Hashemikamangar Sedighe Sadat, Vahedi Mahtab, Khadivi Moghadam Mohammadreza, Behniafar Behnaz, Chiniforush Nasim
Professor, Dental Research Center, Dentistry Research Institute, Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Dental Student, Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Heliyon. 2024 Jul 26;10(15):e35224. doi: 10.1016/j.heliyon.2024.e35224. eCollection 2024 Aug 15.
The present study aimed to determine the cumulative effect of two photodynamic therapy methods with methylene blue and indocyanine green and two topical fluoride therapy methods with fluoride varnish and silver diamine fluoride alone and in combination on the microhardness and topography of demineralized enamel and cementum surfaces.
Seventy-two sound human teeth were selected, and their buccal and lingual surfaces were assigned to two main groups of enamel and cementum using simple randomization. The initial surface hardness (SH) of the enamel and cementum in each sample was determined using a micro-Vickers hardness tester using a 200-g force in 10 s. Then artificial caries was induced by immersion in a demineralizing/remineralizing solution (i.e., each tooth provided two samples, one on the buccal aspect and the other on the lingual aspect). Each enamel/cementum main group was divided into two subgroups using simple randomization based on the local fluoride type (fluoride varnish and silver diamine fluoride) and the type of the photosensitizer agent (methylene blue and indocyanine green). Finally, 16 groups were achieved (n = 9). The final surface hardness of the enamel and cementum samples was determined as described above. Finally, the sample surfaces were prepared for the surface topography evaluation under a scanning electron microscope. The baseline microhardness was compared between the 16 study groups in the first step using one-way ANOVA. Then, three-way ANOVA was used to evaluate the effect of fluoride, laser, and surface (enamel and cementum) on microhardness.
All the groups exhibited decreased microhardness due to the induction of artificial caries. In both main groups of enamel and cementum, the lowest decrease in microhardness was recorded with combined photodynamic therapy and methylene blue photosensitizer material and fluoride varnish (15.1 % for cementum and 16.7 % for enamel), and the highest decrease in microhardness was recorded in the methylene blue group (35.7 % for cementum and 34.9 % for enamel).
The combination of photodynamic therapy with the photosensitizer substance methylene blue or indocyanine green together with fluoride varnish or silver diamine fluoride is effective on the remineralization of demineralized enamel and cementum. Although there is no difference between the combination of photodynamic therapy with fluoride varnish compared to fluoride varnish alone, both of these treatments are more effective than using photodynamic therapy alone.
本研究旨在确定亚甲蓝和吲哚菁绿两种光动力疗法以及单独使用和联合使用氟化物漆和氟化亚锡两种局部氟化物疗法对脱矿釉质和牙骨质表面的显微硬度和形貌的累积影响。
选取72颗健康人牙，通过简单随机化将其颊面和舌面分为釉质和牙骨质两个主要组。使用显微维氏硬度计在10秒内施加200克力，测定每个样本中釉质和牙骨质的初始表面硬度（SH）。然后将牙齿浸泡在脱矿/再矿化溶液中诱导人工龋（即每颗牙齿提供两个样本，一个在颊面，另一个在舌面）。根据局部氟化物类型（氟化物漆和氟化亚锡）和光敏剂类型（亚甲蓝和吲哚菁绿），通过简单随机化将每个釉质/牙骨质主要组再分为两个亚组。最终得到16个组（n = 9）。如上述方法测定釉质和牙骨质样本的最终表面硬度。最后，制备样本表面以进行扫描电子显微镜下的表面形貌评估。第一步使用单因素方差分析比较16个研究组之间的基线显微硬度。然后，使用三因素方差分析评估氟化物、激光和表面（釉质和牙骨质）对显微硬度的影响。
由于人工龋的诱导，所有组的显微硬度均降低。在釉质和牙骨质两个主要组中，联合光动力疗法与亚甲蓝光敏剂材料和氟化物漆时，显微硬度降低最少（牙骨质为15.1%，釉质为16.7%），而亚甲蓝组的显微硬度降低最多（牙骨质为35.7%，釉质为34.9%）。
光动力疗法与亚甲蓝或吲哚菁绿光敏剂物质联合氟化物漆或氟化亚锡对脱矿釉质和牙骨质的再矿化有效。虽然光动力疗法与氟化物漆联合使用与单独使用氟化物漆之间没有差异，但这两种治疗方法都比单独使用光动力疗法更有效。
