Effect of Er,Cr:YSGG Laser on the Prevention of Primary and Permanent Teeth Enamel Demineralization: SEM and EDS Evaluation

Comparative evaluation of fluoride-free remineralization agents with and without Er,Cr:YSGG laser on artificial enamel remineralization

This study aimed to evaluate the efficacy of fluoride-free remineralizing agents in initial enamel caries, with and without combined Er,Cr:YSGG laser application. The remineralization effect of various agents and their combinations on artificial initial caries was investigated using 10 experimental groups (n = 7): NC, negative control; PC, positive control; TM, calcium-phosphate compounds (CPP-ACP); TD, theobromine-containing toothpaste; RG, ROCS® remineralizing gel; L, Er,Cr:YSGG laser (2780 nm; 0.25 W; repetition rate, 20 Hz; pulse duration, 140 μs; tip diameter, 600 μm; without air/water cooling); L + fluoride toothpaste; L + TM; L + TD; and L + RG. The demineralized bovine enamel specimens were subjected to an 8-day pH cycle by daily application of the remineralizing agents and laser therapy once prior to the pH cycle and paste application. The enamel samples underwent the Vickers surface microhardness test, and one sample per group was analyzed with scanning electron microscopy. The Kruskal Wallis test was used to compare the microhardness recovery percentage (SMHR%) for each group, and multiple comparisons were made with the Dunn test. Groups L (p = 0.003), RG (p = 0.019), L + TM (p < 0.001), L + fluoride toothpaste (p = 0.001),and L + RG (p = 0.036) exhibited significant increase in SMHR%. The tested remineralizing agents exhibited no statistically significant difference in effect when used alone and in combination with Er,Cr:YSGG laser. Combined application of Er,Cr:YSGG laser and ROCS® remineralization gel effectively promoted enamel remineralization, while use of CPP-ACP and fluoride toothpaste alone was ineffective. Theobromine-containing toothpaste exhibited the least SMHR%. Long-term evaluation of these agents is recommended.

Enamel Erosion Reduction through Coupled Sodium Fluoride and Laser Treatments before Exposition in an Acid Environment: An In Vitro Randomized Control SEM Morphometric Analysis

(1) Background: Erosive lesions of dental enamel are steadily increasing owing to both the availability of exogenous acid and the production of endogenous acid. The aim of this study was to investigate the erosion-inhibiting potential of a diode laser irradiation and topical application of fluoride used alone or in combination on the enamel surface of extracted teeth before exposure to an acidic solution. (2) Methods: The four axial enamel surfaces of 40 healthy molars were used for four study groups: (A) no treatment; (B) application of fluoride gel for 120 s; (O) a diode laser application for 120 s; and (X) a combined laser/fluoride for 120 s. Each enamel surface was examined by SEM (scanning electron microscopy). (3) Results: At 700× magnification, it was possible to detect the enamel prisms of the test area of groups A, B, and O, while no structures such as enamel prisms were highlighted for group X because they were covered by an amorphous layer. The mean number of prisms ×1000 µm2 was 7.2 units with an SD of 0.72 for group A, 8 units with an SD of 0.96 for group B, and 4.8 units with a SD of 0.4 for group O. Student’s t-test showed no significant difference between group A and B with a p = 0.054. Group O showed a significant reduction of prims ×1000 µm2 compared with group A (p = 0.0027) and group B (p = 0.0009). Student’s t-test showed no significant difference between groups A and B with a p = 0.054. Group O showed a significant reduction of prims density with respect to group A (p = 0.0027) and group B (p = 0.0009). (4) Conclusions: This amorphous layer might be correlated with the effect of laser on enamel, which reduces both water and carbonate ion; increases the crystallinity of hydroxyapatite, and improves the mechanical properties of enamel; which is responsible for greater protection expressed by the enamel of group X against acid attacks.

Shear bond strength of metallic brackets bonded to enamel pretreated with Er,Cr:YSGG LASER and CPP-ACP

Background

Increased risk of enamel demineralization during and after orthodontic treatment raises the demand for better preventive measures including combinations of laser, CPP-ACP, and fluoride. The combination of Er,Cr:YSGG laser with CPP-ACP was proved to have a synergetic effect compared to each of them alone. Shear bond strength (SBS) of orthodontic brackets bonded to the enamel surface after being treated with preventive measures is critical. The aim of this study was to compare the SBS and failure mode of metallic brackets bonded to teeth with no pretreatment and pretreated enamel surface, either with Er,Cr:YSGG laser alone or combined with CPP-ACP.

Methods

Sixty sound extracted human premolar teeth were allocated randomly to 3 groups: In Group 1 (control), teeth were etched and bonded directly; in Group 2, laser pretreatment of the enamel surface was done followed by etching and bonding as in the control group; in Group 3, the enamel surface was lased then CPP-ACP was applied according to the manufacturer instructions, etched and bonded. SBS and Adhesive remnant index (ARI) were evaluated.

Results

No significant differences were found between the 3 groups neither in the SBS nor in the ARI scores.

Conclusions

The use of combined Er,Cr:YSGG laser with CPP-ACP as a preventive measure before bonding orthodontic brackets does not endanger the bracket’s bonding strength.