Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
Department of Orthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
Lasers Med Sci. 2023 Aug 1;38(1):172. doi: 10.1007/s10103-023-03837-8.
This study aimed to evaluate the efficacy of fluoride-free remineralizing agents in initial enamel caries, with and without combined Er,Cr:YSGG laser application. The remineralization effect of various agents and their combinations on artificial initial caries was investigated using 10 experimental groups (n = 7): NC, negative control; PC, positive control; TM, calcium-phosphate compounds (CPP-ACP); TD, theobromine-containing toothpaste; RG, ROCS® remineralizing gel; L, Er,Cr:YSGG laser (2780 nm; 0.25 W; repetition rate, 20 Hz; pulse duration, 140 μs; tip diameter, 600 μm; without air/water cooling); L + fluoride toothpaste; L + TM; L + TD; and L + RG. The demineralized bovine enamel specimens were subjected to an 8-day pH cycle by daily application of the remineralizing agents and laser therapy once prior to the pH cycle and paste application. The enamel samples underwent the Vickers surface microhardness test, and one sample per group was analyzed with scanning electron microscopy. The Kruskal Wallis test was used to compare the microhardness recovery percentage (SMHR%) for each group, and multiple comparisons were made with the Dunn test. Groups L (p = 0.003), RG (p = 0.019), L + TM (p < 0.001), L + fluoride toothpaste (p = 0.001),and L + RG (p = 0.036) exhibited significant increase in SMHR%. The tested remineralizing agents exhibited no statistically significant difference in effect when used alone and in combination with Er,Cr:YSGG laser. Combined application of Er,Cr:YSGG laser and ROCS® remineralization gel effectively promoted enamel remineralization, while use of CPP-ACP and fluoride toothpaste alone was ineffective. Theobromine-containing toothpaste exhibited the least SMHR%. Long-term evaluation of these agents is recommended.
本研究旨在评估无氟再矿化剂在初始釉质龋中的疗效，以及与 Er,Cr:YSGG 激光联合应用的效果。使用 10 个实验组（n=7）来研究各种试剂及其组合对人工初始龋的再矿化效果：NC，阴性对照；PC，阳性对照；TM，钙磷化合物（CPP-ACP）；TD，含可可碱的牙膏；RG，ROCS®再矿化凝胶；L，Er,Cr:YSGG 激光（2780nm；0.25W；重复率，20Hz；脉冲持续时间，140μs；尖端直径，600μm；无气/水冷却）；L+含氟牙膏；L+TM；L+TD；和 L+RG。通过每天应用再矿化剂和激光治疗，对脱矿牛牙釉质标本进行为期 8 天的 pH 循环，在 pH 循环和糊剂应用前进行一次激光治疗。对牙釉质样本进行维氏表面显微硬度测试，每组取一个样本进行扫描电子显微镜分析。采用 Kruskal Wallis 检验比较各组的表面显微硬度恢复百分率（SMHR%），并用 Dunn 检验进行多重比较。L 组（p=0.003）、RG 组（p=0.019）、L+TM 组（p<0.001）、L+含氟牙膏组（p=0.001）和 L+RG 组（p=0.036）的 SMHR%显著增加。单独使用和与 Er,Cr:YSGG 激光联合使用时，测试的再矿化剂在效果上没有统计学上的显著差异。Er,Cr:YSGG 激光联合 ROCS®再矿化凝胶的应用能有效促进牙釉质再矿化，而单独使用 CPP-ACP 和含氟牙膏则无效。含可可碱的牙膏表现出最低的 SMHR%。建议对这些试剂进行长期评估。
