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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. PLoS One 2020; 15:e0237195. [PMID: 32764819 PMCID: PMC7413416 DOI: 10.1371/journal.pone.0237195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 07/21/2020] [Indexed: 11/19/2022] Open
Abstract
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.
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Artificial Caries Resistance in Enamel after Topical Fluoride Treatment and 445 nm Laser Irradiation. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9101642. [PMID: 31781651 PMCID: PMC6874945 DOI: 10.1155/2019/9101642] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/26/2019] [Accepted: 10/18/2019] [Indexed: 11/24/2022]
Abstract
Objective This in vitro study is aimed at investigating the caries preventive effectiveness of 445 nm diode laser in combination with topical fluoridation. Materials and methods A total of 30 caries-free bovine teeth were used in this study. Eighteen teeth were covered with nail varnish except four windows on the labial surface. The windows were assigned to no treatment/control (C), laser (L) (0.3 W, 60 s, and 90 J/cm2), fluoride (F), and fluoride followed by laser (FL) treatment groups. Artificial caries lesions were created, and the teeth were sectioned and investigated under polarized light microscopy for quantitative measurement of the resulted lesion depth. Ten teeth were used for surface temperature measurement and two teeth for scanning electron microscopy (SEM). Extra twelve human molars were used for the intrapulpal temperature measurement. The absorbance of fluoride at 445 nm was measured. Results The means of lesion depth for the C, L, F, and FL groups were 123.48 (±21.93), 112.33 (±20.42), 99.58 (±30.68), and 89.03 (±30.38) μm, respectively. The pairwise differences of the L, F, and FL groups compared with the C group were significant (p < 0.05). The differences between groups were tested: FL versus L p=0.02, F versus L p=0.16, and FL versus F p=0.91, and the difference of the F versus FL was not significant (p=0.91). Temperature increment at the enamel surface and pulp roof were ∆T = 16.67 (±4.11) and 2.12 (±0.66)°C, respectively. The topical fluoride absorbance at 445 nm is five orders higher than that at 810 nm. SEM shows that after laser irradiation the enamel surface was intact and without thermal damage. Conclusions The 445 nm laser irradiation may be useful for caries prevention, and its effectiveness is lower than those previously achieved using the argon ion laser.
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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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Kim YM, Lee HY, Lee HJ, Kim JB, Kim S, Joo JY, Kim GC. Retention Improvement in Fluoride Application with Cold Atmospheric Plasma. J Dent Res 2017; 97:179-183. [PMID: 28945493 DOI: 10.1177/0022034517733958] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to apply fluoride formulations to enamel with cold atmospheric plasma (CAP) and analyze the fluoride uptake, retention, and acid resistance quantitatively. Human enamel specimens were divided randomly into 2 groups: group APF1, 1.23% acidulated phosphate fluoride (APF) gel; group APF2, 1.23% APF gel with CAP. Fluoride and CAP were applied to the samples 4 times at 1-wk intervals. The specimens were also stored in artificial saliva for 4 wk to evaluate the retention of fluoride. The fluoride content on the fluoride-treated enamel was measured by an electron probe microanalyzer. To detect the resistance to demineralization, the calcium-to-phosphate ratio of the enamel samples was measured after the application of APF gel with or without CAP, followed by soaking in the demineralization solution. In groups APF1 and APF2, the amount of fluoride detected increased depending on the application frequency, and more fluoride was detected in group APF2 than in group APF1. In the experiment examining the maintenance effect, fluoride was not detected in group APF1, whereas fluoride was detected in group APF2 up to the fourth week. As for the resistance to demineralization, the calcium-to-phosphate ratio of the enamel treated with APF and CAP was higher than that treated with APF alone, and it increased with the frequency of treatment. This study suggests that the combination treatment of CAP and fluoride improves retention of fluoride on the enamel and resistance to demineralization when compared with treatment with fluoride alone.
