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Moshkelgosha V, Zandian R, Sohrabi M, Fekrazad R. Effect of CO 2 Laser-Assisted Titanium Tetra-fluoride on Demineralization of Enamel Around Orthodontic Brackets. J Lasers Med Sci 2024; 15:e9. [PMID: 39050994 PMCID: PMC11267097 DOI: 10.34172/jlms.2024.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/30/2024] [Indexed: 07/27/2024]
Abstract
Introduction: One of the clinical problems following orthodontic treatment is white spot lesions around orthodontic brackets due to enamel demineralization. Confronting enamel demineralization during fixed treatments has long been a challenge for orthodontists. The aim of this in vitro study was to evaluate the effect of CO2 laser and Titanium Tetra-fluoride (TiF4) application on the prevention of enamel demineralization around orthodontic brackets. Methods: Eighty permanent premolars were selected and bonded with brackets. They were randomly divided into four groups (n=20): topical titanium tetra-fluoride gel 4% (TiF4), CO2 laser (10.6 μm wavelength for 10 seconds, peak power=291 W), fluoride+laser (F+L) and control (C). All specimens were demineralized for 10 days in a 0.2 M acetate buffer solution. The mean lesion depths were determined by using polarized light microscopy. Results: The mean depth of lesion was the highest in the C group and then decreased in the TiF4, CO2 laser, and F+L groups, respectively. The difference between all groups was significant (P<0.05), except for the CO2 laser and F+L groups. Conclusion: The lowest amount of demineralization around the orthodontic brackets was observed in the L+F group, followed by the CO2 laser, TiF4, and control groups, respectively.
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Affiliation(s)
- Vahid Moshkelgosha
- Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mona Sohrabi
- Dental Caries Prevention Research Center, Qazvin University of Medical Science, Qazvin, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Adel SM, El-Harouni N, Vaid NR. White Spot Lesions: State of the Art Biomaterials and Workflows used in Prevention, Progression and Treatment. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Wenyan H, Pujue Z, Yuhang H, Zhenni L, Yuejun W, Wenbin W, Ziling L, Pathak JL, Sujuan Z. The impact of Er:YAG laser combined with fluoride treatment on the supragingival plaque microbiome in children with multiple caries: a dynamic study. BMC Oral Health 2022; 22:537. [PMID: 36424564 PMCID: PMC9685943 DOI: 10.1186/s12903-022-02537-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/25/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As a minimally invasive tool for caries prevention tool, the pulsed erbium:yttrium-aluminum-garnet (Er:YAG) laser is being used in a large number of studies. Microorganisms are extremely vital in the occurrence and development of dental caries. However, the impact of Er:YAG laser irradiation combined with fluoride on the dynamic microbial changes that occur in dental plaques is still uncertain. In this study, we examined the effect of an Er:YAG laser combined with fluorine on supragingival microbial composition and diversity in children with multiple caries. METHODS In this study, dental plaque samples (n = 48) were collected from 12 children with over 8 filled teeth. Supragingival plaques from left mandibular molars before (CB) and after fluoride treatment (CA) and right mandibular molars before (EB) and after fluoride+Er:YAG laser treatment (EA) were collected from each patient. In CB and EB groups, the samples were collected just before the treatments. In CA and EA groups, the samples were collected 1 month after treatments. Then, all specimens were subjected to 16S rRNA high-throughput sequencing to investigate the changes in microbial composition and diversity in mandibular molar supragingival plaques before and after fluoride or fluoride+Er:YAG laser treatment. RESULTS The dental plaque microbial diversity was higher in the EA group than in the EB group (baseline levels), and the microbial composition changed in EA group compared with EB group (P < 0.05). The levels of microorganisms associated with caries occurrence, including Proteobacteria, Fusobacteria, and Bacteroidetes, declined, while the levels of Faecacterium, Fastidiosipila, Vibrio, and Shewanella increased in EA group compared with EB group. The declines in Firmicutes, Streptococcus, Fusobacterium, and Veillonella levels were significantly lower in the EA group than in the CA group. CONCLUSION The combined application of the Er:YAG laser and fluoride may be more effective than using fluoride alone in reducing the proportion of cariogenic bacteria, increasing the diversity of plaque microorganisms, and further promoting the microecological balance.
