CO<sub>2</sub> Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel

Valério, Rodrigo Alexandre; Rocha, Carlos; Galo, Rodrigo; Borsatto, Maria Cristina; Saraiva, Maria da Conceição Pereira; Corona, Silmara Aparecida Milori

doi:10.1155/2015/547569

Cited by 13 publications

(14 citation statements)

References 39 publications

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“…Laser application followed by nano hydroxyapatite application showed the highest mean microhardness; nHA (341.57±5.99 VHN), nFHA (320.67±3.09 VHN). The increased microhardness of the softened enamel following laser irradiation has been attributed to the ultrastructural changes including crystal size growth and recrystallization of porous enamel as a result of high temperature rise in the surface ( 14 ). It is possible that the chemical and structural alterations facilitated nanohydroxyapatite deposition, thus improving microhardness of enamel surface ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects

Assal¹,

Saafan²,

Moustafa³

et al. 2018

J Clin Exp Dent

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BackgroundThe aim of this study was to evaluate the effect of combining fractional CO2 LASER and nanohydroxy apatite on surface microhardness and color of enamel with initial defects.Material and MethodsTwo types of nano hydroxylapatite (nHAP) was prepared; Pure hydroxyapatite (nHA) and Fluoro hydroxyapatite (nFHA), Sixty extracted premolar teeth without visible caries or structural defects on enamel surface were used, immersed in 10 ml of a demineralizing solution for 2 weeks to create artificial white spot lesions, they were randomly allocated into two groups; Group 1: nHA, Group 2: nFHA, each group is then subdivided into 2 subgroups (A and B) where two different in vitroremineralization procedures have been performed, the first procedure utilizes a 10 wt% nHA aqueous slurries only, the second was first exposed to irradiation from a fractional CO2 laser then (nHAP) was applied. Microhardness and color were measured using a micro-Vickers hardness tester and spectrophotometer respectively.ResultsLaser treated teeth in both groups showed the highest mean hardness and lowest color difference where ΔE was less than 3.3 units, in both tests the pure type of nanohydroxyapatite gave better results than the nanofluroapatite type.ConclusionsNano-hydroxyapatite has remarkable remineralizing effects on initial lesions of enamel, certainly higher when combined with laser application. Key words:CO2 LASER, Enamel remineralization, Nanohydroxy apatite.

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Section: Discussionmentioning

confidence: 99%

The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects

Assal¹,

Saafan²,

Moustafa³

et al. 2018

J Clin Exp Dent

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“…9,15 This effect is probably related to the temperature increase of the irradiated surface, leading to a decreased permeability, reduced enamel solubility and partial denaturation of the organic matrix. 37 The products of the heated organic material can obstruct the pores of the tooth enamel, 18 thereby preventing the penetration of acid ions and decreasing enamel dissolution. 12,18 Another relevant aspect is the reduction of the enamel dissolution critical pH to 4.8 after CO 2 laser irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…37 The products of the heated organic material can obstruct the pores of the tooth enamel, 18 thereby preventing the penetration of acid ions and decreasing enamel dissolution. 12,18 Another relevant aspect is the reduction of the enamel dissolution critical pH to 4.8 after CO 2 laser irradiation. If fluoride is present in the irradiated surface, the critical-pH point is further reduced to 4.3, hampering the formation or progression of caries when both treatments are combined.…”

Section: Discussionmentioning

confidence: 99%

“…10 This process decreases the permeability and hampers the acid diffusion, thereby reducing enamel demineralization. [11][12][13] Some CO2 parameters, such as output power 14,15 and a wavelength of 10.6 um 3,12, [16][17][18] have been widely studied to prevent demineralization or increase enamel microhardness. However, different pulse emission modes of the CO 2 laser have not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of CO2 Laser Treatment and Acidulated Phosphate Fluoride on Enamel Demineralization and Biofilm Formation

