Influência do uso do laser na prevenção da cárie radicular

Abstract

Objective: This study evaluated the influence of different lasers, associated or not with sodium fluoride application, in the prevention of root caries. Materials and Methods: For this study, 128 specimens of human root dentin (4.25mm X 4.25mm and 3.00mm thick) were randomly divided into 8 groups: (G1=no treatment, G2=application of fluoride gel, G3= Er:YAG laser irradiation, G4=application of fluoride gel + Er:YAG laser irradiation, G5= Nd:YAG laser irradiation, G6=application of fluoride gel + Nd:YAG laser irradiation, G7=CO2 laser irradiation, G8= application of fluoride gel + CO2 laser irradiation. For the groups that received laser irradiation, half of the specimen was irradiated ( mm) and the other half was not (control region). In the groups that received fluoride gel, this was applied before laser irradiation for 4 minutes. After treatment of samples, these were submitted to a cariogenic challenge (pH cycles) in demineralizing (pH=5.0) and remineralizing (pH=7,0) solutions for 6 hours and 18 hours, respectively, completing an experimental period of 14 days. The evaluation of the proposed treatments in the experimental groups was performed using the following tests: 1-) measurement of the percentage of demineralization by light microscopy – MO; 2-) assessment of the morphology of the irradiated surface by scanning electron microscopy – MEV; 3-) microhardness analysis of the bottom walls of demineralized root dentin at different depths through the test of longitudinal microhardness; 4-) quantification of the percentage of the elements calcium, phosphorus and fluoride through micro analysis by energy dispersive X-ray EDS. Data were submitted to different statistical tests, depending on the analyzed property. Results: Nd:YAG and CO2 lasers were more effective in decreasing the percentage of demineralization than the Er:YAG laser. The lowest percentage of demineralization was observed in the G7. In the scanning electron microscopy, the Er:YAG laser provided more satisfactory changes than the others, considering that there was a more smooth and homogeneous dentine, without cracks or carbonization areas. The Er:YAG laser was also greater in increasing the acid resistance of the dentin, when evaluated by microhardness test. The G3 obtained the highest average values of Knoop microhardness. Regarding the analysis of EDS, there was a tendency of incorporating fluoride in the irradiated areas, especially after irradiation with Er:YAG and CO2 lasers. Conclusions: All the tested lasers showed promising results in the prevention of root caries and for the analyzed properties, no synergism resulting from the application of fluoride gel prior to laser irradiation was found.