Holmium:YAG laser: effects on dentin demineralization

Abstract

The Holmium:YAG laser at 2.12 microns wavelength was used to compare the changes in resistance to demineralization of the dentinal root surfaces of human extracted teeth in vitro. Three protocols were used: Group #1, and application of nonfilled resin/NaF (4%) solution followed by exposure with the Holmium:YAG laser beam; Group #2, an application of an aqueous solution of NaF (4%) only; and Group #3, irradiation with the laser beam only. The teeth were exposed on the root surfaces with untreated control and experimental sites on opposite sides of the teeth. A 3 mm spot size covered an area of 3 X 5 mm with 0.450 (+/- .05) joules at a fluence of 2.66 - 3.3 J/cm 2 . All teeth were decalcified in a 10% Formic acid solution for a timed period. Samples were prepared for staining by sectioning the teeth at the dentoenamel junction and 3 mm apically to produce a cross-section of each tooth root surface. Each sample was placed in toluidine blue dye to observe the depth of dye penetration into the dentin of treated and control sites. Toluidine blue dye showed a consistent greater depth of dye penetration into the dentinal areas of the untreated control sites versus the resin/NaF-lased group. The topical fluoride only group did not appear different than the untreated control sites of the teeth. The lased only group showed areas of dye penetration similar to the untreated control sides with other areas of little or no dye penetration. The finding that HO:YAG laser energy/chemical agent produced increased resistance to demineralization of dentinal surfaces in vitro suggested potential clinical applications of this combined modality.