Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil,
Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Caries Res. 2021;55(6):617-628. doi: 10.1159/000520215. Epub 2021 Oct 22.
This single-blind, controlled crossover in situ study aimed to evaluate the effect of CO2 laser (9.3 µm) irradiation combined with AmF/NaF/SnCl2 solution on prevention and control of erosive tooth wear (ETW) in human enamel.
Two trial conditions were analyzed, condition 1 as ETW prevention (sound tooth surface) and condition 2 as ETW control (in vitro initial erosive lesion). The experiment was conducted in 2 phases, one with and one without exposure to AmF/NaF/SnCl2 solution. Hundred and ninety-two samples of human enamel (3 × 3 × 1 mm) were randomly divided into 4 experimental groups for each condition: C, without treatment (negative control); F, AmF/NaF/SnCl2 solution (positive control); L, CO2 laser irradiation; and L + F, CO2 laser + AmF/NaF/SnCl2 solution. Twelve volunteers used a removable device, each containing 8 samples per phase. Ex vivo erosive challenges (4 × 5 min/day) and rinsing protocol (1 × 30 s/day) were performed. The surface loss was determined using optical profilometer (n = 12 per group), and the surface morphology was observed with scanning electron microscopy (n = 3).
In condition 1, data were analyzed by one-way ANOVA and condition 2 by two-way repeated-measures ANOVA, both with Tukey post hoc tests (α = 5%). In condition 1, groups L (4.59 ± 2.95 µm) and L + F (1.58 ± 1.24 µm) showed significantly less surface loss in preventing ETW than groups C and F. In condition 2, in controlling the progression of ETW, L + F was the only group with no significant surface loss between initial erosive lesion (3.65 ± 0.16 µm) and after erosive challenge (4.99 ± 1.17 µm).
CO2 9.3-µm laser application prevented and controlled ETW progression in human enamel, with greater efficiency when combined with AmF/NaF/SnCl2 solution application.
本单盲、对照交叉体内研究旨在评估 CO2 激光（9.3μm）辐照联合 AmF/NaF/SnCl2 溶液对预防和控制人釉质侵蚀性牙磨损（ETW）的效果。
分析了两种试验条件，条件 1 为 ETW 预防（健康牙面），条件 2 为 ETW 控制（体外初始侵蚀性病变）。实验分为两个阶段，一个阶段有暴露于 AmF/NaF/SnCl2 溶液，另一个阶段无暴露。将 192 个人类釉质样本（3×3×1mm）随机分为每个条件的 4 个实验组：C 组，无处理（阴性对照）；F 组，AmF/NaF/SnCl2 溶液（阳性对照）；L 组，CO2 激光照射；L+F 组，CO2 激光+AmF/NaF/SnCl2 溶液。12 名志愿者使用可移动装置，每个装置在每个阶段包含 8 个样本。进行体外侵蚀性挑战（4×5min/天）和冲洗方案（1×30s/天）。使用光学轮廓仪（每组 n=12）测定表面损失，使用扫描电子显微镜（n=3）观察表面形态。
条件 1 采用单因素方差分析，条件 2 采用双向重复测量方差分析，均采用 Tukey 事后检验（α=5%）。在条件 1 中，与 C 组和 F 组相比，L 组（4.59±2.95μm）和 L+F 组（1.58±1.24μm）在预防 ETW 方面显示出显著较少的表面损失。在条件 2 中，在控制 ETW 进展方面，L+F 组是唯一一组在初始侵蚀性病变（3.65±0.16μm）和侵蚀性挑战后（4.99±1.17μm）之间没有明显表面损失的组。
CO2 9.3μm 激光应用在预防和控制人釉质 ETW 进展方面具有疗效，与应用 AmF/NaF/SnCl2 溶液联合应用时效果更佳。
