layer on the dentin surface. Results: The optical transmission values of the laser radiation for dentin were significantly dependent on the sample thickness (P = 0.006) as well as its moisture content (P = 0.013) and were independent of the presence of a smear layer. There was a 40% reduction in bacteria after the radiography of the 500-µm-thick dentin samples, which was shown as the lowest laser dose (443 J/cm2). Conclusion: These findings indicate that the diode laser with light emission at a wavelength of 445 nm is interesting for the supportive cavity disinfection within the scope of caries therapy and show potential for clinical applications.

Combined effects of a topical fluoride treatment and 445 nm laser irradiation of enamel against a demineralization challenge: A light and electron microscopic ex vivo study.

This study investigated the caries-preventive effect of 445 nm laser radiation in combination with fluoride on the prevention of white spot lesions. Previously, several studies have indicated the ability of 488 nm argon ion laser irradiation to reduce early enamel demineralization. A diode laser (445 nm) could be an alternative technology for possible caries-preventive potential. Each sample of a group of seventeen caries-free bovine teeth was treated in four different ways on four different zones of the labial surface: control/no treatment (C), laser irradiation only (L) (0.3 W, 60 s and applied dose of 90 J/cm2), amine fluoride application only (10,000 ppm and pH 3.9) (F), and amine fluoride application followed by laser irradiation (FL). After treatment, the teeth were subjected to a demineralization solution (pH 4.3 for 48 h at 37 °C) to induce subsurface lesions. After sectioning, the teeth were examined by light microscopy. Three teeth were analyzed by scanning electron microscopy (SEM). The depths of the subsurface lesions in the C, L, F, and FL groups were 103.01 (± 13.04), 96.99 (± 14.51), 42.59 (± 17.13), and 24.35 (± 11.38) µm, respectively. The pairwise group comparison showed the following results: p < 0.001 for FL versus C, FL versus L, F versus C, and F versus L, p = 0.019 for FL versus F and p = 0.930 for L versus C. The SEM micrographs support the light-microscopic examination. The results of the current study have shown that using relatively low irradiation settings of 445 nm laser on fluoridated enamel may be effective for prevention of white spot lesions.