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Affiliation(s)
- Huang Wenyan
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Zheng Pujue
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Huang Yuhang
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Liu Zhenni
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Wu Yuejun
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Wu Wenbin
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Li Ziling
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Janak L. Pathak
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
| | - Zeng Sujuan
- grid.410737.60000 0000 8653 1072Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182 Guangdong China
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The effects of combining erbium, chromium: Yttrium-scandium-gallium-garnet laser irradiation with fluoride application in controlling the progression of enamel erosion. Saudi Dent J 2021; 33:1126-1132. [PMID: 34938058 PMCID: PMC8665161 DOI: 10.1016/j.sdentj.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/05/2022] Open
Abstract
Fluoride alone increased the microhardness of the enamel surface. Fluoride alone halted the progression of enamel erosion. Laser irradiation before fluoride-induced similar effects as fluoride alone. Laser irradiation alone did not prevent the progression of enamel erosion.
Objective Increasing enamel resistance to acid may be useful for preventing cavitation and could reduce changes in the enamel’s microhardness. Topical fluoride application and laser irradiation promote acid resistance of dental substrates. The aim of the study was to assess the efficacy of erbium, chromium: yttrium-scandium-gallium-garnet laser irradiation in combination with fluoride application to control enamel erosion. Design Sixty human premolar specimens were prepared (N = 60) and were randomly assigned to 5 groups, twelve specimens in each group (n = 12/group) according to surface treatment. The groups were as follows: group 1 (C): control with no treatment; group 2 (F): application of 1.23% acidulated phosphate fluoride gel alone; group 3 (L): laser irradiation alone; group 4 (F+L): acidulated phosphate fluoride gel followed by laser irradiation; group 5 (L+F): laser irradiation followed by acidulated phosphate fluoride gel. All the specimens were eroded 10 min in citric acid. Baseline measurements were performed using a Vickers microhardness tester before surface treatment. Subsequently, all specimens were subjected to a 60 min erosion-remineralization cycle for five days followed by measurements of the final surface microhardness. Statistical comparisons were performed by a one-way analysis of variance and Tukey’s post hoc analysis. Results The control, laser, and fluoride + laser groups showed a statistically significant decrease in microhardness values between baseline and post-erosion measurements (P < 0.05), indicating that these treatments could not prevent erosion progression. However, the fluoride and laser + fluoride groups showed a significant increase in microhardness values compared to baseline. Conclusions Our results suggest that compared to that of the control group, acidulated phosphate fluoride application as well as laser irradiation prior to fluoride application increased enamel surface microhardness and prevented the progression of enamel erosion.
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Valizadeh S, Rahimi Khub M, Chiniforush N, Kharazifard MJ, Hashemikamangar SS. Effect of Laser Irradiance and Fluoride Varnish on Demineralization Around Dental Composite Restorations. J Lasers Med Sci 2021; 11:450-455. [PMID: 33425296 DOI: 10.34172/jlms.2020.70] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: This study aimed to assess the effects of CO2 and erbium-doped yttrium aluminum garnet (Er:YAG) lasers with and without fluoride varnish on demineralization around composite restorations. Methods: This in vitro experimental study evaluated 96 extracted human premolars. After preparation and restoration of class V cavities in the buccal surface of the teeth with composite resin, they were randomly divided into 8 groups of control, CO2 laser (L1), CO2 laser-NaF (L1F), NaF-CO2 laser (FL1), Er:YAG laser (L2), Er:YAG laser-NaF (L2F), NaF-Er:YAG laser (FL2) and NaF (F). The entire surface of the teeth, except for the restored cavity in the buccal surface and 1 mm around the margin, was coated with two layers of nail varnish. The teeth then underwent pH cycling for 10 days (3 hours in demineralizing solution and 21 hours in remineralizing solution) to artificially induce demineralization. The amount of calcium and phosphorous released into the cariogenic solution was quantified using atomic absorption spectroscopy and spectrophotometry. The Vickers hardness tester was used to measure the hardness of the tooth structure adjacent to composite restoration. Data were analyzed using one-way ANOVA and Tukey's test. Results: The four groups of L1F, FL1, FL2 and L2F showed minimum loss of calcium and phosphorous ions, and the mean hardness of FL1 and FL2 groups was higher than that of other groups. Conclusion: The CO2 and Er:YAG lasers alone have no significant effect on the resistance of tooth structure to cariogenic solution. However, they can exert a synergistic effect when used along with NaF varnish. Fluoride varnish applied prior to laser irradiation confers further resistance to the tooth structure and positively affects its hardness.
