Demineralization Inhibition by High-Speed Scanning of 9.3 µm CO2 Single Laser Pulses Over Enamel.

BACKGROUND AND OBJECTIVE: In vitro studies were conducted to evaluate the use of an automated system for high-speed scanning of single 9.3 µm CO2 laser pulses in the inhibition of caries-like lesion formation in the enamel of extracted human molars. The effect of the laser in generating an acid-resistant layer and the effect of the layer on inhibiting surface mineral loss during pH cycling was explored. STUDY DESIGN/MATERIALS AND METHODS: Laser irradiation was performed with fluences of 0.6, 0.8, and 1.0 J/cm2 for single pulses of 1 mm diameter (1/e2 ), with pulse durations of 17, 22, and 27 microseconds, respectively. The laser was scanned at a 750 Hz pulse repetition rate in an automated pattern covering an area of 7 mm2 in 0.3 sec. Six treatment groups were investigated: three groups for each fluence for laser-only and three for laser irradiation with additional fluoride from a toothpaste slurry (sodium fluoride at 1100 ppm). Each group used non-irradiated areas, which included untreated controls for the laser-only groups and a fluoride-only treatment for the groups with additional fluoride. pH cycling was performed on both groups, followed by microhardness testing to determine the relative mineral loss (∆Z) from a caries-like formation and surface mineral loss (∆S). RESULTS: Laser irradiation with the 9.3 µm CO2 laser generated an acid-resistant layer of about 15 µm in depth. For the laser-irradiated samples with additional fluoride application, the relative mineral loss (∆Z) was 113 ± 63 vol%-µm, while for those with only fluoride application ∆Z was 572 ± 172 vol%-µm. At the highest fluence (1.0 J/cm2 ) used, an 80.2% inhibition of caries-like lesion was measured by ∆Z. Using only laser irradiation at the highest fluence resulted in an inhibition of caries-like lesion of 79.5% for the irradiated samples (∆Z = 374 ± 149 vol%-µm) relative to the control (∆Z = 1826 ± 325 vol%-µm). Surface microhardness tests resulted in an inhibition of surface softening, as measured by the Knoop Hardness Value (KHN) (108 ± 33 KHN for laser irradiated with additional fluoride, for non-irradiated controls with fluoride only 52 ± 16 KHN). Inhibition of surface loss was observed for all laser fluences, but the maximum surface loss for the untreated control group was only 2.2 ± 0.49 µm. CONCLUSIONS: The results demonstrate a significant benefit of the 9.3 µm CO2 laser at fluences of 0.6, 0.8, and 1.0 J/cm2 in caries-like lesion inhibition as measured by the relative mineral loss in depth and surface mineral loss, without significant damage to the enamel. Additionally, inhibition of surface softening and surface loss during pH cycling was observed. The surface loss was small compared with the overall lesion depth and thickness of the generated acid-resistant layer. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Histopathological and biomechanical changes in soft palate in response to non-ablative 9.3-µm CO2 laser irradiation: an in vivo study.

The purpose of this study was to investigate in vivo the biomechanical and morphological changes in soft palates of Wistar rats from non-ablative irradiation with a 9.3-µm CO2 laser. A blinded, randomized, controlled study was designed with 45 Wistar rats categorized into treated and control sets. The treated set was exposed to 9.3-µm CO2 laser irradiation at an average power of 1.0 W and a single pulse fluence of 0.16 J/cm2 scanned using an automated system at a repetition rate of 315 Hz in a patterned area covering 0.4 cm2 in 6 s. The tissue of each animal was excised and divided into two halves. One-half was sectioned for histopathology, and the other half was used to measure tissue stiffness, which was reported as the effective Young's modulus. Measurements for both sets were taken at three time points: days 1, 21, and 35. There were no significant adverse events or changes in the behavior of the rats over the duration of the study. The treated set exhibited an order of magnitude increase in stiffness relative to the controls, which was maintained over the three time points. Histopathology showed a moderate contraction/disruption of the lamina propria collagen observed at day 1 and collagen accumulation observed at days 21 and 35 in the tissue remodeling phase. Non-ablative 9.3-µm CO2 laser irradiation can safely increase oral mucosal stiffness and can be used as an effective treatment to reduce tissue vibrations that are associated with snoring.