Abstract
Objective To evaluate the influence of ultrapulsed CO2 laser in combination with commercial fluoride products in order to verify the increase of microhardness of artificial enamel caries lesions. Materials and Methods Bovine enamel specimens were prepared, and artificial enamel caries lesions were created. Teeth were randomly divided into 5 groups (n=10): treated with laser (L), laser + neutral fluoride gel 2% (LNF), laser + acidulated phosphate fluoride gel 1.23% (LAFG), laser + acidulated fluoride mousse 1.23% (LAFM), and laser + fluoride varnish 5% (LFV). Microhardness was evaluated at baseline, after caries induction, after CO2 laser irradiation + fluoride treatment in the 1st week, and after fluoride treatment at 3rd and 5th week. Results There was a decrease in microhardness in all groups after artificial enamel caries lesion formation; no increase in microhardness was found in the first and third weeks in all groups (p > 0.05). In the fifth week, an increase in microhardness occurred in all groups (p < 0.05). Conclusion Although CO2 laser irradiation in combination with different commercial fluoride products was capable of increasing microhardness on enamel caries lesions in bovine tooth enamel it is necessary to confirm these results by testing the isolated effect of fluoride on enamel surface microhardness. Also, although microhardness was higher in the fluoride varnish group than in the other groups in the fifth week it is not possible to discard the best effect of fluoride varnish treatment on absence of artifacts that may occur with the other fluoride treatments. Clinical Relevance In order to prove that CO2 laser may contribute to an increase in microhardness when applied to enamel lesions in combination with different commercial fluoride products it is necessary to conduct additional studies. Also, higher microhardness of fluoride varnish group should be carefully considered.
Highlights
Dental caries is still a public health problem, and untreated caries lesions are the most prevalent chronic oral problem, as observed in the Global Burden of Disease study in 2010 [1, 2]
An increase in microhardness occurred in all groups in comparison to the decay period
Mousses, and varnishes have been employed in Pediatric, Preventive, and General Dentistry, but questions remain regarding application time and the capacity of such products to affect the remineralization of early caries lesions in dental enamel
Summary
Dental caries is still a public health problem, and untreated caries lesions are the most prevalent chronic oral problem, as observed in the Global Burden of Disease study in 2010 [1, 2]. Enamel caries lesions are formed during alternating periods of demineralization and remineralization [6]. Invasive approaches have been the treatment of choice in order to manage caries lesions with thoroughgoing preservation of tooth structures [7], i.e., the application of different types of fluoride agents, in different concentrations. Fluoride acts to prevent caries by being a biocide [9, 10] and by reducing the solubility of enamel and dentin through its incorporation into tooth tissue to form fluoroapatite [11,12,13]. Fluoride acts to remineralize damaged tooth tissue following demineralization [11, 13, 14]
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