The effects of combining erbium, chromium: Yttrium-scandium-gallium-garnet laser irradiation with fluoride application in controlling the progression of enamel erosion

EFFECT OF LASER IRRADIATION ASSOCIATED WITH FLUORIDE IN DECREASING EROSIVE TOOTH WEAR: A SYSTEMATIC REVIEW WITH A NETWORK META-ANALYSIS

OBJECTIVE

The present systematic review with a network meta-analysis (NMA) aimed to evaluate the effect of high-power lasers, associated or not with fluoride compounds, to control and prevent Erosive Tooth Wear (ETW).

METHODS

The review was registered in the PROSPERO (CRD42021242547) and followed the PICO question: P (population): enamel and dentin substrate; I (Intervention): high-power laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control of ETW. The electronic databases PubMed, Scopus, and EMBASE were searched. Two independent reviewers evaluated in vitro and in situ studies. The risk of bias was assessed using the RoBDEMAT tool. The estimated treatment effect derived from direct and indirect comparisons were analyzed and the difference between these effects was calculated based on the data of enamel and dentin surface loss (in μm).

RESULTS

A total of 179 studies were retrieved and after the exclusion of duplicates, 103 studies had their titles and abstracts evaluated. Thirty-nine studies had their full text analyzed for data extraction (Cohen Kappa = 0.88). For sound enamel, the laser irradiation (L), fluoride application (F) and, the association of treatments (L + F) promoted higher protection than No-Treatment (NT). For eroded enamel, L + F and F did not differ, but both treatments reduced surface loss compared to NT and L. For sound and eroded dentin, treatments with laser increased surface loss.

CONCLUSIONS

Although a high-power laser has some potential to prevent erosive tooth wear, this effect is not better than that of standard fluoride. The use of laser in the management of dentin erosive wear can be harmful.

Advances in Preventive and Therapeutic Approaches for Dental Erosion: A Systematic Review

This review discusses both preventive measures and clinically implemented therapy procedures that have been developed recently for the prevention and treatment of tooth erosion.

METHODS

The databases PubMed, Scopus, and Web of Science were used for a thorough search. Studies on the prevention and treatment of dental erosion that were conducted in English and used in vitro were among the inclusion criteria.

RESULTS

The search turned up 391 papers in total, with 34 of those publications matching the requirements for inclusion. Varnishes, toothpastes, and solutions containing fluoride and other substances were used as preventive measures.

CONCLUSIONS

Dental erosion is a significant issue, and taking preventative steps is crucial to lessening the disease's spread and its effects. Interventions based on fluoride seem to be successful at halting erosion and encouraging remineralization. To effectively address severe tooth erosion, therapeutic methods, including composite restorations, prosthetic crowns, and veneers, are available. Dental erosion causes aesthetic and functional issues that are best addressed with less invasive treatments like direct composite restorations. To improve and broaden the range of available treatments for this common dental issue, additional research and development are required.

Potential role of Er:YAG laser and fluoride in the dental enamel remineralization: a Raman spectroscopy preliminary <i>ex vivo</i> study

Background and aims: Dental caries are a widespread oral disease and a serious public health problem, starting by teeth demineralization, which is a loss of minerals such as calcium and phosphate. Modern caries treatment is aimed at preventing the disease progression by teeth remineralization which is a supply of minerals to the enamel. The most popular remineralization method is the treatment of teeth with fluoride. Er:YAG laser has also gained research attention as a method for improving the uptake of fluoride and phosphate by introducing chemical and morphological changes into the structure of enamel but, while some researchers described it as effective, others found no significant effect from its application. This work aimed to further study the effect of Er:YAG laser, alone or combined with fluoride, to dental enamel. Materials and Methods: Twenty upper central human incisors, extracted for periodontal reasons, were used in the study. Samples were demineralized by acetic acid and divided into four groups: a) control, b) fluoride + Er:YAG laser, c) Er:YAG laser alone and d) fluoride alone. The remineralization rate of teeth was estimated by Raman Spectroscopy. Results: In comparison with the control group, the phosphate peak’s intensity increased notably for the teeth treated by fluoride, but decreased slightly for the teeth treated with Er:YAG laser and with a combination of the laser and fluoride. Conclusions: With the limits of this study, due to the limited samples number, Er:YAG laser, alone and combined with fluoride, seems to be not effective, at the parameters used, for the enamel remineralization.