Effects of an argon laser on the crystalline properties and rate of dissolution in acid of tooth enamel in the presence of sodium fluoride

Er,Cr:YSGG laser associated with acidulated phosphate fluoride gel (1.23% F) for prevention and control of dentin erosion progression

To evaluate the effect of Er,Cr:YSGG laser, associated with fluoride application, on the prevention/control of dentin erosion. Dentin slabs were embedded in acrylic resin, flattened, and polished. Half of the specimens were previously eroded (10 min immersion in 1% citric acid solution) and half were kept sound. The specimens (n = 10 each substrate) were randomly allocated into the experimental groups, according to the following treatments: control (no treatment); APF gel (1.23% F, 1 min); Er,Cr:YSGG laser irradiation (P1: 0.25 W, 20 Hz, 2.8 J/cm², tip S75, beam diameter of 750 μm, 1 mm away from the surface); Er,Cr:YSGG laser irradiation (P2: 0.50 W, 20 Hz, 5.7 J/cm², tip S75, beam diameter of 750 μm, 1 mm away from the surface); APF gel + Er,Cr:YSGG laser P1 and; APF gel + Er,Cr:YSGG laser P2. Afterwards, the specimens underwent an erosion-remineralization cycling, consisting of a 5-min immersion into 0.3% citric acid, followed by 60-min exposure to artificial saliva. This procedure was repeated 4×/day, for 5 days. Surface loss (SL, in μm) was determined by optical profilometry. Specimens from each group were analyzed by environmental scanning electron microscopy (n = 3). Data were statistically analyzed (α = 0.05). For the eroded specimens, APF gel presented the lowest SL, being different from the control. For the sound specimens, none of the groups differed from the control, except for Er,Cr:YSGG laser P2, which presented the highest SL. When substrates were compared, only the eroded specimens of the control and APF + Er,Cr:YSGG laser P1 Groups showed higher SL. Selective structure removal was observed for the laser-treated groups. None of the Er,Cr:YSGG laser parameters were effective in the prevention/control dentin erosion. The laser was also unable to enhance the protection of fluoride against dentin erosion.

Chemical and Morphological Changes of Primary Teeth Irradiated with Nd:YAG Laser: An Ex Vivo Long-Term Analysis

OBJECTIVE

The aim of this study was to assess any long-term chemical and morphological Nd:YAG laser modifications on irradiated primary enamel.

BACKGROUND DATA

Previous studies on irradiated primary human enamel employed methodologies that evaluated the short-term effects only.

METHODS

One hundred and eighty-six irradiated (with and/or without fluoride) primary enamel teeth from high-caries-risk children, which were exfoliated over a 1-year period, were collected, and the sample surface area was submitted for scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, and X-ray energy-dispersive spectrometry (EDS). The subsurface was analyzed by Knoop microhardness and light microscopy (LM). Data were analyzed by one way ANOVA and Tukey tests (α=0.05) and Kruskall-Wallis and Tukey tests (α=0.05).

RESULTS

FTIR analysis revealed a higher concentration of phosphate and carbonate in the irradiated (0.987±0.064) and lower concentration in the control groups (1.477±0.310). SEM analysis showed that the control samples exhibited a slightly smoother surface than the irradiated groups. The EDS analysis did not show any differences in the amount of calcium, phosphorus, or fluoride among the groups. The microhardness analysis revealed that sealant (249.86±7.15) and laser irradiation (262.44±22.69) led to higher hardness values than the negative control group (128.35±25.19). LM indicated significantly reduced caries formation in the laser (5.35±5.38%) and the laser plus acidulated phosphate fluoride (APF) groups (10.35±0.88%) compared with the negative control group (72.56±12.86%).

CONCLUSIONS

Even with the limitations of the present study, these results suggest that Nd:YAG irradiation clinically modified the chemical composition of the enamel surface regardless of fluoride concentration, which successfully inhibited demineralization of primary tooth enamel over a 1-year period without significant morphological changes.

Laser-Casein phosphopeptide effect on remineralization of early enamel lesions in primary teeth

Background

The aim of this study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth.

Material and Methods

Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crème, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win.

