Bakhtiary Pegah, Gharavi Matine, Ebrahimi Hooman, Salem Katayoun
Dept. of Pediatric Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Postgraduate Student, Dept. of Pediatric Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
J Dent (Shiraz). 2025 Sep 1;26(3):233-240. doi: 10.30476/dentjods.2024.102452.2363. eCollection 2025 Sep.
Remineralizing early enamel lesions in primary dentition remain a significant challenge in dentistry, requiring innovative approaches to enhance enamel repair.
This study aimed to evaluate the efficacy of a commercially available nanohydroxyapatite paste (Nano P), alone and in combination with air dielectric barrier discharge cold atmospheric plasma (CAP) and a 940-nm diode laser, on enamel remineralization.
In this study, 105 intact anterior primary teeth were randomly assigned into one control and six experimental groups: (I) control, (II) Fluoride varnish, (III) Nano P, (IV) Nano P + dye + laser, (V) Nano P + laser, (VI) CAP, and (VII) Nano P + CAP. Caries-like lesions were induced by demineralization. Microhardness was evaluated before and after demineralization and 4 weeks post-remineralization with pH cycling. Data analysis was conducted using one-way ANOVA (α=.05) and Tamhane's Post-Hoc test, with effect sizes determined by Cohen's d test and Hedges' g correction. The percentage of recovery of the enamel microhardness was calculated.
Initial and secondary microhardness were similar across groups ( Value >.05). Post-remineralization, significant differences were observed (< 0.05), with the highest microhardness in the Nano P+ laser group, followed by Nano P+ dye+ laser, Nano P+ CAP, Nano P, fluoride varnish, CAP, and the control. Pairwise comparisons showed significant differences between all pairs except Nano P+ laser and Nano P+ dye + laser (= 0.7, Effect size=0.4).
Nano P combined with a laser, followed by Nano P with plasma, and Nano P alone significantly increased microhardness more than fluoride or plasma, suggesting these combinations as effective alternatives for enamel remineralization in primary teeth.
乳牙早期釉质病变的再矿化仍是牙科领域的一项重大挑战，需要创新方法来促进釉质修复。
本研究旨在评估市售纳米羟基磷灰石糊剂（纳米P）单独使用以及与空气介质阻挡放电冷大气等离子体（CAP）和940纳米二极管激光联合使用对釉质再矿化的效果。
在本研究中，105颗完整的乳前牙被随机分为1个对照组和6个实验组：（I）对照组，（II）氟化物 varnish，（III）纳米P，（IV）纳米P + 染料 + 激光，（V）纳米P + 激光，（VI）CAP，以及（VII）纳米P + CAP。通过脱矿诱导形成龋样病变。在脱矿前后以及进行pH循环再矿化4周后评估显微硬度。使用单因素方差分析（α = 0.05）和Tamhanes事后检验进行数据分析，效应大小由Cohen's d检验和Hedges' g校正确定。计算釉质显微硬度的恢复百分比。
各组的初始和二次显微硬度相似（值 > 0.05）。再矿化后，观察到显著差异（< 0.05），纳米P + 激光组的显微硬度最高，其次是纳米P + 染料 + 激光、纳米P + CAP、纳米P、氟化物 varnish、CAP和对照组。两两比较显示，除纳米P + 激光和纳米P + 染料 + 激光外（= 0.7，效应大小 = 0.4），所有组对之间均存在显著差异。
纳米P与激光联合使用，其次是纳米P与等离子体联合使用，以及单独使用纳米P，比氟化物或等离子体更能显著提高显微硬度，表明这些联合方法是乳牙釉质再矿化的有效替代方法。