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Affiliation(s)
- Y M Kim
- 1 Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - H Y Lee
- 2 School of Electrical and Computer Engineering, Pusan National University, Busan, South Korea
| | - H J Lee
- 2 School of Electrical and Computer Engineering, Pusan National University, Busan, South Korea
| | - J B Kim
- 3 Department of Preventive Dentistry, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - S Kim
- 4 Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - J Y Joo
- 5 Department of Periodontology, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, South Korea
| | - G C Kim
- 1 Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan, South Korea
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dos Reis Derceli J, Faraoni-Romano JJ, Azevedo DT, Wang L, Bataglion C, Palma-Dibb RG. Effect of pretreatment with an Er:YAG laser and fluoride on the prevention of dental enamel erosion. Lasers Med Sci 2013; 30:857-62. [PMID: 24149579 DOI: 10.1007/s10103-013-1463-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 10/08/2013] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate the effect of the Er:YAG laser and its association with fluoride (1.23% acidulate phosphate fluoride gel) on the prevention of enamel erosion. Sixty specimens were obtained from bovine enamel (4 × 4 mm), which were ground flat, polished, and randomly divided into five groups according to the preventive treatments: control-fluoride application; L--Er:YAG laser; L+F--laser + fluoride; F+L--fluoride + laser; L/F--laser/fluoride simultaneously. Half of the enamel surface was covered with nail varnish (control area), and the other half was pretreated with one of the preventive strategies to subsequently be submitted to erosive challenge. When the laser was applied, it was irradiated for 10 s with a focal length of 4 mm and 60 mJ/2 Hz. Fluoride gel was applied for 4 min. Each specimen was individually exposed to regular Coca-Cola® for 1 min, four times/day, for 5 days. Wear analysis was performed with a profilometer, and demineralization was assessed with an optical microscope. Data were analyzed using the Kruskal-Wallis test (wear)/Dunn test and ANOVA/Fisher's exact tests. The group L/F was similar to control group. The other groups showed higher wear, which did not present differences among them. In the demineralization assessment, the groups F+L and L/F showed lower demineralization in relation to the other groups. It can be concluded that none preventive method was able to inhibit dental wear. The treatments L/F and F+L showed lower enamel demineralization.
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Affiliation(s)
- Juliana dos Reis Derceli
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n - Monte Alegre, CEP 14040-904, Ribeirão Preto, São Paulo, Brazil
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Altan AB, Baysal A, Berkkan A, Göktolga-Akın EG. Effects of Er:YAG Laser Irradiation and Topical Fluoride Application on Inhibition of Enamel Demineralization. Turk J Orthod 2013. [DOI: 10.13076/j.tjo.2013.26.01_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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de Sant'Anna GR, dos Santos EAP, Soares LES, do Espírito Santo AM, Martin AA, Duarte DA, Pacheco-Soares C, Brugnera A. Dental enamel irradiated with infrared diode laser and photo-absorbing cream: part 2--EDX study. Photomed Laser Surg 2009; 27:771-82. [PMID: 19878028 PMCID: PMC2957072 DOI: 10.1089/pho.2008.2401] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (micro-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). BACKGROUND DATA Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive micro-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. MATERIALS AND METHODS Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (lambda = 810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using micro-EDX after two sets of treatments and pH cycling cariogenic challenges. RESULTS The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. CONCLUSION micro-EDX may be able to detect compositional changes in mineral phases of lased enamel under cariogenic challenge. Our results suggest that with a combined laser and photo-absorbing agent (CL) treatment, there was a possible disorganization of organic content in the tooth enamel with hydroxyapatite crystal reordering and reorganization.
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de Sant'anna GR, dos Santos EAP, Soares LES, do Espírito Santo AM, Martin AA, Duarte DA, Pacheco-Soares C, Brugnera A. Dental enamel irradiated with infrared diode laser and photoabsorbing cream: Part 1 -- FT-Raman Study. Photomed Laser Surg 2009; 27:499-507. [PMID: 19415988 PMCID: PMC2957074 DOI: 10.1089/pho.2008.2331] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. BACKGROUND DATA Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. MATERIALS AND METHODS Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm(2) for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. RESULTS There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). CONCLUSION The FT-Raman technique may be suitable for detecting compositional and structural changes occurring in mineral phases and organic phases of lased enamel under cariogenic challenge.
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Affiliation(s)
- Giselle Rodrigues de Sant'anna
- Vale do Paraíba University, UNIVAP, Research and Development Institute, IP&D, Laboratory of Biomedical Vibrational Spectroscopy, LEVB and Dental Laser Center, São José dos Campos, São Paulo, Brazil.
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Vlacic J, Meyers IA, Walsh LJ. Laser-activated fluoride treatment of enamel as prevention against erosion. Aust Dent J 2007; 52:175-80. [PMID: 17969284 DOI: 10.1111/j.1834-7819.2007.tb00485.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Erosion is the loss of dental hard tissues from an acidic challenge, often resulting in exposure of dentinal tubules and hypersensitivity to environmental stimuli. Laser-activated fluoride (LAF) therapy with 488nm laser energy has been shown previously to increase the resistance of human enamel and dentine to acid dissolution. The aims of this study were to investigate the action spectrum of LAF in protecting tooth enamel from softening in response to an erosive challenge, and to examine for any temperature change with the treatment. MATERIALS AND METHODS Buccal and lingual surfaces of extracted sound molar and premolar teeth were used to prepare matched pairs of enamel slabs (N = 10 per group). After application of 1.23% neutral sodium fluoride gel (12 300ppm F ion), slab surfaces were lased with 488, 514.5, 532, 633, 670, 830 or 1064nm wavelength (energy density 15J/cm(-2); spot size 5mm), then exposed to an erosive challenge (1.0M HCI for five minutes). The Vicker's hardness number (VHN) was recorded before fluoride gel application and again following the acid challenge. Negative controls did not receive laser exposure. RESULTS All wavelengths of laser light examined provided a protective LAF effect against softening, compared with the negative control surfaces. CONCLUSION From these findings, we conclude that the action spectrum of the LAF effect extends across the visible spectrum, providing protection to dental enamel from an erosive challenge.
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Affiliation(s)
- J Vlacic
- School of Dentistry, The University of Queensland, Brisbane.
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Müller KP, Rodrigues CRMD, Núñez SC, Rocha R, Jorge AOC, Ribeiro MS. Effects of low power red laser on induced-dental caries in rats. Arch Oral Biol 2007; 52:648-54. [PMID: 17292847 DOI: 10.1016/j.archoralbio.2006.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Revised: 12/13/2006] [Accepted: 12/14/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of low power red laser associated with acidulated phosphate fluoride on the development of induced-dental caries in rats. DESIGN Dental caries were induced in molars of 40 rats divided into five groups: control group (CG), the teeth were not submitted to any treatment; laser group (LG), teeth were irradiated with a low power red laser (LPRL), power of 30 mW and dose of 5 J/cm(2); fluoride group (FG), teeth were treated with topical acidulated phosphate fluoride (APF) 1.23% applied for 4 min; laser+fluoride group (LFG), teeth were irradiated with LPRL followed by APF; fluoride+laser group (FLG), teeth were treated with APF followed by LPRL. The animals were killed after 48 days, and the first and second molars were extracted to analyze the caries lesion area, microhardness, and calcium and phosphorus ratio. RESULTS There were no statistical differences among FG, LFG, and FLG regarding to caries area and microhardness, although the caries area were smaller in LFG. Ca/P ratio did not show significant differences among all groups. CONCLUSIONS Although LPRL before APF application appeared to diminish the caries progression, LPRL did not present any additional benefit compared with acidulated phosphate fluoride on the prevention of induced-dental caries in rats.
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Affiliation(s)
- Karin P Müller
- Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, Brazil
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Vlacic J, Meyers IA, Kim J, Walsh LJ. Laser-activated fluoride treatment of enamel against an artificial caries challenge: comparison of five wavelengths. Aust Dent J 2007; 52:101-5. [PMID: 17687954 DOI: 10.1111/j.1834-7819.2007.tb00472.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Laser-activated fluoride (LAF) therapy with 488 nm laser energy has been shown previously to increase the resistance of human enamel and dentine to acid dissolution in laboratory models of dental caries. The aims of this study were to examine whether LAF therapy, conducted using a range of wavelengths in the visible and near infrared regions, can protect human dental enamel from an artificial cariogenic challenge. MATERIALS AND METHODS Buccal and lingual surfaces of extracted sound, molar and premolar teeth were used to prepare matched pairs of enamel slabs (N=10 per group). After application of neutral sodium fluoride gel (12300 ppm F ion), slab surfaces were lased (energy density 15 J/cm2; spot size 5mm, wavelength 532, 633, 670, 830 or 1064nm), then exposed to an artificial cariogenic challenge for a period of seven days. The Vicker's hardness number (VHN) was recorded before and after laser treatment and again following the cariogenic challenge. Negative controls did not receive laser exposure. RESULTS All wavelengths of laser light examined provided an effective LAF effect, compared with the unlased negative control surfaces. CONCLUSION Using this in vitro model, we conclude that the action spectrum of the LAF effect extends across the visible and near-infrared regions of the spectrum.