Results

The subjects of group D demonstrated a significant increase in the calcium and phosphate contents of enamel surface compared to those of groups A (P < 0.001, P < 0.001), B (P < 0.001, P < 0.001) and C (P = 0.024, P = 0.04), respectively. A statistically significant difference was seen for mean VHN between groups A and B (P = 0.002). SEM evaluations confirmed the results.

Conclusions

The combination of Nd:YAG laser and CPP-ACP crème could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth.

Key words:CPP-ACP, enamel remineralization, microhardness, Nd:YAG, primary teeth, SEM.

Lasers in orthodontics

Many types of dental lasers are currently available that can be efficiently used for soft and hard tissue applications in the field of orthodontics. For achieving the desired effects in the target tissue, knowledge of laser characteristics such as power, wavelength and timing, is necessary. Laser therapy is advantageous because it often avoids bleeding, can be pain free, is non-invasive and is relatively quick. The high cost is its primary disadvantage. It is very important to take the necessary precautions to prevent possible tissue damage when using laser dental systems. Here, we reviewed the main types and characteristics of laser systems used in dental practice and discuss the applications of lasers in orthodontics, harmful effects and laser system safety.

Potential Mechanism for the Laser-Fluoride Effect on Enamel Demineralization

Laser-induced prevention of dental caries has been studied extensively. However, the cariostatic mechanisms of a combined fluoride-laser treatment are not well-understood. Using micro- computed tomography (micro-CT), we quantified the effect of fluoride and/or Er:YAG laser treatment on enamel demineralization. The mean mineral loss (%/V) for each group was 4,870 ± 1,434 (fluoride followed by laser treatment), 6,341 ± 2,204 (laser treatment), 7,669 ± 2,255 (fluoride treatment), and 10,779 ± 2,936 (control). The preventive effect of the laser ( p < 0.001) and fluoride ( p = 0.010) treatment was statistically significant. Characterized by micro-x-ray diffraction (XRD) analysis, the significant contraction in the a-axis after both laser and combined laser/fluoride treatment was revealed (both p < 0.05). In conclusion, subablative low-energy Er:YAG laser irradiation following fluoride treatment may instantaneously transform enamel hydroxyapatite into fluoridated hydroxyapatite to reduce enamel solubility as a preventive treatment for enamel demineralization.

Evaluation of primary tooth enamel surface morphology and microhardness after Nd:YAG laser irradiation and APF gel treatment--an in vitro study

OBJECTIVE

Laser irradiation and fluoride has been used as a preventive tool to combat dental caries in permanent teeth, but little has been done for primary teeth which are more prone to caries. The purpose of this study was to evaluate microhardness alterations in the primary tooth enamel after Nd-YAG laser irradiation alone and combined with topical fluoride treatment either before or after Nd-YAG laser irradiation.

METHOD

Ten primary molars were sectioned and assigned randomly to: control group, Nd-YAG laser irradiation, Nd-YAG lasing before APF and APF followed by Nd-YAG lasing. The groups were evaluated for microhardness. Surface morphological changes were observed using SEM.

RESULTS

Statistical comparisons were performed. The control group's SEM showed a relatively smooth enamel surface and lasing group had fine cracks and porosities. In the lasing + fluoride group a homogenous confluent surface was seen. In the fluoride + lasing group an irregular contour with marked crack propagation was noted. There was a significant increase in the microhardness of the treatment groups.

CONCLUSION

Nd-YAG laser irradiation and combined APF treatment of the primary tooth enamel gave morphologically hardened enamel surface which can be a protective barrier against a cariogenic attack.

Effect of Nd:YAG laser and acidulated phosphate fluoride on bovine and human enamel submitted to erosion/abrasion or erosion only: an in vitro preliminary study

OBJECTIVE

The aim of the present in vitro study was to evaluate, using two different methodologies, the effectiveness of pulsed Nd:YAG laser irradiation associated with topical acidulated phosphate fluoride (APF) for preventing enamel erosion and structure loss under regimes of erosion and abrasion or erosion only.

BACKGROUND DATA

An increased incidence of noncarious lesions (erosion and abrasion) has been observed, consequently new preventative therapies have been proposed.

