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Randomized in situ study on the efficacy of CO2 laser irradiation in increasing enamel erosion resistance

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Abstract

Objectives

The aim of this double-blind, randomized in situ study was to evaluate the erosion-preventive effect of a specific set of CO2 laser parameters, associated or not with fluoride.

Methods

Two hundred forty bovine enamel blocks were prepared for individual palatal appliances (n = 6 samples/appliance). The study had four phases of 5 days each, with ten volunteers and the following treatments: CO2 laser irradiation (L), fluoride treatment (F), combined fluoride and laser treatment (FL), and no treatment, control (C). Laser irradiation was performed at 0.3 J/cm2 (5 μs/226 Hz/10.6 μm) and the fluoride gel contained AmF/NaF (12′500 ppm F−/pH = 4.8–6). For erosive demineralization, the appliances were immersed extra-orally in citric acid (0.05 M/20 min/pH = 2.3) twice daily. Analysis of enamel surface loss was done using a 3D-laser profilometer on 3 days. Additionally, fluoride uptake was quantified and scanning electron microscopies were done. Data were analyzed with repeated measures ANOVA and post hoc pairwise comparisons (α = 0.05).

Results

At all analyzing days, both laser groups caused the lowest means of enamel loss, which were also statistically significant lower than C (p < 0.05). At day 5, FL means ± SD (33.6 ± 12.6 μm) were even significantly lower than all other groups (C 67.8 ± 15.4 μm; F 57.5 ± 20.3 μm; L 46.8 ± 14.5 μm). Significantly increased enamel fluoride uptake was observed for both fluoride-containing groups (p < 0.05) at day 1.

Conclusion

Compared to the control, the CO2 laser irradiation with a specific set of laser parameters (0.3 J/cm2/5 μs/226 Hz) either alone or in combination with a fluoride gel (AmF/NaF) could significantly decrease enamel erosive loss up to 5 days in situ.

Clinical relevance

Combined CO2 laser-fluoride treatment has a significant anti-erosive effect.

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Acknowledgments

This study was part of joint thesis supervision between RWTH Aachen University, Germany and University of São Paulo, Brazil.

Funding

This study was funded by FGD (Forschungsgemeinschaft Dental #360303, Germany), START Program of the Medical Faculty of the RWTH Aachen University (#AZ43/09, Germany), and CNPq (#305574/2008–6, Brazil). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Stomatology, Integrated Clinic, School of Dentistry, University of São Paulo, São Paulo, Brazil

    K. M. Ramalho & R. G. Rocha

  2. Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil

    C. P. Eduardo

  3. Department of Medical Statistics, Medical Faculty, RWTH Aachen University, Aachen, Germany

    N. Heussen

  4. Department of Restorative, Preventive & Pediatric Dentistry, Universität Bern, Bern, Switzerland

    H. Meyer-Lueckel

  5. Department of Operative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    F. Lampert & Marcella Esteves-Oliveira

  6. Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany

    C. Apel

Authors
  1. K. M. Ramalho
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  2. C. P. Eduardo
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  3. N. Heussen
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  4. R. G. Rocha
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  5. H. Meyer-Lueckel
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  6. F. Lampert
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  7. C. Apel
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  8. Marcella Esteves-Oliveira
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Corresponding author

Correspondence to Marcella Esteves-Oliveira.

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Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by Ethical Committee of Medical School of the RWTH Aachen University (#EK 134/09)

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Informed consent was obtained from all individual participants included in the study.

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Ramalho, K.M., Eduardo, C.P., Heussen, N. et al. Randomized in situ study on the efficacy of CO2 laser irradiation in increasing enamel erosion resistance. Clin Oral Invest 23, 2103–2112 (2019). https://doi.org/10.1007/s00784-018-2648-y

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  • DOI: https://doi.org/10.1007/s00784-018-2648-y

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