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Affiliation(s)
- J Vlacic
- School of Dentistry, The University of Queensland, Brisbane
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Westerman GH, Hicks MJ, Flaitz CM, Powell GL. In vitro caries formation in primary tooth enamel: role of argon laser irradiation and remineralizing solution treatment. J Am Dent Assoc 2006; 137:638-44. [PMID: 16739544 DOI: 10.14219/jada.archive.2006.0260] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors evaluated the effects of argon laser (AL) diation and remineralizing solution (RS) treatment alone and in combination on carieslike lesion formation in primary tooth enamel in an in vitro study. MATERIALS AND METHODS The authors divided 10 caries free primary tooth enamel surfaces into four segments and assigned them to one of four treatment groups: no treatment control, AL irradiation alone at 13.5 joules per square centimeters (0.270 watts, 5-millimeter beam, 10 seconds), RS treatment alone for two minutes and AL irradiation before RS treatment. The authors created in vitro caries using a modified ten Cate solution. They evaluated longitudinal sections (three per tooth segment, 30 per treatment group) for mean lesion depth. RESULTS After lesion formation, mean lesion depths (+/- standard deviation) were 179 +/- 16 micrometers for the no treatment controls, 137 +/- 19 microm for AL irradiation alone, 87 +/- 9 microm for RS treatment alone and 68 +/- 12 microm for AL irradiation before RS treatment. All treatment groups had mean lesion depths that were significantly less than those for the matched no-treatment control group (analysis of variance [ANOVA], Duncan multiple range [DMR] test, P < .05). AL irradiation before RS treatment significantly reduced lesion depth compared with AL irradiation alone or RS treatment alone (ANOVA, DMR test, P < .05). CONCLUSIONS The maximum reduction in lesion depth in primary tooth enamel was achieved when the RS--which contained calcium, phosphate and fluoride in a carbopol base--was combined with AL irradiation. CLINICAL IMPLICATIONS It would appear that to improve clinical caries resistance to enamel dissolution, AL irradiation before RS treatment could be used.
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Affiliation(s)
- Gary H Westerman
- Department of Community and Preventive Dentistry, Creighton University Medical Center, School of Dentistry, Omaha, NE 68178, USA.
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Cecchini RCM, Zezell DM, de Oliveira E, de Freitas PM, Eduardo CDP. Effect of Er:YAG laser on enamel acid resistance: Morphlogical and atomic spectrometry analysis. Lasers Surg Med 2005; 37:366-72. [PMID: 16240417 DOI: 10.1002/lsm.20247] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES This study evaluated the effect of Er:YAG laser on enamel acid resistance. STUDY DESIGN/MATERIALS AND METHODS Seventy human enamel slabs were randomly divided into seven groups (n = 10): G1, Er:YAG laser (Key Laser 2, KaVo, Germany) 60 mJ, 2 Hz, 33.3 J/cm2 (handpiece no. 2051, non-contact); G2, Er:YAG laser 80 mJ, 2 Hz, 44.4 J/cm2 (handpiece no. 2051, non-contact); G3, Er:YAG laser 120 mJ, 2 Hz, 66.6 J/cm2 (handpiece no. 2051, non-contact); G4, Er:YAG laser 64 mJ, 2 Hz, 20 J/cm2 (handpiece no. 2055, contact); G5, Er:YAG laser 86.4 mJ, 2 Hz, 26.9 J/cm2 (handpiece no. 2055, contact); G6, Er:YAG laser 135 mJ, 2 Hz, 42.2 J/cm2 (handpiece no. 2055, contact); G7, control. After laser irradiation, samples were submitted to an acid challenge. For both the nos. 2051 and 2055 handpieces, irradiation was performed with a water cooled spray (5.0 ml/minutes). The calcium and phosphorous ions delivered from the tooth surface were quantified by atomic emission spectrometry, and morphological analysis of the enamel surface was performed under scanning electron microscopy. Kruskal-Wallis and multiple comparisons tests were applied to distinguish significant differences among the treatments (alpha = 5%). RESULTS Groups G1, G2, and G4 presented decreased demineralization. The SEM evaluation revealed different surface alterations as a result of the different energies used. CONCLUSION Lower energies can decrease enamel solubility without severe alterations of the enamel.