MATERIALS AND METHODS

Two different methodologies were performed. For the first, 100 bovine crowns were submitted to four different treatments (n = 25): no treatment (control), 4 min application of APF, Nd:YAG laser irradiation (1 W, 100 mJ, 10 Hz, 141.5 J/cm(2)), and Nd:YAG laser irradiation + 4 min of APF. After the specimens were exposed to citric acid (2% w/v; 30 min), they were submitted to 5000 brushing cycles. Specimen mass was measured before and after the treatments. For the second methodology, 20 human crowns were embedded in acrylic resin and cut surfaces were exposed and polished. The specimens were divided into four groups (n = 10): no treatment (control), APF for 4 min, Nd:YAG laser irradiation (1 W, 100 mJ, 10 Hz, 125 J/cm(2)), and Nd:YAG laser irradiation + APF. The samples were then immersed in citric acid (2% w/v; 90 min). Vickers hardness was obtained before and after the treatments.

RESULTS

The Nd:YAG laser irradiation + APF (bovine and human enamel) was more effective and yielded statistically significant results for surface microhardness and enamel wear.

CONCLUSION

Nd:YAG laser irradiation associated with APF reduced bovine enamel wear and human enamel softening when samples were submitted to a regime of erosion and abrasion or erosion only in vitro.

Laser-activated fluoride treatment of enamel as prevention against erosion

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.

Laser-activated fluoride treatment of enamel against an artificial caries challenge: comparison of five wavelengths

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.

Effect of low-level laser treatment after installation of dental titanium implant-immunohistochemical study of RANKL, RANK, OPG: An experimental study in rats

BACKGROUND AND OBJECTIVES

This experiment using an animal experimental model was conducted in order to investigate the effect of low-level laser therapy (LLLT) on the healing of the dental titanium implant.

STUDY DESIGN/MATERIALS AND METHODS

The experimental group received LLLT for a week and the control group did not. Each group consisted of 10 rats. Two rats from the groups were euthenized on the days 1, 3, 7, 14, and 21 of the experiment. The expression of receptor activator of nuclear factor kB ligand (RANKL), osteoprotegerin (OPG), and receptor activator of nuclear factor kB (RANK) were investigated.

RESULTS

The expression of RANKL was observed from the initial stage of the installation of the implant for both the experimental and control groups. However, the degree of expression was higher in the experimental group. The degree of expression of OPG increased remarkably in the experimental group, while in the control group the degree of expression increased only slightly. In the experimental group, the expression of RANK was observed from the first day, but in the control group, it was weakly observed after day 3. The overall expression within the bone was slight on day 7 in the control group, while an active expression was observed in the experimental group. Bone density after installation of dental titanium implant during osseointegration in the experimental group was higher than the control group. The surface and structure of the titanium implant was not damaged by low-level laser (LLL).

CONCLUSIONS

From the above results, the expression of OPG, RANKL, and RANK during the osseointegration of the dental titanium implant was observed within bone tissue. The application of the LLL influenced the expression of OPG, RANKL, and RANK, and resulted in the expansion of metabolic bone activity and increased the activity of bone tissue cells.

Laser-fluoride effect on root demineralization

Although the individual cariostatic effects of laser and fluoride have been shown, the combined effect of CO(2) laser and fluoride on root demineralization remains uncertain and was the main aim of this study. By using a pH-cycling system and Polarized Light Microscopy, we demonstrated the synergistic effect of fluoride combined with CO(2) laser treatment on reducing root demineralization. The mean lesion depths (in microm) for each group were 160 +/- 14 (Control), 113 +/- 8 (Laser treatment alone), 111 +/- 6 (Fluoride treatment alone), and 25 +/- 7 (Fluoride followed by laser treatment). A significant laser-enhanced fluoride uptake, characterized by the ToF-SIMS analysis, was revealed by the 37% and 400% increments in loosely and firmly bound fluorides (both p < 0.002) in laser-irradiated areas, compared with the non-irradiated controls. In conclusion, there is a significant synergistic effect of combined CO(2) laser and fluoride treatment on the inhibition of root demineralization, possibly due to laser-enhanced fluoride uptake in the root.

