Objective: The purpose of this study was to evaluate, using atomic force microscopy (AFM), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), the morphological and structural changes of the enamel after irradiation with the Er:YAG laser. Background data: A previous study showed that subablative Er:YAG laser irradiation produced undesirable morphological changes on the enamel surface, such as craters and cracks; however, the enamel acid resistance was not increased. Methods: Fifty-two samples of human enamel were divided into four groups (n ¼ 13): Group I was the control (no laser irradiation), whereas Groups II, III, and IV were irradiated with the Er:YAG 100 mJ (12.7 J /cm 2 ), 100 mJ (7.5 J/cm 2 ), and 150 mJ (11 J/cm 2 ), respectively, at 10 Hz with water spray. The morphological changes were observed by AFM and SEM. The weight percentages (wt%) of calcium (Ca), phosphorus (P), oxygen (O) and chlorine (Cl) were determined in the resultant craters and their periphery using EDS. Kruskal-Wallis and Mann-Whitney U tests were performed ( p 0.05) to distinguish significant differences among the groups. Results: The AFM images showed cracks with depths between 250 nm and 750 nm for Groups II and IV, respectively, and the widths of these cracks were 5.37 mm and 2.58 mm. The interior of the cracks showed a rough surface. The SEM micrographs revealed morphological changes. Significant differences were detected in Ca, P, and Cl in the crater and its periphery. Conclusions: AFM observations showed triangular-shaped cracks, whereas craters and cracks were evident by SEM in all irradiated samples. It was not possible to establish a characteristic chemical pattern in the craters.

Morphological changes of Er:YAG irradiated enamel represented mild to severe damages. Conditions employed in this study are not recommended for deciduous caries prevention. Er:YAG energy density influenced chemical changes in enamel to enhance its structure. Acid dissolution removed fluoride from enamel surface.

The results of this study suggest that acid resistance of enamel due to subablative Er:YAG laser irradiation on the samples did not increase as expected. Morphological microscopic changes included craters and cracks on the irradiated zones.

The purpose of this study was to evaluate the shear bond strength, the adhesive remnant index scores, and etch surface of teeth prepared for orthodontic bracket bonding with self-etching primer and Er:YAG laser conditioning. One hundred and twenty bovine incisors were randomly divided into four groups. In Group I (Control), the teeth were conditioned with 35% phosphoric acid for 15 seconds. In Group II the teeth were conditioned with Transbond Plus SEP (5 sec); III and IV were irradiated with the Er:YAG 150 mJ (11.0 J/cm2), 150 mJ (19.1 J/cm2), respectively, at 7–12 Hz with water spray. After surface preparation, upper central incisor stainless steel brackets were bonded with Transbond Plus Color Change Adhesive. The teeth were stored in water at 37°C for 24 hours and shear bond strengths were measured, and adhesive remnant index (ARI) was determined. The conditioned surface was observed under a scanning electron microscope. One-way ANOVA and chi-square test were used. Group I showed the significantly highest values of bond strength with a mean value of 8.2 megapascals (MPa). The lesser amount of adhesive remnant was found in Group III. The results of this study suggest that Er:YAG laser irradiation could not be an option for enamel conditioning.

Background. An increase in the acid resistance of dental enamel, as well as morphological and structural changes produced by Er:YAG laser irradiation, has been reported. Purpose. To evaluate the chemical changes associated with acid resistance of enamel treated with Er:YAG laser. Methods. Forty-eight enamel samples were divided into 4 groups (n = 12). Group I (control); Groups II, III, and IV were irradiated with Er:YAG at 100 mJ (12.7 J/cm2), 200 mJ (25.5 J/cm2), and 300 mJ (38.2 J/cm2), respectively. Results. There were significant differences in composition of irradiated groups (with the exception of chlorine) and in the amount of calcium released. Conclusions. Chemical changes associated with an increase in acid resistance of enamel treated with Er:YAG laser showed a clear postirradiation pattern characterized by a decrease in C at.% and an increase in O, P, and Ca at.% and no changes in Cl at.%. An increased Ca/P ratio after Er:YAG laser irradiation was associated with the use of higher laser energy densities. Chemical changes produced by acid dissolution showed a similar trend among experimental groups. Stable or increased Ca/P ratio after acid dissolution was observed in the irradiated groups, with reduction of Ca released into the acid solution.