Souza-Gabriel Aline Evangelista, Turssi Cecília Pedroso, Colucci Vivian, Tenuta Lívia Maria Andaló, Serra Mônica Campos, Corona Silmara Aparecida Milori
Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Department of Dentistry, São Leopoldo Mandic Research Institute, Campinas, SP, Brazil.
Arch Oral Biol. 2015 Jun;60(6):804-10. doi: 10.1016/j.archoralbio.2015.01.016. Epub 2015 Feb 20.
This in situ study evaluated the effect of fluoride varnish combined with CO2 laser in controlling enamel demineralization caused by cariogenic challenges.
In a crossover study conducted in 2 phases of 14 days each, 14 volunteers (n = 14) wore palatal appliances with bovine enamel slabs treated with fluoride varnish + CO2 laser (FV + CO2), fluoride varnish (FV), nonfluoride placebo varnish (PV) and nonfluoride placebo varnish + CO2 laser (PV + CO2). Drops of sucrose solution were dripped onto enamel slabs allowing the accumulation of biofilm. At the first phase, half of the volunteers received 4 enamel slabs treated with FV while the remainders received slabs exposed to the PV with and without CO2 laser. In the second phase, the vonlunteers were reversed treatments. The slabs were evaluated for cross-sectional microhardness (CSMH) and the concentration of loosely bound fluoride (CaF2) and firmly bound fluoride (FAp). The concentration of fluoride in biofilm were also determined.
Two-way ANOVA showed that the CSMH values were higher in laser-irradiated enamel, regardless of the fluoride varnish. Friedman test showed that FV group presented significantly larger amount of fluoride in biofilm (P < 0.05). In the enamel, the largest amount of fluoride was found in the groups FV + CO2, which was not different from FV (P > 0.05).
The synergistic effect of fluoride varnish and CO2 laser on enamel demineralization was not observed, however, CO2 laser reduces enamel demineralization.
CO2 laser might reduce the demineralization of subsurface enamel, although its association with a high concentrated fluoride therapy may not result in a positive synergistic interaction.
本原位研究评估了氟化物清漆联合二氧化碳激光在控制致龋因素引起的牙釉质脱矿方面的效果。
在一项交叉研究中，分两个阶段进行，每个阶段为期14天，14名志愿者（n = 14）佩戴腭部矫治器，矫治器上附有经氟化物清漆 + 二氧化碳激光（FV + CO2）、氟化物清漆（FV）、非氟化物安慰剂清漆（PV）和非氟化物安慰剂清漆 + 二氧化碳激光（PV + CO2）处理的牛牙釉质块。将蔗糖溶液滴在牙釉质块上，以使生物膜积聚。在第一阶段，一半志愿者接受4块经FV处理的牙釉质块，其余志愿者接受经有或无二氧化碳激光处理的PV的牙釉质块。在第二阶段，志愿者接受相反的处理。对牙釉质块进行横断面显微硬度（CSMH）、松散结合氟（CaF2）和牢固结合氟（FAp）浓度的评估。还测定了生物膜中的氟浓度。
双向方差分析表明，无论氟化物清漆如何，激光照射的牙釉质的CSMH值更高。弗里德曼检验表明，FV组生物膜中的氟含量显著更高（P < 0.05）。在牙釉质中，FV + CO2组的氟含量最高，与FV组无差异（P > 0.05）。
未观察到氟化物清漆和二氧化碳激光对牙釉质脱矿的协同作用，然而，二氧化碳激光可减少牙釉质脱矿。
二氧化碳激光可能会减少牙釉质表层下的脱矿，尽管其与高浓度氟治疗联合使用可能不会产生积极的协同相互作用。
