In Vitro Comparison Of Fluoride Gel Alone and in Combination With Er,Cr:YSGG Laser on Reducing White Spot Lesions in Primary Teeth

Abstract

Introduction: Laser therapy has been suggested as a method for caries-prevention, and ErCr:YSGG laser is increasingly used in dentistry. This study aimed to compare the efficacy of fluoride gel alone and in conjunction with Er,Cr:YSGG laser for remineralization of white spot lesions (WSLs) in primary teeth. Methods: This study was conducted on 20 primary teeth with WSLs extracted for orthodontic reasons. Three sections were made of each tooth at the site of WSLs. The surface area of WSLs was measured under a stereomicroscope at ×25 magnification. Samples were assigned to 3 groups of control (group 1), exposure to 1.23% APF gel for 4 minutes (group 2) and Er,Cr:YSGG laser (0.5 W power, 20 Hz frequency, 60% water, 40% air, pulse duration of 5±1 seconds) plus fluoride (group 3). All samples were stored in artificial saliva for 10 days and then the surface area of the WSLs was measured again under a stereomicroscope. Data were analyzed using the Kruskal-Wallis, MannWhitney and Wilcoxon signed rank tests. Results:The reduction in surface area of the WSLs was significantly different between the control and fluoride (P < 0.001) and also the control and laser plus fluoride groups (P < 0.001); the difference between fluoride and laser plus fluoride groups was not significant (P = 0.265).Comparison of the surface area of WSLs before and after the intervention showed no significant difference in group one (P = 0.737) while this difference in groups 2 (P < 0.001) and 3 (P < 0.001) was statistically significant. Conclusion:The results showed that Er,Cr:YSGG laser irradiation plus 1.23% APF gel was not significantly different from the application of fluoride gel alone in enhancing the remineralization of WSLs.

Effect of Er,Cr:YSGG on Remineralization Using CPP - ACPF (MI - Paste Plus) after Enamel Erosion Caused by Carbonated Soft Drink in Primary Teeth: In-Vitro Study

“…Studies investigating the simultaneous application of fluoride and laser to enhance acid resistance on primary teeth are scarce. Subramaniam and Pandey studied the cumulative effect of Er,Cr:YSGG laser (4W) and CPP-ACP, while Molaasadollah et al, (0.5W) observed its conjunction with APF [22], [26]. In the present study, the DD readings at baseline are by Kamath et al, [11].…”

“…In the present study, primary teeth from children aged 6-13 years were collected from the public as well as private centres to include different genetic and socioeconomic variations. Unlike previous researches, primary teeth used in this study were not sectioned [19], [26]. Similar to Subramaniam and Pandey, primary teeth were used as a whole to avoid exerting mechanical stress on the tooth which may affect DD readings and to allow scanning of all axial surfaces for more accurate measurements [22].…”

“…However, other studies implemented the air/water cooling parameters to avoid the excessive increase of temperature beyond the ablation threshold or causing pulpal damage [22], [26]. Previous studies measured the temperature after Er,Cr:YSGG application under the same parameters without air/water mist at the enamel surface (212 ± 23°C) and in the pulp (2.1°C) [30], [31].…”

“…However, the findings of this study oppose to Molaasadollah et al, in which irradiation by Er,Cr:YSGG laser followed by the APF application was comparable to applying APF alone in reducing the area of WSL in primary teeth measured under a stereomicroscope. This disagreement can be attributed to the different laser parameters/material used, a single application of surface treatment, a different method of assessment [26].…”

Treatment methods of white spot lesions

“…53 APF jelin Er,Cr:YSGG lazer ile birlikte kullanımı ile BNL remineralizasyonunda anlamlı bir iyileşme elde edilememiştir. 54 Bir başka çalışmada ise Nd:YAG ve CO 2 lazerlerin tek başlarına flor uygulamasına göre daha etkili olduğu ancak dekalsifiye mine yüzeyine APF jel ile birlikte uygulandığında asitlere daha dirençli bir yapı elde edildiği gösterilmiştir. 52 Lazerin tek başına uygulanmasındansa florür preparatlarıyla birlikte uygulanmasının daha etkili sonuçlar verdiği başka birçok araştırmacı tarafından bildirilmiştir.…”