Effect of pretreatment with an Er:YAG laser and fluoride on the prevention of dental enamel erosion

Abstract

The aim of this study was to evaluate the effect of the Er:YAG laser and its association with fluoride (1.23% acidulate phosphate fluoride gel) on the prevention of enamel erosion. Sixty specimens were obtained from bovine enamel (4 × 4 mm), which were ground flat, polished, and randomly divided into five groups according to the preventive treatments: control-fluoride application; L--Er:YAG laser; L+F--laser + fluoride; F+L--fluoride + laser; L/F--laser/fluoride simultaneously. Half of the enamel surface was covered with nail varnish (control area), and the other half was pretreated with one of the preventive strategies to subsequently be submitted to erosive challenge. When the laser was applied, it was irradiated for 10 s with a focal length of 4 mm and 60 mJ/2 Hz. Fluoride gel was applied for 4 min. Each specimen was individually exposed to regular Coca-Cola® for 1 min, four times/day, for 5 days. Wear analysis was performed with a profilometer, and demineralization was assessed with an optical microscope. Data were analyzed using the Kruskal-Wallis test (wear)/Dunn test and ANOVA/Fisher's exact tests. The group L/F was similar to control group. The other groups showed higher wear, which did not present differences among them. In the demineralization assessment, the groups F+L and L/F showed lower demineralization in relation to the other groups. It can be concluded that none preventive method was able to inhibit dental wear. The treatments L/F and F+L showed lower enamel demineralization.

The Effect of Er:YAG Laser Irradiation Combined With Fluoride Application on the Resistance of Primary and Permanent Dental Enamel to Erosion

“…In other words, the tested measures could not prevent the erosive effect of Coca-Cola on enamel micro-hardness. This result was in line with that of dos Reis Derceli et al 40 They also showed that the Er:YAG laser irradiation, APF gel application or combination of both could not prevent enamel erosion caused by Coca-Cola. Rocha et al 25 indicated that the application of stannous fluoride gel alone or combined with CO 2 laser irradiation could not protect the primary teeth against the erosive action of hydrochloric acid.…”

“…Many studies have assessed the efficacy of fluoride alone and in combination with other protective measures in the prevention of erosion. 3,24,[39][40][41][42] Laser irradiation alone or combined with fluoride application has also been suggested to increase enamel acid resistance, 31,43 and some studies demonstrated the positive efficacy of Er:YAG laser in increasing enamel resistance against acid attacks and dental caries. 30,31,44 Although both caries and erosion are caused by the demineralization of enamel, their main etiologic factors and mechanism of development are totally different.…”

“…Considering the high absorption of erbium lasers by the tooth structure and its use in the previous studies to minimize enamel demineralization, 32,40,44 Er:YAG laser was used in this study. To prevent mechanical injury to the enamel, Er:YAG laser with sub-ablative fluency was irradiated on the enamel surfaces.…”

Er:YAG laser irradiation to control the progression of enamel erosion: an in situ study

“…Studies performed by Altinok et al (2011) [21] and Dos Reis Derceli et al (2013) [22] evaluated the use of Er:YAG laser to control the eroded enamel demineralization by means of in vitro analysis. In situ studies can lead lower lesions in erosion progression by accumulation of acquired pellicle by means of saliva, which is considered a protective factor [23].…”

Erbium Lasers for the Prevention of Enamel and Dentin Demineralization: A Literature Review

“…53 In addition to the results described, another study applied irradiation with the same prefocused irradiation mode (4 mm distance), without water irrigation, with 60 mJ and 2Hz, and showed no beneficial results. 54 At 8 and 16 mm distances, tissue loss areas were observed. 53 These groups presented the same distance from the focus point, thus producing similar results on the irradiated enamel.…”