Abstract
Background The aim of this study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth. Material and Methods Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crème, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win. Results The subjects of group D demonstrated a significant increase in the calcium and phosphate contents of enamel surface compared to those of groups A (P < 0.001, P < 0.001), B (P < 0.001, P < 0.001) and C (P = 0.024, P = 0.04), respectively. A statistically significant difference was seen for mean VHN between groups A and B (P = 0.002). SEM evaluations confirmed the results. Conclusions The combination of Nd:YAG laser and CPP-ACP crème could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth. Key words:CPP-ACP, enamel remineralization, microhardness, Nd:YAG, primary teeth, SEM.
Highlights
Dental caries can be prevented when demineralization and remineralization processes are in a balance [1,2]
We expected that combination of Nd:YAG laser and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in comparison with any of these treatments alone induces a remarkable increase in calcium and phosphate content of artificial early enamel caries and, thereby, significant improvement in enamel microhardness
Based on the supportive findings of the present and previous studies regarding the tested hypothesis, three primary mechanisms involved in the cariostatic effect of laser irradiation in conjunction with CPP-ACP treatment can be explained. -Increased calcium and phosphate deposition in enamel subsurface In the present research, the highest mean weight percentage of calcium and phosphate was obtained for the CPP-ACP and laser treated subjects followed by CPPACP alone, lasing alone and negative control subjects
Summary
Dental caries can be prevented when demineralization and remineralization processes are in a balance [1,2]. The heating and melting processes results in significant reduction of carbonate content of hydroxyapatite up to a complete loss resulting in enamel that is more resistant to demineralization [8,9] Laser irradiation in this regard, should be applied at a low level of energy to preserve the integrity of tooth enamel [10]. We expected that combination of Nd:YAG laser and CPP-ACP in comparison with any of these treatments alone induces a remarkable increase in calcium and phosphate content of artificial early enamel caries and, thereby, significant improvement in enamel microhardness. The aim of this study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth. Conclusions: The combination of Nd:YAG laser and CPP-ACP crème could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth
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