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Affiliation(s)
- Sara Valizadeh
- Assistant Professor, Laser Research Center of Dentistry, Dentistry Research Institute, Restorative Dentistry Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nasim Chiniforush
- Assistant Professor, Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Javad Kharazifard
- Research Member, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ghelejkhani A, Nadalizadeh S, Rajabi M. Effect of casein-phosphopeptide amorphous calcium phosphate and fluoride with/without erbium, chromium-doped yttrium, scandium, gallium, and garnet laser irradiation on enamel microhardness of permanent teeth. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.311427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Erkmen Almaz M, Ulusoy NB, Akbay Oba A, Erdem Ü, Doğan M. Thermal, morphological, and spectral changes after Er, Cr:YSGG laser irradiation at low fluences on primary teeth for caries prevention. Microsc Res Tech 2020; 84:150-159. [PMID: 33219723 DOI: 10.1002/jemt.23637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/22/2020] [Indexed: 11/10/2022]
Abstract
The aim of this study was to determine the temperature increase in the pulp chamber and possible thermal effects on molecular structure of primary teeth during the irradiation with Er,Cr:YSGG laser. Primary central incisors were divided into three groups (n = 20). Labial surfaces in each group were irradiated by Er,Cr:YSGG laser within different power and frequencies as following groups: I: 0.25 W, 20 Hz, II: 0.50 W, 20 Hz, III: 0.75 W, 20 Hz. A thermocouple was placed inside the pulp chamber so that the temperature increments were recorded during the enamel irradiation. Morphological changes of enamel surfaces were experimentally evaluated by SEM. Fourier-transform infrared spectroscopy and RAMAN analyses were carried out to determine the differentiations in the molecular structure. The experimental results obtained were analyzed statistically by means of one-way analysis of variance. Statistically significant differences were detected between groups (p < .05). Group III exhibited the highest values for the temperature parameters. Besides, the conical craters, cracks, and formation of ablation areas were observed for all the groups. Also, it was obtained that the hydroxyapatite lost the hydroxyl ions due to the thermal effect of the laser. Temperature rise throughout the Er,Cr:YSGG laser irradiation for prevention of primary enamel demineralization presented a positive correlation with the laser output power level. The formations of adverse morphological and spectral changes were detected on the surface of teeth after the laser application. On this basis, the Er,Cr:YSGG laser applications should be treated with much more caution considering enamel surface and pulpal tissues in primary teeth.
