Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, Universidade de Campinas-UNICAMP, Av. Limeira 901, Piracicaba, SP, Brazil.
Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.
Clin Oral Investig. 2023 Dec;27(12):7753-7763. doi: 10.1007/s00784-023-05365-9. Epub 2023 Nov 24.
This in situ study aimed to investigate the efficacy of CO laser at a 10.6-µm wavelength combined with 1.23% acidulated phosphate fluoride (APF) and fluoridated dentifrice with 1100 µg F/g (FD) to control enamel caries progression.
Sixteen volunteers wore palatal appliances containing eight demineralized enamel specimens for four 14-day phases under sucrose exposure. These specimens were submitted to CO laser irradiation and APF alone or combined with FD. Treatment groups were non-fluoridated dentifrice-NFD, NFD + CO laser, NFD + APF, NFD + CO laser + APF, FD, FD + CO laser, FD + APF, and FD + CO laser + APF. Mineral loss, calcium fluoride (CaF), fluorapatite (FAp), and fluoride in the biofilm were analyzed by analysis of variance followed by the Student-Newman-Keuls test, p < 0.05.
The highest mineral loss inhibition was noted when FD and CO laser irradiation were combined, which did not significantly differ from the FD + CO laser + APF group. The CaF, FAp, and F in the biofilm were more pronounced when the FD and APF were combined. The CO laser irradiation promoted a slightly higher concentration of CaF in the enamel and F in the biofilm.
Although APF promotes the high formation of CaF and FAp, the combined use of FD with CO laser overcomes the APF effect in inhibiting the progression of artificial caries-like lesions in situ.
Under the in situ design of this study, remineralization of white spot lesions was achieved through CO laser irradiation and daily use of fluoridated dentifrice. Future clinical trials are encouraged to substantiate this finding.
本原位研究旨在探讨 10.6μm 波长 CO 激光联合 1.23%酸性磷酸氟（APF）和含 1100μg F/g 氟化物牙膏（FD）对控制釉质龋进展的疗效。
16 名志愿者佩戴含有 8 个脱矿釉质标本的腭部装置，在蔗糖暴露下进行 4 个为期 14 天的阶段。这些标本接受 CO 激光照射和 APF 单独或联合 FD 处理。处理组为非氟化牙膏-NFD、NFD+CO 激光、NFD+APF、NFD+CO 激光+APF、FD、FD+CO 激光、FD+APF 和 FD+CO 激光+APF。通过方差分析和 Student-Newman-Keuls 检验分析矿物质损失、氟化钙（CaF）、氟磷灰石（FAp）和生物膜中的氟，p<0.05。
当 FD 和 CO 激光照射联合使用时，观察到最大的矿物质损失抑制作用，与 FD+CO 激光+APF 组无显著差异。当 FD 和 APF 联合使用时，CaF、FAp 和生物膜中的 F 更为明显。CO 激光照射可促进釉质中 CaF 和生物膜中 F 的浓度略有升高。
尽管 APF 促进了 CaF 和 FAp 的高形成，但 FD 与 CO 激光联合使用克服了 APF 抑制人工龋损样病变进展的作用。
在本研究的原位设计下，通过 CO 激光照射和每日使用含氟牙膏实现了白斑病变的再矿化。鼓励未来的临床试验证实这一发现。