Thermal ablation of FEL irradiation using gypsum as an indicator

Thermal effects produced in a laser-irradiated sample were studied by micro-X-ray diffraction and micro-Fourier transform infrared spectroscopy (FTIR). Gypsum, transformed into bassanite at 124 degrees C and into anhydrite at 147 degrees C, was used as a thermal indicator. Pit formation by a wavelength-tunable free electron laser (FEL) irradiation on the gypsum pellet maximized at a wavelength of 3.0 microm, 2 mJ/shot, and pits were not detected in those irradiated at 2.6 or 3.8 microm compared with the maximum at 3.0 microm and diminished at 2.0 or 4.0 microm in the human tooth case. Micro-X-ray diffraction and micro-FTIR did not reveal any appreciable bassanite or anhydrite in the irradiated regions. From the laser ablation viewpoint, these results allow the FEL ablation to be considered as plasma or evaporative ones. This study indicated that the micro-pulse of laser was effective to prevent thermal damages of laser irradiation.

Increased fluoride uptake and acid resistance by CO2 laser-irradiation through topically applied fluoride on human enamel in vitro

OBJECTIVES

The aim of the current in vitro study was to evaluate the effect of CO(2)-laser treatment immediately after applying amine fluoride solution on enamel. It was hypothesized that such a treatment would increase enamel fluoride uptake, and reduce dissolution rate and thermal surface alterations.

METHODS

Fluoride uptake was determined in 40 human enamel sections randomly assigned to four groups (n=10), which were either left untreated (1), exposed to a 1% amine fluoride solution for 15s without irradiation (2), irradiated for 15s with a continuous-wave carbon dioxide laser (3), or laser-treated for 15s through the amine fluoride solution applied immediately beforehand (4). Fluoride uptake was determined with an ion selective electrode after acid dissolution of the specimens (surface and subsurface layers). For the determination of acid resistance, another 40 enamel sections were treated according to the above protocol. Acid resistance was determined in surface and subsurface layers by measuring eluted calcium upon 3% lactic acid exposure with atomic absorption spectrometry. Enamel surface alterations after laser irradiation were monitored using scanning electron microscopy.

RESULTS

Laser irradiation through the fluoride solution led to significantly higher fluoride contents in the surface enamel layer compared to fluoride treatment alone or laser treatment alone (p=0.002). Laser treatment with or without fluoride resulted in an increased acid resistance of enamel specimens. Fewer surface alterations were observed upon SEM examination of specimens irradiated through the amine fluoride solution compared to counterparts treated with laser only.

CONCLUSIONS

CO(2) laser light application through an amine fluoride solution may be useful and effective in the prevention of caries.

Effects of CO2 laser on fluoride uptake in enamel

OBJECTIVES

The objective of this study was to investigate the effects of CO(2) laser on fluoride uptake in the loosely- and firmly-bound forms in enamel.

METHODS

Five human molars were cut into halves before being treated with 2.0% NaF topical gel. Each half had three windows on the enamel surface, including one control and two experimental windows irradiated by two laser therapies. One half of each tooth was treated with 1 M KOH solution to remove the loosely-bound fluoride (calcium fluoride). A tooth section was obtained from each window and the relative fluorine concentration was analyzed with Secondary Ion Mass Spectrometry (SIMS). The morphology of the enamel surfaces in the windows was examined using an Environmental Scanning Electron Microscope (ESEM).

RESULTS

Significant laser-induced increases in the uptake of fluoride were revealed in both loosely-bound and firmly-bound apatitic fluoride, with both laser treatments (all p<0.001). Calcium fluoride-like deposits on the enamel surfaces receiving the combined laser-fluoride treatment were revealed by ESEM.

CONCLUSIONS

The finding of this study substantiated the laser effect in increasing the fluoride uptake into enamel.

Sintering mechanism of the CaF2 on hydroxyapatite by a 10.6-l microm CO2 laser

BACKGROUND AND OBJECTIVES

Laser has been reported as a heat source for melting and re-crystallization. Occurring at about 1100 degrees C, the melting of surface dental enamel along with re-crystallization might have an assistant role in the therapy of hypersensitive tooth, apical sealing of endodontic surgery in dentistry, preventive dentistry for pit and fissure sealing, and fluoridation. For laser to be accepted in clinical applications, it is desired that, studies must show the incorporation of CaF(2) into hydroxyapatite could reduce the sintering temperature for the sake of safety.