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Affiliation(s)
- Merve Erkmen Almaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | | | - Aylin Akbay Oba
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | - Ümit Erdem
- Scientific and Technological Research Application Center, Kırıkkale University, Kırıkkale, Turkey
| | - Mustafa Doğan
- Scientific and Technological Research Application Center, Kırıkkale University, Kırıkkale, Turkey
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Yilmaz N, Baltaci E, Baygin O, Tüzüner T, Ozkaya S, Canakci A. Effect of the usage of Er,Cr:YSGG laser with and without different remineralization agents on the enamel erosion of primary teeth. Lasers Med Sci 2020; 35:1607-1620. [PMID: 32472426 DOI: 10.1007/s10103-020-03015-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
The aim of the present study was to evaluate the effects of different remineralization agents associated with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) (0.5 W power, 20 Hz frequency, 60% water, 40% air, 25 mJ pulse energy, 8.84 J/cm2 fluence, 60 μs pulse duration, 600 μm tip diameter, and an approximate 1-1.5 mm distance to the target) laser irradiation on erosion induced by the consumption of carbonated drinks in human primary enamel. There were 8 groups and 10 primary teeth in each g0roup. The distribution was as follows: group 1, casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF); group 2, Er,Cr:YSGG laser+CPP-ACPF; group 3, fluor varnish; group 4, Er,Cr:YSGG Laser+fluoride varnish; group 5, ROCS® medical mineral gel; group 6, Er,Cr:YSGG laser + ROCS® medical mineral gel; group 7, Er,Cr:YSGG laser; and group 8, artificial saliva. The samples in the groups were submerged in artificial saliva and acid twice a day for 6 s at 6-h intervals and were then exposed to an erosion cycle 15 times. In the groups in which the Er,Cr:YSGG laser was applied in combination with the remineralization agents, the laser application was made first, and then the remineralization agents were applied for 4 min in each group. The Friedman and Wilcoxon signed-rank tests and the Bonferroni correction were used in statistical analyses, and the significance level was taken as p < 0.05. According to the results, all agents had a statistically significant difference (groups 1, 2, 3, 4, and 6: p = 0.005, p < 0.017; groups 5 and 7: p = 0.007, p < 0.017) between BL-RM periods. However, all agents had a statistically significant remineralization effect on primary teeth enamel (groups 1, 2, 3, 6, and 7: p = 0.005, p < 0.017; group 4: p = 0.011, p < 0.017) except that group 5 (p = 0.074, p < 0.017) between DM-RM periods. The coadministration of an agent with the laser did not make any difference at a statistical level (p = 0.804, p > 0.05). The results were supported by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. As a result of this study, CPP-ACPF had a notable impact in terms of the remineralization effect on eroded enamel, and the Er,Cr:YSGG laser alone may be an alternative method, which may be related to the modified hydroxyapatite structure, 38.5% H0.56Ca4.56O13P3Y0.44, that was determined in XRD analysis.
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Affiliation(s)
- Nagehan Yilmaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
| | - Ezgi Baltaci
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Ozgul Baygin
- Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Tamer Tüzüner
- Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Serdar Ozkaya
- Department of Materials and Metallurgical Engineering, Faculty of Engineering, Karadeniz Technical University, Trabzon, Turkey
| | - Aykut Canakci
- Department of Materials and Metallurgical Engineering, Faculty of Engineering, Karadeniz Technical University, Trabzon, Turkey
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Al-Maliky MA, Frentzen M, Meister J. Laser-assisted prevention of enamel caries: a 10-year review of the literature. Lasers Med Sci 2019; 35:13-30. [PMID: 31399861 DOI: 10.1007/s10103-019-02859-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 08/01/2019] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Mohammed Abbood Al-Maliky
- Department of Periodontology, Operative and Preventive Dentistry, Dental Faculty, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany. .,Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), University of Bonn, Bonn, Germany. .,Department of Biomedical Applications, Institute of Laser for Postgraduate Studies, University of Baghdad, Baghdad, Iraq.
| | - Matthias Frentzen
- Department of Periodontology, Operative and Preventive Dentistry, Dental Faculty, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Jörg Meister
- Department of Periodontology, Operative and Preventive Dentistry, Dental Faculty, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany.,Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), University of Bonn, Bonn, Germany
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Hajizadeh H, Nemati-Karimooy A, Babaee-Rishkhori P. Effect of Erbium:Yttrium-Aluminum-Garnet Laser Combined with Mineralizing Agents on Microhardness of Demineralized Dentin. Eur J Dent 2019; 13:11-16. [PMID: 31170757 PMCID: PMC6635968 DOI: 10.1055/s-0039-1688730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective
The aim of this study was to assess the combined effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser and mineralizing agents including casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride in improving the resistance of demineralized dentin at new demineralization process.
Materials and Methods
One hundred and twenty healthy dentin surfaces were prepared and demineralized using acidic solutions. Primary microhardness was measured (h1), and samples were randomly divided into six groups. Each group received a different protocol as follows: Group A (control group): no additional treatment, Group B: applying a fluoridated gel, Group C: applying a CPP-ACP-containing cream, Group D: irradiation of Er:YAG laser, Group E: irradiation of Er:YAG laser combined with the application of a fluoridated agent, and Group F: irradiation of Er:YAG laser combined with the application of CPP-ACP-containing cream. Microhardness values were measured afterward (h2). Then, all the groups were re-exposed to acidic solution, and microhardness was measured for the third time (h3). The microhardness data were analyzed using analysis of variance and Scheffe's post hoc test.
Results
Although application of mineralizing agents increased the microhardness of demineralized dentin in comparison with the control group, no significant difference was observed using two agents. Comparison of laser groups showed an increase in microhardness only after the irradiation of Er:YAG laser combined with the application of a fluoridated agent. Demineralizing process reduced the microhardness values in all the groups, but the application of a CPP-ACP agent caused the least reduction among the laser irradiated groups. Comparison of hardness changes at the beginning and end of the experiment did not show any significant differences between the groups.
Conclusion
Comparison of treatment modalities used in this study exhibited that fluoride had the greatest impact on dentin resistance. Laser irradiation on demineralized dentin did not increase the hardness or resistance to acidic attacks.
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Affiliation(s)
- Hila Hajizadeh
- Department of Restorative and Cosmetic Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Nemati-Karimooy
- Department of Restorative and Cosmetic Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Cosma LL, Şuhani RD, Mesaroş A, Badea ME. Current treatment modalities of orthodontically induced white spot lesions and their outcome - a literature review. Med Pharm Rep 2019; 92:25-30. [PMID: 30957083 PMCID: PMC6448498 DOI: 10.15386/cjmed-1090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction White spot lesion is a demineralization of the enamel that appears as a white spot on the surfaces of the tooth. The cause of this spot is determined by the activity of the bacterial plaque and it represents the initial stage of a carious lesion. This lesion is a common side effect for patients with fixed orthodontic appliances mainly because of the brackets' position that favors the accumulation of plaque that ultimately leads to the formation of the white spot. Methods We conducted a search on a single database, PubMed. "Orthodontic", "white spot lesions", "enamel demineralization treatment" and "remineralization" were the search terms used. We found 324 articles, but we took in consideration only the ones from the last 10 years, which resulted in 223 articles. Results The first step after research was article selection: first by scrutinizing the title and secondly by reviewing the abstracts or full texts. The exclusion criteria were: meta-analysis, reviews, original articles regarding prevention of white spot lesions and their prevalence or incidence. We included the articles that seemed relevant for the treatment of white spot lesions, made either on extracted teeth either on orthodontic patients. We found 75 articles to be eligible for this research and we eliminated 5 because of the lack of an abstract or full text and a further 22 were rejected because they did not fit the aforementioned criteria. Conclusion Although some traditional methods for the treatment of white spot lesions seem to have undesirable results, nowadays with new technologies and thorough investigations in nanotechnology, the eradication of the lesion appears to be short term.