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Affiliation(s)
- Renata Cristina M Cecchini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo (USP), São Paulo, SP, 05508-900, Brazil
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Santaella MRLA, Braun A, Matson E, Frentzen M. Effect of diode laser and fluoride varnish on initial surface demineralization of primary dentition enamel: an in vitro study. Int J Paediatr Dent 2004; 14:199-203. [PMID: 15139955 DOI: 10.1111/j.1365-263x.2004.00550.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Previous investigations have demonstrated improved enamel caries resistance after laser irradiation. The purpose of this in vitro study was to assess the caries-preventive potential of 809 nm diode laser treatment of the enamel of primary teeth compared to topical fluoride application. METHODS Eighty samples of sound primary teeth were embedded in plastic and stored in saline solution. The enamel surface of 80 samples was polished in an area of 2 x 2 mm. These tooth specimens were randomly assigned to one control and three test groups: (1) no treatment/control; (2) application of 0.1 mg of fluoride varnish (Duraphat) for 6 h; (3) diode laser application (809 nm, 140 mJ, 50 Hz, Ø 600 micro m fibre, contact mode, absorber, 1 min; ORA-LASER01 I.S.T.); and (4) combined application - laser/fluoride varnish. Caries-like lesions were created by pH-cycling. After lesion formation, longitudinal sections were taken and examined by polarized light microscopy. RESULTS In the control group, all samples showed lesions up to 30 micro m in depth. After laser application, lesions could be identified in 15 out of 20 samples. Topical fluoride treatment in groups 2 (varnish) and 4 (laser/varnish) completely inhibited the development of caries-like lesions in all samples. CONCLUSION In this in vitro investigation, topical fluoride treatment enhances the resistance of sound enamel of primary teeth more effectively than diode laser application.
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Affiliation(s)
- M R L A Santaella
- Department of Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
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Nammour S, Demortier G, Florio P, Delhaye Y, Pireaux JJ, Morciaux Y, Powell L. Increase of enamel fluoride retention by low fluence argon laser in vivo. Lasers Surg Med 2003; 33:260-3. [PMID: 14571451 DOI: 10.1002/lsm.10219] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this in vivo study was to investigate if argon laser irradiation of enamel can increase the retention of fluoride. STUDY DESIGN/MATERIALS AND METHODS Ninety-eight teeth in 12 patients were randomly divided into three groups: (1) EF group: 40 teeth were only treated by fluoride gel (application for 5 minutes followed by 1 minute rinsing with distilled water). (2) EFL group: 40 teeth were treated the same way as in the EF group but they were lased after fluoridation. (3) E group of 18 teeth were kept without any treatment and considered as reference. In order to quantify the fluoride content in the enamel samples, the teeth were analyzed by proton beam delivered by a tandem accelerator (PIgammaE, particle induced gamma-ray emission). The fluoride content of enamel surface is not homogeneous. Therefore, it is necessary to analyze the same enamel area after each treatment. Each tooth was maintained in a fixed tooth holder which was designed to analyze the tooth enamel surface at the same place (1 mm(2) and around 20 mum in depth) after various treatments. A low energy density of argon laser beam was used: 10.74 J/cm(2), 30 seconds of irradiation time and 340 m W of output power. RESULTS The results after 7 days showed that the lased enamel still retained 157.4 +/- 23.371 ppm or 42.29% of fluoride after fluoridation process whereas the unlased enamel retained 45.59 +/- 9.377 ppm or 12.25% of fluoride. CONCLUSIONS We concluded that the use of argon laser at low energy density (10.74 J/cm(2)) significantly increases the fluoride retention in lased enamel which had approximately three times more fluoride than the unlased enamel.
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Affiliation(s)
- S Nammour
- Department of Stomatology, University Hospital Saint Pierre, Université Libre de Bruxelles, Rue Paul Spaak 3, B-1000 Brussels, Belgium.