STUDY DESIGN/MATERIALS AND METHODS

In this study, the Sharplan 20XJ CO(2) laser with 10.6- microm wavelength was set under the following parameters: power, 5 W; repetitive mode, 0.1 second; beam, focused. Fluorite was added to hydroxyapatite as a synthetic compound to lower the sintering temperature. Human dental enamel without caries was used for in vitro sintering test. Scanning electron microscopy (SEM), X-ray diffractometer (XRD), Fourier transforming infrared spectroscopy (FTIR), and differential thermal analysis/thermogravimetric analysis (DAT/TGA) were used for the investigation of sintering mechanism of CaF(2).

RESULTS

Fusion between hexagonal shape crystals and cubic shape crystals (CaF(2)) were observed under SEM study. Hexagonal shape crystals indicated the formation of fluorapatite under XRD analysis. Under FTIR study, we examined reductions of water (3445 cm(-1)) and hydroxyl bands (3567 and 627 cm(-1)) in irradiated compounds. From the DTA pattern of synthetic compound, it showed the endothermic reaction reaching its peak point around 1180 +/- 20 degrees C. It was attributed to the phase transformation and/or initial melting.

CONCLUSIONS

In this study, we proposed the interrelationship of the eutectics between initiator (CaF(2)) and the reaction product (calcium hydroxide) that reduced the sintering temperature. It appeared that the co-eutectics interacted to reduce the sintering temperature of hydroxyapatite below 800 degrees C and that the key eutectic was calcium hydroxide. The clinical feasibility of the melting and re-crystallization of hydroxyapatite under 10.6-microm CO(2) laser would be therefore enhanced.

The effects of argon laser irradiation on enamel decalcification: An in vivo study

Enamel decalcification is a significant problem in orthodontic patients. The argon laser has been shown to reduce decalcification during an acidic challenge in vitro. The purpose of this study was to investigate the in vivo effects of argon laser irradiation on enamel decalcification during orthodontic treatment. Nine volunteers whose treatment plans included 4 first premolar extractions were enrolled in the study. The 36 extracted premolars were assigned to 1 of the following 4 groups: group 1, control group with no treatment; group 2 (pumice-laser), teeth were pumiced for 3 seconds and treated with a 325 mW, 5-mm diameter laser beam for 60 seconds; group 3 (pumice-etch-laser), teeth were pumiced for 3 seconds, acid-etched with 30% phosphoric acid for 30 seconds, and treated for 60 seconds with laser; and group 4 (laser only), teeth were treated for 60 seconds with laser. A specially designed (oversized) orthodontic band was fitted on each of the premolars to create a pocket for decalcification. The bands were cemented in place for 5 weeks. After extraction, the teeth were sectioned and examined under polarized light microscopy. Images of lesions were digitally analyzed and measured. Average lesion depths were calculated from 3 depth measurements recorded 10 microm apart. Average lesion area was calculated with the aid of imaging analysis software. Data were analyzed with analysis of variance (P <.05) and Student t tests. Significant differences were found in lesion depth (P <.001) and lesion area (P <.01) among the 4 test groups. The average lesion depths were 15.93 +/- 9.31 microm (control), 6.45 +/- 8.70 microm (pumice-laser), 1.71 +/- 4.82 microm (pumice-etch-laser), and 1.34 +/- 3.80 microm (laser only). The average lesion areas were 1028.67 +/- 725.68 microm (2) (control), 555.49 +/- 948.20 microm (2) (pumice-laser), 79.91 +/- 226.03 microm (2) (pumice-etch-laser), and 55.71 +/- 157.59 microm (2) (laser only). The average lesion depth in the laser-only group was reduced by 94.1% and the average lesion area was reduced by 94.4% when compared with the control group. In the pumice-etch-laser group, the average lesion depth was reduced by 89.1% and the average lesion area was reduced by 92.2% when compared with the control group. There were no significant differences in lesion depth and lesion area between maxillary and mandibular teeth (P <.06 and P <.08, respectively) and between the teeth on the right and left sides (P <.68 and P <.55, respectively). These results show that argon laser irradiation is effective in reducing enamel decalcification during orthodontic treatment. Pumicing and etching do not appear to reduce the effect of laser on enamel solubility.