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Affiliation(s)
- Lavinia Luminiţa Cosma
- Department of Pediatric Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Diana Şuhani
- Department of Pediatric Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Mesaroş
- Department of Dental Propedeutics and Esthetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mîndra Eugenia Badea
- Department of Prevention in Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Molaasadollah F, Asnaashari M, Mashhadi Abbas F, Jafary M. In Vitro Comparison Of Fluoride Gel Alone and in Combination With Er,Cr:YSGG Laser on Reducing White Spot Lesions in Primary Teeth. J Lasers Med Sci 2017; 8:160-165. [PMID: 29071020 DOI: 10.15171/jlms.2017.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Laser therapy has been suggested as a method for caries-prevention, and ErCr:YSGG laser is increasingly used in dentistry. This study aimed to compare the efficacy of fluoride gel alone and in conjunction with Er,Cr:YSGG laser for remineralization of white spot lesions (WSLs) in primary teeth. Methods: This study was conducted on 20 primary teeth with WSLs extracted for orthodontic reasons. Three sections were made of each tooth at the site of WSLs. The surface area of WSLs was measured under a stereomicroscope at ×25 magnification. Samples were assigned to 3 groups of control (group 1), exposure to 1.23% APF gel for 4 minutes (group 2) and Er,Cr:YSGG laser (0.5 W power, 20 Hz frequency, 60% water, 40% air, pulse duration of 5±1 seconds) plus fluoride (group 3). All samples were stored in artificial saliva for 10 days and then the surface area of the WSLs was measured again under a stereomicroscope. Data were analyzed using the Kruskal-Wallis, MannWhitney and Wilcoxon signed rank tests. Results: The reduction in surface area of the WSLs was significantly different between the control and fluoride (P<0.001) and also the control and laser plus fluoride groups (P<0.001); the difference between fluoride and laser plus fluoride groups was not significant (P=0.265). Comparison of the surface area of WSLs before and after the intervention showed no significant difference in group one (P=0.737) while this difference in groups 2 (P<0.001) and 3 (P<0.001) was statistically significant. Conclusion: The results showed that Er,Cr:YSGG laser irradiation plus 1.23% APF gel was not significantly different from the application of fluoride gel alone in enhancing the remineralization of WSLs.
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Affiliation(s)
- Fatemeh Molaasadollah
- Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mashhadi Abbas
- Department of Oral & Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences
| | - Maral Jafary
- Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fekrazad R, Najafi A, Mahfar R, Namdari M, Azarsina M. Comparison of enamel remineralization potential after application of titanium tetra fluoride and carbon dioxide laser. Laser Ther 2017; 26:113-119. [PMID: 28785131 DOI: 10.5978/islsm.17-or-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/03/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS The aim was comparison of enamel remineralization after application of APF, TiF4 and CO2 laser alone or in combination. MATERIALS AND METHODS Enamel blocks were prepared from human third molars. The initial surface hardness was determined by Vicker's hardness tester. The samples underwent a demineralization regimen for 7 days to produce artificial initial caries. The hardness of enamel blocks with white spot lesions was measured, and the samples which had the mean hardness change of 65-90%, were selected, and randomly divided into 5 groups (N=15): G1: control; G2: APF 1.23%; G3: TiF4 4%; G4: TiF4 4% followed by CO2 laser (10.6 µm wavelength, 1 W peak power, 10 ms pulse duration, 500 ms repeat time, 0.2 mm beam spot size, 2 cm distance); G5: CO2 laser (same parameters) followed by TiF4 4%. Surface hardness recovery was measured after the treatments. Three samples in each group were observed under scanning electron microscope at ×1,000 magnification. Data were analyzed by repeated measure ANOVA and Bonferrouni tests. Significance level was set at 0.05. RESULTS G2, G3, G4 indicated significant differences with control and G5 (p<0.05). Surface hardness in G5 was not significantly different from control (p=0.7) in enamel hardness test. There was not a significant difference between G2 & G3, G2 & G4, and G3 & G4 (p=1). The SEM results indicated globules of calcium fluoride on the surface in G2, and a smooth glaze-like surface layer in G3 and G4. In G5, some micro-cracks without any glaze-like layer were observed. CONCLUSIONS APF, TiF4 and TiF4 before CO2 laser irradiation significantly increased the micro-hardness of initially demineralized enamel surfaces. CO2 laser irradiation before TiF4 application could not remineralize the white-spot lesions.