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Delbem ACB, Cury JA, Nakassima CK, Gouveia VG, Theodoro LH. Effect of Er:YAG Laser on CaF2Formation and Its Anti-Cariogenic Action on Human Enamel: Anin VitroStudy. ACTA ACUST UNITED AC 2003; 21:197-201. [PMID: 13678456 DOI: 10.1089/104454703768247765] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effect of Er:YAG laser on the formation of CaF(2), after the application of acidulated phosphate fluoride (APF), and its influence on the anti-cariogenic action in human dental enamel. BACKGROUND DATA Er:YAG laser was designed to promote ablation of the enamel. However, the possibility of using this energy to increase the enamel's resistance to caries has hardly been explored, and neither has its interaction with the use of fluorides. MATERIALS AND METHODS One hundred and twenty blocks of enamel were allocated to four groups of 30 blocks each: (1) C, control group; (2) Er:YAG, laser; (3) APF; and (4) Er:YAG+APF. Of these, 80 blocks were submitted to pH cycling for 14 days. In the other 40 blocks, fluoride (CaF(2)) was measured before cycling. After pH cycling, surface microhardness (SMH), microhardness in cross-section (converted to mineral contents % vol. min.), and fluoride after cycling (40 blocks) were also determined. RESULTS SMH decreased in all groups. The control group showed the highest decrease, and Er:YAG+APF showed the lowest decrease (p < 0.05). Groups APF and Er:YAG showed the same results (p > 0.05). Mineral content at depths 10, 20, and 40 microm was lower in the control and Er:YAG groups, and higher in groups APF and Er:YAG+APF. CaF(2) (microgF/cm(2)) deposited before pH cycling was higher in the APF group when compared to the Er:YAG+APF group. Control and Er:YAG groups showed the lowest values (p > 0.05). CONCLUSION It was concluded that Er:YAG laser influenced the deposition of CaF(2) on the enamel and showed a superficial anti-cariogenic action, but not in depth.
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Affiliation(s)
- A C B Delbem
- School of Dentistry of Araçatuba, Paulista State University--UNESP, SP, Brazil.
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Westerman GH, Flaitz CM, Powell GL, Hicks MJ. Enamel caries initiation and progression after argon laser irradiation: in vitro argon laser systems comparison. JOURNAL OF CLINICAL LASER MEDICINE & SURGERY 2002; 20:257-62. [PMID: 12470455 DOI: 10.1089/10445470260420768] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this in vitro laboratory study was to determine the effect of low-fluence argon laser (AL) irradiation delivered from two different argon laser systems on enamel caries-like lesion initiation and progression. BACKGROUND DATA Previous in vitro investigations and a recent in vivo pilot study have shown that AL irradiation of enamel provided a protective effect against in vitro and in vivo cariogenic challenges. MATERIALS AND METHODS Twenty extracted human molars were selected, and 10 teeth were assigned to the HGM argon laser group and 10 were assigned to the LaserMed argon laser group. The exposed buccal windows of sound enamel were exposed to low-fluence irradiation, while the lingual windows of enamel were not exposed to laser irradiation and served as the no-treatment (control) group. Enamel caries-like lesions were created using an acidified gel. Two longitudinal sections were taken per sample (n = 20 lesions per group) and evaluated by polarized light microscopy for body of the lesion depths after lesion initiation (8 weeks) and progression (12 weeks) periods. RESULTS After lesion initiation and progression, the body of lesion depths were similar for both argon-irradiated groups (p > 0.05). With the no-treatment (control) group, there were significant increases in lesion depth with a 61-78% increase for the lesion initiation period and a 50-69% increase for the lesion progression period when compared with the argon laser-treated groups. CONCLUSION Argon laser irradiation provides a certain degree of protection against in vitro enamel caries initiation and progression. Resistance to a continuous caries challenge was similar with either argon laser delivery systems (HGM and LaserMed). Argon laser irradiation may prove to be beneficial in reducing the caries susceptibility of sound enamel and white spot lesions in the clinical environment.
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Affiliation(s)
- Gary H Westerman
- Department of Community and Preventive Dentistry, Creighton University, School of Dentistry, Omaha, Nebraska, USA.
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