Effects of pulsed Nd:YAG laser on tensile bond strength and caries resistance of human enamel.

This study aims to evaluate the effects of pulsed Nd:YAG laser on the tensile bond strength (TBS) of resin to human enamel and caries resistance of human enamel. A total of 201 human premolars were used in this in vitro study. A flat enamel surface greater than 4 × 4 mm in area was prepared on each specimen using a low-speed cutting machine under a water coolant. Twenty-one specimens were divided into seven groups for morphology observations with no treatment, 35% phosphoric acid etching (30 seconds), and laser irradiation (30 seconds) of pulsed Nd:YAG laser with five different laser-parameter combinations. Another 100 specimens were used for TBS testing. They were embedded in self-cured acrylic resin and randomly divided into 10 groups. After enamel surface pretreatments according to the group design, resin was applied. The TBS values were tested using a universal testing machine. The other 80 specimens were randomly divided into eight groups for acid resistance evaluation. Scanning electron microscope (SEM) results showed that the enamel surfaces treated with 1.5 W/20 Hz and 2.0 W/20 Hz showed more etching-like appearance than those with other laser-parameter combinations. The laser-parameter combinations of 1.5 W/15 Hz and 1.5 W/20 Hz were found to be efficient for the TBS test. The mean TBS value of 14.45 ± 1.67 MPa in the laser irradiated group was significantly higher than that in the untreated group (3.48 ± 0.35 MPa) but lower than that in the 35% phosphoric acid group (21.50 ± 3.02 MPa). The highest mean TBS value of 26.64 ± 5.22 MPa was identified in the combination group (laser irradiation and then acid etching). Acid resistance evaluation showed that the pulsed Nd:YAG laser was efficient in preventing enamel demineralization. The SEM results of the fractured enamel surfaces, resin/enamel interfaces, and demineralization depths were consistent with those of the TBS test and the acid resistance evaluation. Pulsed Nd:YAG laser as an enamel surface pretreatment method presents a potential clinical application, especially for the caries-susceptible population or individuals with recently bleached teeth.