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Affiliation(s)
- Reza Fekrazad
- DDS, MSc, FLD, FICD; Associate professor of periodontology department, Dental Faculty-Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Ahmad Najafi
- DDS; Assistant Professor of Operative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramona Mahfar
- Dental Student; Department of Operative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- PhD; Assistant Professor of Biostatistics Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadese Azarsina
- DDS; Assistant Professor of Operative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ramalho KM, Hsu CYS, de Freitas PM, Aranha ACC, Esteves-Oliveira M, Rocha RG, de Paula Eduardo C. Erbium Lasers for the Prevention of Enamel and Dentin Demineralization: A Literature Review. Photomed Laser Surg 2015; 33:301-19. [DOI: 10.1089/pho.2014.3874] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Karen Müller Ramalho
- Department of Stomatology, School of Dentistry of the University of São Paulo (USP) Prof. São Paulo, SP, Brazil
| | - Chin-ying Stephen Hsu
- Department of Dentistry, Faculty of Dentistry, National University of Singapore (NUS), Singapore
| | - Patrícia Moreira de Freitas
- Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), São Paulo, SP, Brazil
| | - Ana Cecília Correa Aranha
- Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), São Paulo, SP, Brazil
| | - Marcella Esteves-Oliveira
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Rodney Garcia Rocha
- Department of Stomatology, School of Dentistry of the University of São Paulo (USP) Prof. São Paulo, SP, Brazil
| | - Carlos de Paula Eduardo
- Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), São Paulo, SP, Brazil
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Nakagaki S, Iijima M, Endo K, Saito T, Mizoguchi I. Effects of CO2 laser irradiation combined with fluoride application on the demineralization, mechanical properties, structure, and composition of enamel. Dent Mater J 2015; 34:287-93. [PMID: 25904170 DOI: 10.4012/dmj.2014-225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We investigated the effects of CO2 laser irradiation combined with acidulated phosphate fluoride (APF) application on the demineralization of enamel. APF gel was applied to the buccal enamel of human premolars and CO2 laser was applied. After the specimens were immersed in demineralization solution for 72 h, they were subjected to depth-dependent micro-CT and nanoindentation analyses. Micro-X-ray diffraction and X-ray photoelectron spectroscopy were performed to analyze the surfaces. Some surface regions of the enamel in specimens that were laser-irradiated with low output and APF-treated showed significantly higher values of MD and hardness than specimens treated with APF alone. A higher fluoride concentration in the enamel surface was observed in specimens treated with CO2 laser irradiation plus APF gel application. In conclusion, CO2 laser irradiation with low output is preferable to improve acid resistance.
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Affiliation(s)
- Susumu Nakagaki
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido
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Montasser MA, Taha M. Effect of enamel protective agents on shear bond strength of orthodontic brackets. Prog Orthod 2014; 15:34. [PMID: 25138692 PMCID: PMC4138552 DOI: 10.1186/s40510-014-0034-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 03/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper aimed to study the effect of two enamel protective agents on the shear bond strength (SBS) of orthodontic brackets bonded with conventional and self-etching primer (SEP) adhesive systems. METHODS The two protective agents used were resin infiltrate (ICON) and Clinpro; the two adhesive systems used were self-etching primer system (Transbond Plus Self Etching Primer + Transbond XT adhesive) and a conventional adhesive system (37% phosphoric acid etch + Transbond XT primer + Transbond XT adhesive ). Sixty premolars divided into three major groups and six subgroups were included. The shear bond strength was tested 72 h after bracket bonding. Adhesive remnant index scores (ARI) were assessed. Statistical analysis consisted of a one-way ANOVA for the SBS and Kruskal-Wallis test followed by Mann-Whitney test for the ARI scores. RESULTS In the control group, the mean SBS when using the conventional adhesive was 21.1 ± 7.5 MPa while when using SEP was 20.2 ± 4.0 MPa. When ICON was used with the conventional adhesive system, the SBS was 20.2 ± 5.6 MPa while with SEP was 17.6 ± 4.1 MPa. When Clinpro was used with the conventional adhesive system, the SBS was 24.3 ± 7.6 MPa while with SEP was 11.2 ± 3.5 MPa. Significant differences in the shear bond strength of the different groups (P = .000) was found as well as in the ARI scores distribution (P = .000). CONCLUSION The type of the adhesive system used to bond the orthodontic brackets, either conventional or self-etching primer, influenced the SBS, while the enamel protective material influenced the adhesive remnant on the enamel surface after debonding.
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Affiliation(s)
- Mona A Montasser
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt.
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