Laser-matrix-fluoride effects on enamel demineralization

Laser and fluoride have been shown to inhibit enamel demineralization. However, the role of organic matrix and their interactions remains unclear. This study investigated the interaction among CO2 laser irradiation, fluoride, and the organic matrix on the demineralization of human enamel. Twenty-four molars were selected and cut into halves. One half of each tooth was depleted of its lipid and protein. The other half served as a matched control. Each tooth half had two window areas, treated with a 2.0% NaF gel. All left windows then received a laser treatment. Next, the tooth halves were subjected to a four-day pH-cycling procedure that created caries-like lesions. Tooth sections were cut from the windows, and microradiographs were used for quantification of the demineralization. The combined fluoride-laser treatment led to 98.3% and 95.1% reductions in mineral loss for enamel with and without organic matrix, respectively, when compared with sound enamel.

Study on acid resistance of human dental enamel and dentin irradiated by semiconductor laser with Ag(NH3)2F solution

OBJECTIVE

The purpose of this study was to investigate the acquired acid resistance of human dental enamel and dentin treated by 38% diamine silver fluoride [Ag(NH3)2F] solution and semiconductor (diode) laser irradiation in vitro.

BACKGROUND DATA

There have been no reports on the acid-resistant effect by combined use of fluoride and semiconductor laser.

METHODS

Sixty crowns of extracted human molars were divided into two groups for enamel and dentin samples, and each group was subdivided into three subgroups of 10 each. Each subgroup of enamel and dentin samples served as a control; one was treated with Ag(NH3)2F and the other was treated with Ag(NH3)2F and semiconductor laser irradiation at 2 W for 30 sec. Then all samples were immersed in 5 ml of 0.1 M lactic acid (pH 4.8) at 37 degrees C for 24 h. The concentration of calcium ion (Ca2+) dissolved in the solution was measured by atomic absorption spectrophotometry, and the samples were observed by stereoscopy and scanning electron microscopy (SEM).

RESULTS

In both enamel and dentin samples, dissolved Ca2+ concentration in Ag(NH3)2F- or Ag(NH3)2F- and laser-treated group was significantly decreased compared with that in the control (p < 0.01). SEM findings showed that numerous cubic particles ranging from 0.1 to 0.5 mcirom were observed only in the combined treated groups of both enamel and dentin samples.

CONCLUSIONS

A significantly decreased solubility of human enamel and dentin was acquired after treatment by Ag(NH3)2F and semiconductor laser irradiation, which suggested that this combined use has the capability of a more efficient acid-resistant effect on human dental hard tissues.

Effect of argon laser irradiation on shear bond strength of orthodontic brackets: an in vitro study

Argon lasers, due to their significant time savings over conventional curing lights, are being investigated for use in bonding orthodontic brackets. They are also being investigated for their ability to confer demineralization resistance on enamel. The purpose of this study was to evaluate the effects of argon laser irradiation on bond strength at 3 different laser energies (200, 230, and 300 mW) and at 3 unique time points of laser application (before, during, or after bracket placement). One hundred-fifty human posterior teeth were divided into 9 study groups and 1 control group. After debonding, the adhesive remnant index was scored for each tooth. There was no evidence of an effect of energy level on bond strength, P =.903, or of an interaction between timing of bracket placement and energy level, P =.858. When combining data across energy levels, the mean bond strength was significantly different between all 3 bracket placement groups, P <.001. In addition, the mean bond strength of teeth lased after bonding was significantly higher than the control group, P <.05. There were no statistically significant differences between adhesive remnant index scores among the 10 groups. Lasing the enamel before or after bonding does not adversely affect bond strength. Use of the argon laser to bond orthodontic brackets can yield excellent bond strengths in significantly less time than conventional curing lights, while possibly making the enamel more resistant to demineralization.

Caries resistance in enamel by laser irradiation and topical fluoride treatment

PURPOSE

The purpose of this in vitro study was to compare caries resistance of sound human enamel following argon laser (AL) irradiation, as well as, combinations of topical fluoride foams and AL irradiation.