et al. 2019

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Introduction: This study evaluated the impact of CO 2 laser treatment and acidulated phosphate fluoride (APF) on enamel demineralization and biofilm formation, using in vitro and in situ designs. Methods: Demineralized enamel slabs were distributed among 8 groups: placebo, placebo + continuous CO 2 laser, placebo + repeated CO 2 laser, placebo + ultrapulsed CO 2 laser, 1.23% APF, APF + continuous CO 2 laser, APF + repeated CO 2 laser and APF + ultrapulsed CO 2 laser. In the in vitro study, 15 enamel slabs from each group were subjected to a pH-cycling regimen for 14 days. In the cross over in situ design, 11 volunteers wore palatal appliances with demineralized enamel slabs for 2 periods of 14 days each. Drops of sucrose solution were dripped onto enamel slabs 8×/day. Biofilms formed on slabs were collected and the colony-forming units (CFU) of Streptococcus mutans and Lactobacillus were determined. Results: For both in vitro and in situ studies, there was no significant difference between treatments (P > 0.05). However, all treatments increased microhardness of demineralized enamel (P < 0.05). After a further in situ cariogenic challenge, with the exception of the placebo, all treatments maintained microhardness values (P < 0.05). Microbiological analysis showed no difference in Streptococcus mutans (P > 0.05) or Lactobacillus (P > 0.05) counts between groups. Conclusion:The results suggest that APF gel combined with the CO 2 laser, regardless of the pulse emission mode used, was effective in controlling enamel demineralization, but none of the tested treatments was able to prevent bacterial colonization.

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“…Nd:YAG laser irradiation was demonstrated to be effective in preventing occlusal caries in pits and fissures of primary teeth by low energy level [183]. CO 2 laser was also effective in the control of demineralization, with the advantages like being quick, comfortable, and simple application, especially in children, considering the difficulty of using a fluoride [184]. More long-term studies are required for understanding the longevity of the laser therapies in preventing caries and remineralization effect on WSLs [179].…”

Section: Lasermentioning

confidence: 99%

Management of White Spot Lesions

Deveci̇¹,

Çınar²,

Tiralı³

2018

Dental Caries - Diagnosis, Prevention and Management

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It has been reported that white spot lesions (WSLs) can be seen as a result of prolonged plaque accumulation on the affected surface of the teeth. They are more often associated with fixed orthodontic treatment and defined as "the presence of clinically detectable, localized areas of enamel demineralization." These lesions are managed in the first step by establishing a good oral hygiene to enhance remineralization, and prophylaxis with products mostly containing fluoride, calcium, or phosphate. The aim of this chapter is to outline the risk factors and preventive measures of WSLs, and the currently used methods to manage it based on the latest evidence.A review of the literature has shown that WSLs develop as a result of prolonged "undisturbed" plaque accumulation on the affected teeth surface, commonly due to inadequate oral hygiene [4][5][6][7][8][9]. Under these conditions, acids diffuse into the enamel and the demineralization continues in the subsurface enamel, then the intact enamel surface collapses and becomes cavitated [10]. It has been shown that these lesions can appear within 4 weeks [11].The concept of caries process was explained with a model; it was initiated by fluctuations in pH caused by the bacteria that are always metabolically active in the biofilm or dental plaque. These fluctuations may cause erratic loss and gain of mineral ("demineralization" and "remineralization") [12]. As a total result of these continuous demineralization and remineralization processes of enamel that occur episodically based on the presence of cariogenic bacteria in dental plaque and the availability of refined carbohydrates for fermentation to organic acids [13], dissolution of the dental hard tissues develops and a caries lesion forms [14].In the first stage of the enamel defect there is a lower mineral distribution and also a lower interprismatic mineral content in the surface layer [15]. It has been proposed that further dissolution of the outer 10-30 microns of enamel is prevented relatively by several metabolic formations. The protective roles of salivary proline-rich proteins and other salivary inhibitors like statherin have also been emphasized [16]. But they cannot penetrate the deeper parts of the enamel due to their macromolecule structures; so their stabilizing role is limited for the surface enamel [17]. The white-spot lesion's shape is determined by the distribution pattern of the biofilm and the direction of the enamel prisms [18].The presence of fixed orthodontic appliances causes an increasing number of plue retention sites as a result of the presence of brackets, bands, wires, and other applications, which makes the cleaning of teeth more difficult [4,5,7,9,10,[19][20][21][22].When the orthodontic bands are removed and the feasibility of tooth cleaning is provided, it results a reduced porosity of the deeper parts of lesions (Figure 1). The return of fluids to supersaturation condition causes a shift in equilibrium and reprecipitation of minerals at the sites of demineralization. As a result of this...

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CO₂ Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel

Cited by 13 publications

References 39 publications

The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects

The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects

The Impact of CO2 Laser Treatment and Acidulated Phosphate Fluoride on Enamel Demineralization and Biofilm Formation

Management of White Spot Lesions

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CO2 Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel

Cited by 13 publications

References 39 publications

The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects

The effect of combining laser and nanohydroxy-apatite on the surface properties of enamel with initial defects

The Impact of CO2 Laser Treatment and Acidulated Phosphate Fluoride on Enamel Demineralization and Biofilm Formation

Management of White Spot Lesions

Contact Info

Product

Resources

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CO₂ Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel