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Hashemikamangar SS, Vahedi M, Khadivi Moghadam M, Behniafar B, Chiniforush N. Evaluation of the cumulative effect of photodynamic therapy and local fluoride on the microhardness and topography of demineralized enamel and cementum surfaces. Heliyon 2024; 10:e35224. [PMID: 39161806 PMCID: PMC11332834 DOI: 10.1016/j.heliyon.2024.e35224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 07/16/2024] [Accepted: 07/24/2024] [Indexed: 08/21/2024] Open
Abstract
Background The present study aimed to determine the cumulative effect of two photodynamic therapy methods with methylene blue and indocyanine green and two topical fluoride therapy methods with fluoride varnish and silver diamine fluoride alone and in combination on the microhardness and topography of demineralized enamel and cementum surfaces. Materials and methods Seventy-two sound human teeth were selected, and their buccal and lingual surfaces were assigned to two main groups of enamel and cementum using simple randomization. The initial surface hardness (SH) of the enamel and cementum in each sample was determined using a micro-Vickers hardness tester using a 200-g force in 10 s. Then artificial caries was induced by immersion in a demineralizing/remineralizing solution (i.e., each tooth provided two samples, one on the buccal aspect and the other on the lingual aspect). Each enamel/cementum main group was divided into two subgroups using simple randomization based on the local fluoride type (fluoride varnish and silver diamine fluoride) and the type of the photosensitizer agent (methylene blue and indocyanine green). Finally, 16 groups were achieved (n = 9). The final surface hardness of the enamel and cementum samples was determined as described above. Finally, the sample surfaces were prepared for the surface topography evaluation under a scanning electron microscope. The baseline microhardness was compared between the 16 study groups in the first step using one-way ANOVA. Then, three-way ANOVA was used to evaluate the effect of fluoride, laser, and surface (enamel and cementum) on microhardness. Results All the groups exhibited decreased microhardness due to the induction of artificial caries. In both main groups of enamel and cementum, the lowest decrease in microhardness was recorded with combined photodynamic therapy and methylene blue photosensitizer material and fluoride varnish (15.1 % for cementum and 16.7 % for enamel), and the highest decrease in microhardness was recorded in the methylene blue group (35.7 % for cementum and 34.9 % for enamel). Conclusion The combination of photodynamic therapy with the photosensitizer substance methylene blue or indocyanine green together with fluoride varnish or silver diamine fluoride is effective on the remineralization of demineralized enamel and cementum. Although there is no difference between the combination of photodynamic therapy with fluoride varnish compared to fluoride varnish alone, both of these treatments are more effective than using photodynamic therapy alone.
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Affiliation(s)
- Sedighe Sadat Hashemikamangar
- Professor, Dental Research Center, Dentistry Research Institute, Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Vahedi
- Dental Student, Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Khadivi Moghadam
- Dental Student, Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Behniafar
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Mapar M, Gholizadeh S, Moalemnia M. Effects of Two Remineralizing Agents in Combination with Er:YAG and CO 2 Laser Irradiation on Microhardness of Demineralized Enamel: A Preliminary In Vitro Study. Front Dent 2024; 21:11. [PMID: 38742220 PMCID: PMC11089429 DOI: 10.18502/fid.v21i11.15223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/20/2023] [Indexed: 05/16/2024] Open
Abstract
Objectives: This study assessed the effects of two remineralizing agents namely MI Paste Plus containing casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACFP) and Remin Pro containing hydroxyapatite, fluoride and xylitol (HFX) with/without erbium-doped yttrium aluminium garnet (Er:YAG) and CO2 laser irradiation on demineralized enamel microhardness. Materials and Methods: In this in vitro study, 70 sound human premolars were mesiodistally sectioned, demineralized at a pH of 4.6 for 8 hours, and randomly divided into 7 remineralization groups (n=10): of (I) MI Paste Plus (CPP-ACFP), (II) Remin Pro (HFX), (III) MI Paste Plus+CO2 laser (0.7 W power, 50 Hz), (IV) Remin Pro+CO2 laser, (V) MI Paste Plus+Er:YAG laser (1 W power, 10 Hz), (VI) Remin Pro+Er:YAG laser, and (VII) negative control. The Vickers hardness number of specimens was then measured. The groups were compared by one-way ANOVA and Tukey's test (α=0.05). Results: The mean microhardness was 319.8±49.9, 325.3±44.6, 359.4±35.7, 296.4±33.7, 319.9±58.1, 358.9±28.4, and 240.0±41.6 kg/mm2 in groups 1 to 7, respectively. The difference in microhardness was significant among the groups (P<0.0001). Pairwise comparisons revealed significant differences in microhardness between all groups (P≤0.03) except between groups 1 and 2, 1 and 5, 2 and 5, and 3 and 6 (P>0.05). Conclusion: Both Remin Pro (containing HFX) and MI Paste Plus (containing CPP-ACFP) can cause enamel remineralization. MI Paste Plus+CO2 laser irradiation and Remin Pro+Er:YAG laser irradiation were significantly more effective than the application of each remineralizing agent alone.
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Affiliation(s)
- Mehran Mapar
- Department of Restorative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sara Gholizadeh
- Department of Restorative Dentistry, Khorasgan Islamic Azad Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mina Moalemnia
- Department of Restorative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Laser as an innovative tool, its implications and advances in dentistry: A systematic review. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2022. [DOI: 10.1016/j.jpap.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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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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Ramezani K, Ahmadi E, Etemadi A, Kharazifard MJ, Omrani LR, Akhoundi MSA. Combined Effect of Fluoride Mouthwash and Sub-ablative Er:YAG Laser for Prevention of White Spot Lesions around Orthodontic Brackets. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2208170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background:
Development of white spot lesions (WSLs) around orthodontic brackets compromises esthetics and necessitates additional dental treatments.
Objectives:
This study aimed to assess the efficacy of fluoride mouthwash combined with Er:YAG laser irradiation for the prevention of WSLs around orthodontic brackets.
Methods:
Orthodontic brackets were bonded to 50 bovine incisors. The entire tooth surface was coated with acid-resistant varnish except for a margin around the brackets. The microhardness of the teeth was measured at the respective area using the Vickers hardness test. The teeth were then randomly divided into five groups (n=10) of control (Gc), Orthokin fluoride mouthwash (Gf), 100 mJ/cm2 Er:YAG laser (Gl), laser + mouthwash (Glf), and mouthwash + laser (Gfl). Then, the teeth underwent pH cycling according to the standard protocol for demineralization. The microhardness of the teeth was measured again, and the percentage of change in microhardness was calculated. The amount of calcium released during pH cycling was quantified using atomic absorption spectroscopy. Data were analyzed using one-way ANOVA and Tukey’s test.
Results:
Calcium release (indicative of demineralization) in the Gf, Gfl, and Glf groups was significantly lower than that in the Gc and Gl groups (P<0.05). The reduction in surface microhardness was also the same in the five groups with no significant difference (P>0.05).
Conclusion:
Fluoride mouthwash combined with Er:YAG laser or Er:YAG laser alone cannot decrease the incidence of WSLs around orthodontic brackets compared to fluoride mouthwash alone.
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Tisler CE, Moldovan M, Petean I, Buduru SD, Prodan D, Sarosi C, Leucuţa DC, Chifor R, Badea ME, Ene R. Human Enamel Fluorination Enhancement by Photodynamic Laser Treatment. Polymers (Basel) 2022; 14:polym14142969. [PMID: 35890745 PMCID: PMC9325182 DOI: 10.3390/polym14142969] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 02/06/2023] Open
Abstract
Poor oral hygiene leads to serious damages of theteeth’s surface enamel such as micro-abrasions and acid erosion. These alterations combined with bacterial plaque result in cavity appearance. Prophylactic measures include various techniques for enamel surface restoration. Fluorination is one of the most important treatments for this purpose. Therefore, in the present research, we investigated the classical fluorination treatment compared with laser photodynamic fluorination performed on human enamel samples with poor surface quality. Three sample groups were investigated: veneer (F), inlay (I), and crowns (C). The general morphologic aspect was investigated by scanning electron microscopy (SEM), and the specific details such as the fine microstructure and nanostructure were investigated by atomic force microscopy (AFM) of the surface roughness. The samples were also investigated by Fourier transformed infrared attenuated total reflectance (FTIR-ATR) to evidence the fluorination effect on the enamel surface. Results showed that all initial samples had an altered state with micro-abrasions and erosion with mineral loss, which increase the surface roughness. The F group was the most damaged, having a higher roughness, and the I group was less damaged. Classic fluorination treatment partially restored the enamel by local re-mineralization, but did not obtain the parameters of healthy enamel. However, a significant decrease of the roughness was observed (statistical relevance p = 0.001 with the Breusch–Pagan Test). This fact was supported by the presence of newly formed fluorides in the FTIR-ATR spectra. The photodynamic laser fluorination restores the enamel in an enhanced manner by a strong re-mineralization, which implies a significant roughness value decrease comparable to healthy enamel. The Breusch–Pagan Test confirmed the relevance with p = 0.001. This is due to an extended re-mineralization abundant in fluoride crystals as observed by AFM and FTIR. Statistical p-values regarding laser application were in the range of 0.02–0.06, supporting its relevance in the fluorination effect. The final conclusion is that the photodynamic effect is able to favor the newly formed fluoride deposition onto the affected sites of the enamel surface.