METHODS AND MATERIALS

Thirty extracted human teeth were sectioned into four buccal windows and assigned to one of the following treatment groups: (1) no treatment/control; (2) low fluence (11.5 J/cm2) AL irradiation for 10 seconds; (3) 1.23% APF foam for 4 minutes followed by low fluence AL irradiation; (4) 2.0% NaF foam for 4 minutes followed by low fluence AL irradiation. Caries-like lesions were created by submerging the teeth in ten Cate solution (pH 4.5). Following a 96-hour exposure period, 100 microns longitudinal sections were prepared for polarized light evaluation. Visilog 5.1.1. image analysis software was used to obtain quantitative lesion depths. The Scheffe F-test was used to compare the lesion depths for each of the four treatment groups.

RESULTS

Lesion depths were: 16.1 +/- 6 microns for control; 13.7 +/- 4 microns for AL irradiation alone; 12.1 +/- 4.3 microns for 1.23% APF foam before AL irradiation; and 11.4 +/- 5.9 microns for 2.0% NaF foam before AL irradiation. Significant difference (p < 0.05) was found between the control group and the 2.0% NaF foam before AL irradiation group. AL irradiation alone reduced lesion depth by 15% compared with the control lesion. When AL irradiation was combined with 1.23% APF foam treatment, lesion depth decreased by 25% compared with control lesions, and by 29% when combined with 2.0% NaF foam.

CONCLUSION

Combining AL irradiation and 2.0% NaF foam treatment significantly enhances the resistance of sound enamel to an in vitro cariogenic challenge.

Lasers in dentistry

Since the development of the ruby laser by Maiman in 1960, there has been great interest among dental practitioners, scientists, and patients to use this tool to make dental treatment more pleasant. Oral soft tissue uses are becoming more common in dental offices. The possible multiple uses of lasers in dentistry, beyond soft tissue surgery and dental composite curing, unfortunately, have not yet been realized clinically. These include replacement of the dental drill with a laser, laser dental decay prevention, and laser decay detection. The essential question is whether a laser can provide equal or improved treatment over conventional care. Safe use of lasers also must be the underlying goal of proposed or future laser therapy. With the availability and future development of different laser wavelengths and methods of pulsing, much interest is developing in this growing field. This article reviews the role of lasers in dentistry since the early 1960s, summarizes some research reports from the last few years, and proposes what the authors feel the future may hold for lasers in dentistry.

Argon laser irradiation in root surface caries: in vitro study examines laser's effects

Recent research shows that laser irradiation can improve enamel's resistance to caries. This in vitro study examines the effects of argon laser irradiation on root surface caries. Treated surfaces seemed more resistant to an artificial caries medium than control surfaces.

Removal of benign tumors using the CO 2 laser

The CO 2 laser is most widely used for treatment of lesions affecting the oral mucosa. This paper concerns the use of CO 2 laser surgery in benign tumors. Thirty-seven cases of benign tumors were treated and two of them, a papilloma and a reactional fibroma, are described in detail.

Lasers in the limelight: what will the future bring?

Early lasers produced too much heat and melted tooth enamel. But lasers improved enough to use in dentin bonding and composite curing and to detect carious enamel.

Effect of the ArF excimer laser on human enamel

Human enamel surface was irradiated with ArF excimer laser and examined under light microscopy and scanning electron microscopy (SEM). Enamel surface was irradiated at three different areas with different energy fluences. It is demonstrated that the ArF excimer laser causes ablation of the calcified hard enamel tissue. Ablation curves were measured. There was no significant difference found in the etch depth between the three different areas of enamel surface. The morphology of the irradiated areas seen under the SEM was found to be dependent on energy fluence. It changed with increase in energy fluence from being etched to forming a smooth, fused, glaze-like surface and then at very high energy fluences producing a rough surface. The influence of the laser irradiation was confined to the irradiated area only, with no visible heat damage to the surroundings. These results suggest that excimer laser could be applied in a controlled and defined manner for tooth enamel treatments in dentistry.

Application of the argon laser to dentistry

A review was conducted to determine specific areas of application of the argon laser to dentistry. When appropriate, comparisons between the argon laser and other treatment methods were made. It was concluded that the argon laser has applicability in composite resin placement, in enamel and dentin bonding procedures, in preventive dental therapies, and in endodontic procedures.

Carbon dioxide laser oral safety parameters for teeth

The carbon dioxide laser is used in the oral cavity for a variety of procedures. Although the procedures may not involve the teeth directly, precaution should be exercised to preserve their integrity. The results of this study indicate that the most limiting parameter for oral use of the CO2 laser is damage to the enamel surface, which could be inflicted with as little as 5 W for 0.2 second and a 1 mm beam. Care should be exercised to prevent inadvertent damage to the surface enamel of teeth even at very low energy levels.

