ABSTRACT
Various authors have reported more effective fluoridation from the use of lasers combined with topical fluoride than from conventional topical fluoridation. Besides the beneficial effect of lasers in reducing the acid solubility of an enamel surface, they can also increase the uptake of fluoride. The study objectives were to compare the action of CO(2) and GaAlAs diode lasers on dental enamel and their effects on pulp temperature and enamel fluoride uptake. Different groups of selected enamel surfaces were treated with amine fluoride and irradiated with CO(2) laser at an energy power of 1 or 2 W or with diode laser at 5 or 7 W for 15 s each and compared to enamel surfaces without treatment or topical fluoridated. Samples were examined by means of environmental scanning electron microscopy (ESEM). Surfaces of all enamel samples were then acid-etched, measuring the amount of fluoride deposited on the enamel by using a selective ion electrode. Other enamel surfaces selected under the same conditions were irradiated as described above, measuring the increase in pulp temperature with a thermocouple wire. Fluorination with CO(2) laser at 1 W and diode laser at 7 W produced a significantly greater fluoride uptake on enamel (89 ± 18 mg/l) and (77 ± 17 mg/l) versus topical fluoridation alone (58 ± 7 mg/l) and no treatment (20 ± 1 mg/l). Diode laser at 5 W produced a lesser alteration of the enamel surface compared to CO(2) laser at 1 W, but greater pulp safety was provided by CO(2) laser (ΔT° 1.60° ± 0.5) than by diode laser (ΔT° 3.16° ± 0.6). Diode laser at 7 W and CO(2) laser at 2 W both caused alterations on enamel surfaces, but great pulp safety was again obtained with CO(2) (ΔT° 4.44° ± 0.60) than with diode (ΔT° 5.25° ± 0.55). Our study demonstrates that CO(2) and diode laser irradiation of the enamel surface can both increase fluoride uptake; however, laser energy parameters must be carefully controlled in order to limit increases in pulpal temperature and alterations to the enamel surface.
Subject(s)
Fluorides, Topical/administration & dosage , Lasers, Gas/therapeutic use , Lasers, Semiconductor/therapeutic use , Tooth/drug effects , Tooth/radiation effects , Dental Caries/prevention & control , Dental Enamel/drug effects , Dental Enamel/metabolism , Dental Enamel/radiation effects , Dental Enamel/ultrastructure , Dental Pulp/radiation effects , Fluorides, Topical/pharmacokinetics , Humans , Low-Level Light Therapy/methods , Microscopy, Electron, Scanning , Surface Properties , Temperature , Tooth/metabolism , Tooth/ultrastructureABSTRACT
The hypothesis of this study was the fact that diode lasers can increase the fluoride uptake in dental structures. The main objectives were: (1) to evaluate the effect of diode laser-NaF varnish combination on binding fluoride to dental enamel in an in vitro model and (2) to analyse outer enamel surface changes produced by the laser energy. After NaF enamel varnish and laser irradiation at different levels of energy, specimen surfaces were examined by environmental scanning electron microscopy. The incorporation of F(-) ion into the dental structure was quantitatively determined by using a fluoride ion-selective electrode. Results showed that the laser treatment significantly increased the binding of fluoride to the enamel surface without damaging it. The amount of F(-) estimated was 37 +/- 7 mg/l to the power of 5 W and 58 +/- 12 mg/l to the power of 7 W. These increases were significantly greater than the ones achieved by conventional topical fluoridation. The results were analysed and compared by Kruskal-Wallis and Dunn's multiple comparison tests, and significant statistical differences were found. These suggest that the NaF varnish-diode laser combination may be a useful option for the effective fluoridation of teeth.