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Affiliation(s)
- Corina Elena Tisler
- Department of Prosthetic Dentistry and Dental Materials, “Iuliu Hatieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (C.E.T.); (S.D.B.)
| | - Marioara Moldovan
- Department of Polymer Composites, Institute of Chemistry “Raluca Ripan”, University Babes-Bolyai, 30 Fantanele Street, 400294 Cluj-Napoca, Romania; (M.M.); (D.P.); (C.S.)
| | - Ioan Petean
- Faculty of Chemistry and Chemical Engineering, University Babes-Bolyai, 11 Arany János Street, 400028 Cluj-Napoca, Romania
- Correspondence:
| | - Smaranda Dana Buduru
- Department of Prosthetic Dentistry and Dental Materials, “Iuliu Hatieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (C.E.T.); (S.D.B.)
| | - Doina Prodan
- Department of Polymer Composites, Institute of Chemistry “Raluca Ripan”, University Babes-Bolyai, 30 Fantanele Street, 400294 Cluj-Napoca, Romania; (M.M.); (D.P.); (C.S.)
| | - Codruta Sarosi
- Department of Polymer Composites, Institute of Chemistry “Raluca Ripan”, University Babes-Bolyai, 30 Fantanele Street, 400294 Cluj-Napoca, Romania; (M.M.); (D.P.); (C.S.)
| | - Daniel-Corneliu Leucuţa
- Department of Medical Informatics and Biostatistics, “Iuliu Hatieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400012 Cluj-Napoca, Romania;
| | - Radu Chifor
- Department of Preventive Dental Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Avram Iancu 31, 400083 Cluj-Napoca, Romania; (R.C.); (M.E.B.)
| | - Mîndra Eugenia Badea
- Department of Preventive Dental Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Avram Iancu 31, 400083 Cluj-Napoca, Romania; (R.C.); (M.E.B.)
| | - Razvan Ene
- 14 Department, Orthopedics, Anesthesia and Intensive Care, University of Medicine and Pharmacy Carol Davila, 37 Dionisie Lupu Street, 020021 Bucharest, Romania;
- Orthopaedics and Traumatology Department, Bucharest Emergency University Hospital, 169 Splaiul Independenței Street, 050098 Bucharest, Romania
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AlQussier A, Awliya W. Effect of Erbium, Chromium-doped: Yttrium, Scandium, Gallium and Garnet Laser Tooth Preparation on Gap Formation of Universal Adhesive Bonded to Enamel and Dentin: A Micro-CT and SEM Study. J Lasers Med Sci 2022; 13:e14. [DOI: 10.34172/jlms.2022.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/08/2022] [Indexed: 11/09/2022]
Abstract
Introduction: The presence of gaps at the bonding interface of resin composite restorations is known to have an impact on restoration longevity. This study aimed to evaluate the effect of erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er, Cr:YSGG) laser irradiation on gap formation at the tooth–resin interface and to compare the reliability of micro-computed tomography (µCT) and scanning electron microscopy (SEM) scans for gap formation assessment. Methods: Thirty standardized non-retentive class V cavities were prepared on sound human premolars using either an Er,Cr:YSGG laser or a round carbide bur (n=15 for each). A universal adhesive and A nano-filled resin composite were applied in accordance with the manufacturer’s recommendations. After water storage for 24 hours at 37°C, the teeth were subjected to thermocycling. Gap formation assessments were performed by µCT (Skyscan 1173 µCT, Brucker, Belgium) and SEM (JEOL JSM-6610LV, Japan), and SPSS version 24.0 (IBM Inc., Chicago, USA) was used to analyze the data at P value<0.05. Descriptive statistics were used to describe the gap formation percentages. To compare the impact of both preparation and assessment methods, a non-parametric Mann–Whitney U test was used. Results: In enamel, similar gap formation values were detected for the two preparation methods (bur and laser). However, the laser-prepared group showed higher gap formation values in dentin. Additionally, higher gap formation values were reported for both preparation methods when µCT was used for assessment. Conclusion: Cavity preparation using a Waterlase laser led to higher gap formation percentages at the dentin–resin interface. In addition, SEM assessment is more reliable for assessing the tooth–resin interface.
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Affiliation(s)
- Anfal AlQussier
- DScD Student at King Saud University, and Lecturer at Majmaah University, Riyadh, Kingdom of Saudi Arabia
| | - Wedad Awliya
- Professor at King Saud University, Riyadh, Kingdom of Saudi Arabia
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