Pulpal response to irradiation of enamel with continuous wave CO2 laser

Selected dog's teeth, in vivo, were exposed to carbon dioxide (CO2) laser power densities ranging from 13 to 102 J per cm2. The teeth were extracted 48 h postlasing, fixed with 10% neutral buffered formalin, decalcified with Kristensen's solution, processed, sectioned, stained, and evaluated for pulpal damage. No pulpal damage was observed when compared with nonlased control teeth. It appears that carbon dioxide laser power densities of approximately 13 to 102 J per cm2 could be used to irradiate enamel of teeth without damage to the pulp.

Enhancement of physical properties of resin restorative materials by laser polymerization

A study was conducted to compare the compressive strength, diametral tensile strength, transverse flexural strength, and flexural modulus of a microfilled and a small particle composite resin restorative material following argon laser and conventional visible light polymerization techniques. All physical properties examined in this study were enhanced by laser polymerization. The diametral tensile strength of both types of restorative materials was significantly greater following laser polymerization, as were the transverse flexural strength and the flexural modulus of the microfilled resin restorative material. Additionally, these results were obtained with a laser polymerization time that was one-fourth that used for visible light activation. It was concluded that the argon laser is a potentially advantageous means of initiating the polymerization of dental composite resin restorations.

Thermal effects of lasers on dental tissues

The thermal effects of Nd:YAG, argon, and CO2 laser beams are observed on enamel, dentin, and dental pulp by means of computerized infrared thermography and thermocouple. This study shows that the Nd:YAG laser beam deeply diffuses through the enamel and dentin to the pulp. The argon laser effects are inconsistent depending on whether the enamel surface is cleaned, but after cleaning, the superficial and deep temperatures are low. With the CO2 laser, the enamel and dentin surfaces reach very high temperatures, but only low temperatures are measured in the pulp chamber.

Changes in heated and in laser-irradiated human tooth enamel and their probable effects on solubility

Enamel of intact human teeth laser irradiated in vitro under certain conditions is known to have less subsurface demineralization than unirradiated enamel on exposure to acid; consequently, the potential use of laser irradiance to reduce caries is apparent. The laser-induced physical and/or chemical changes that cause this reduced subsurface demineralization are not known. A laser-irradiated tooth enamel surface will have a temperature gradient that decreases towards the dentin junction. Dependent on irradiant conditions, the temperature may range from greater than 1400 degrees C at the surface to near normal at the dentin-pulp junction. Along this steep temperature gradient, different compositional, structural, and phase changes in the tooth enamel are to be expected. Identification of changes occurring along this gradient has bearing on understanding the dissolution reduction mechanism and, in turn, optimizing its effect. Changes in laser-irradiated material from the highest temperature region have been characterized, but those occurring in sequential layers of decreasing temperatures have not. Since the laser-induced changes are expected to primarily arise from localized heating, previously reported thermally induced changes in tooth enamel on heating in conventional furnaces were utilized to infer corollary changes along the gradient in laser-irradiated tooth enamel. These thermally inferred changes which resulted in modifications in the tooth enamel apatite and/or newly formed phases were correlated with their probable effects on altering solubility. A temperature gradient range from 100-1600 degrees C was considered with subdivisions as follows: I, 100-650 degrees C; II, 650-1100 degrees C; and III, greater than 1100 degrees C. Two of the products formed in range III, alpha-Ca3(PO4)2 and Ca4(PO4)2O, and also identified in the fused-melted material from laser-irradiated tooth enamel, are expected to markedly increase solubility in those regions that contain considerable amounts of these compounds. Products and changes occurring in range II, separate phases of alpha- and/or beta-Ca3(PO4)2 and a modified phase of apatite, may increase or decrease the solubility depending on the Ca/P ratio and the resultant amounts of alpha-, beta-Ca3(PO4)2 formed. Modifications in tooth enamel apatite effected in range I are expected to decrease its solubility; the formation of pyrophosphate in this range may have a substantial effect on reducing the solubility rate.(ABSTRACT TRUNCATED AT 400 WORDS)