Esteves-Oliveira Marcella, Witulski Nadine, Hilgers Ralf-Dieter, Apel Christian, Meyer-Lueckel Hendrik, Eduardo Carlos de Paula
Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany.
Caries Res. 2015;49(6):565-74. doi: 10.1159/000439316. Epub 2015 Sep 30.
The aim of this in vitro study was to evaluate the effect of combined CO2 laser and tin-containing fluoride treatment on the formation and progression of enamel erosive lesions. Ninety-six human enamel samples were obtained, stored in thymol solution and, after surface polishing, randomly divided into 6 different surface treatment groups (n = 16 in each group) as follows: no treatment, control (C); one CO2 laser irradiation (L1); two CO2 laser irradiations (L2); daily application of fluoride solution (F); combined daily fluoride solution + one CO2 laser irradiation (L1F), and combined daily fluoride solution + two CO2 laser irradiations (L2F). Laser irradiation was performed at 0.3 J/cm2 (5 µs/226 Hz/10.6 µm) on day 1 (L1) and day 6 (L2). The fluoride solution contained AmF/NaF (500 ppm F), and SnCl2 (800 ppm Sn) at pH 4.5. After surface treatment the samples were submitted to an erosive cycling over 10 days, including immersion in citric acid (2 min/0.05 M/pH = 2.3) 6 times daily and storage in remineralization solution (≥1 h) between erosive attacks. At the end of each cycling day, the enamel surface loss (micrometers) was measured using a 3D laser profilometer. Data were statistically analyzed by means of a 2-level mixed effects model and linear contrasts (α = 0.05). Group F (-3.3 ± 2.0 µm) showed significantly lower enamel surface loss than groups C (-27.22 ± 4.1 µm), L1 (-18.3 ± 4.4 µm) and L2 (-16.3 ± 5.3 µm) but higher than L1F (-1.0 ± 4.4 µm) and L2F (1.4 ± 3.2 µm, p < 0.05). Under the conditions of this in vitro study, the tin-containing fluoride solution caused 88% reduction of enamel surface loss, while its combination with CO2 laser irradiation at 0.3 J/cm2 hampered erosive loss almost completely.
本体外研究的目的是评估二氧化碳激光与含锡氟化物联合治疗对牙釉质侵蚀性病变形成和进展的影响。获取96个人类牙釉质样本，保存在百里酚溶液中，表面抛光后，随机分为6个不同的表面处理组（每组n = 16），如下：未处理，对照组（C）；一次二氧化碳激光照射（L1）；两次二氧化碳激光照射（L2）；每日应用氟溶液（F）；每日氟溶液 + 一次二氧化碳激光照射联合处理（L1F），以及每日氟溶液 + 两次二氧化碳激光照射联合处理（L2F）。在第1天（L1）和第6天（L2）以0.3 J/cm²（5 µs/226 Hz/10.6 µm）进行激光照射。氟溶液含有AmF/NaF（500 ppm F）和SnCl₂（800 ppm Sn），pH值为4.5。表面处理后，样本进行为期10天的侵蚀循环，包括每天6次浸入柠檬酸（2分钟/0.05 M/pH = 2.3），并在侵蚀攻击之间保存在再矿化溶液中（≥1小时）。在每个循环日结束时，使用3D激光轮廓仪测量牙釉质表面损失（微米）。数据通过二级混合效应模型和线性对比进行统计学分析（α = 0.05）。F组（-3.3 ± 2.0 µm）的牙釉质表面损失显著低于C组（-27.22 ± 4.1 µm）、L1组（-18.3 ± 4.4 µm）和L2组（-16.3 ± 5.3 µm），但高于L1F组（-1.0 ± 4.4 µm）和L2F组（1.4 ± 3.2 µm，p < 0.05）。在本体外研究条件下，含锡氟溶液使牙釉质表面损失减少了88%，而其与0.3 J/cm²的二氧化碳激光照射联合使用几乎完全抑制了侵蚀性损失。
