Volume 9, Issue 3 (9-2024)                   J Res Dent Maxillofac Sci 2024, 9(3): 174-183 | Back to browse issues page


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Baniasad N, Poosti M, Etemadi S, Mahmoudi F, Mirmohammadi K. Effects of Fractional Carbon Dioxide Laser and CPP-ACP Paste on Remineralization and Discoloration of Enamel White Spot Lesions. J Res Dent Maxillofac Sci 2024; 9 (3) :174-183
URL: http://jrdms.dentaliau.ac.ir/article-1-544-en.html
1- Department of Orthodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
2- Private Orthodontic Practice, Tehran, Iran.
3- Department of Orthodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran , etemadi.shahrzad@gmail.com
Abstract:   (208 Views)
Background and Aim: The prevalence of enamel demineralization around orthodontic brackets is high. This study investigated the effects of CO2 laser and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on enamel white spot lesions (WSLs).
Materials and Methods: In this in vitro study, 60 human premolars were stored in a demineralizing solution for 12 weeks to induce WSLs, and divided into four groups (n=15) of no surface treatment (control), CPP-ACP paste application for 4 minutes/day for one week, and CO2 laser (10 mJ, 200 Hz, 10 s) with/without CPP-ACP paste. The teeth were then immersed in artificial saliva for 90 days while being subjected to daily fluoride mouthwash and weekly brushing. Tooth color was measured at baseline, after demineralization, after the interventions, and after 90 days of storage. The Vickers microhardness of the teeth was measured at the enamel surface and 30-, 60-, and 90-µm depths. Data were analyzed by one-way and repeated measures ANOVA and Friedman test. 
Results: No significant difference was found among the four groups concerning color change, and all groups had clinically detectable discoloration after remineralization. Laser irradiation through CPP-ACP paste caused a significant increase in microhardness compared to CPP-ACP alone and the control group (P<0.05). Microhardness at 30-, 60- and 90-µm depths was also significantly greater in laser/CPP-ACP compared to other groups (P=0.0001).
Conclusion: Application of fractional CO2 laser with/without CPP-ACP paste was not effective in improving the color of WSLs. However, application of CO2 laser through CPP-ACP may be suggested for rehardening of demineralized enamel.
 
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Type of Study: Original article | Subject: orthodontic

References
1. Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982 Feb;81(2):93-8. [DOI:10.1016/0002-9416(82)90032-X] [PMID]
2. Ogaard B, Rølla G, Arends J, ten Cate JM. Orthodontic appliances and enamel demineralization. Part 2. Prevention and treatment of lesions. Am J Orthod Dentofacial Orthop. 1988 Aug;94(2):123-8. [DOI:10.1016/0889-5406(88)90360-5] [PMID]
3. Geiger AM, Gorelick L, Gwinnett AJ, Benson BJ. Reducing white spot lesions in orthodontic populations with fluoride rinsing. Am J Orthod Dentofacial Orthop. 1992 May;101(5):403-7. [DOI:10.1016/0889-5406(92)70112-N] [PMID]
4. Øgaard B, Larsson E, Henriksson T, Birkhed D, Bishara SE. Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients. Am J Orthod Dentofacial Orthop. 2001 Jul;120(1):28-35. [DOI:10.1067/mod.2001.114644] [PMID]
5. Paschos E, Kleinschrodt T, Clementino-Luedemann T, Huth KC, Hickel R, Kunzelmann KH, Rudzki-Janson I. Effect of different bonding agents on prevention of enamel demineralization around orthodontic brackets. Am J Orthod Dentofacial Orthop. 2009 May;135(5):603-12. [DOI:10.1016/j.ajodo.2007.11.028] [PMID]
6. Steiner-Oliveira C, Rodrigues LK, Lima EB, Nobre-dos-Santos M. Effect of the CO2 laser combined with fluoridated products on the inhibition of enamel demineralization. J Contemp Dent Pract. 2008 Feb 1;9(2):113-21.
7. Steiner-Oliveira C, Rodrigues LK, Soares LE, Martin AA, Zezell DM, Nobre-dos-Santos M. Chemical, morphological and thermal effects of 10.6-microm CO2 laser on the inhibition of enamel demineralization. Dent Mater J. 2006 Sep;25(3):455-62. [DOI:10.4012/dmj.25.455] [PMID]
8. Kim HE, Kwon HK, Kim BI. Application of fluoride iontophoresis to improve remineralization. J Oral Rehabil. 2009 Oct;36(10):770-5. [DOI:10.1111/j.1365-2842.2009.01992.x] [PMID]
9. Lee YE, Baek HJ, Choi YH, Jeong SH, Park YD, Song KB. Comparison of remineralization effect of three topical fluoride regimens on enamel initial carious lesions. J Dent. 2010 Feb;38(2):166-71. [DOI:10.1016/j.jdent.2009.10.002] [PMID]
10. Hellwig E, Altenburger M, Attin T, Lussi A, Buchalla W. Remineralization of initial carious lesions in deciduous enamel after application of dentifrices of different fluoride concentrations. Clin Oral Investig. 2010 Jun;14(3):265-9. [DOI:10.1007/s00784-009-0290-4] [PMID]
11. Willmot DR. White lesions after orthodontic treatment: does low fluoride make a difference? J Orthod. 2004 Sep;31(3):235-42; discussion 202. [DOI:10.1179/146531204225022443] [PMID]
12. Elsayad I, Sakr A, Badr Y. Combining casein phosphopeptide-amorphous calcium phosphate with fluoride: synergistic remineralization potential of artificially demineralized enamel or not? J Biomed Opt. 2009 Jul-Aug;14(4):044039. [DOI:10.1117/1.3210780] [PMID]
13. Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater. 2009 Jun;4(3):034104. [DOI:10.1088/1748-6041/4/3/034104] [PMID]
14. Poosti M, Ahrari F, Moosavi H, Najjaran H. The effect of fractional CO2 laser irradiation on remineralization of enamel white spot lesions. Lasers Med Sci. 2014 Jul;29(4):1349-55. [DOI:10.1007/s10103-013-1290-9] [PMID]
15. Geiger AM, Gorelick L, Gwinnett AJ, Griswold PG. The effect of a fluoride program on white spot formation during orthodontic treatment. Am J Orthod Dentofacial Orthop. 1988 Jan;93(1):29-37. [DOI:10.1016/0889-5406(88)90190-4] [PMID]
16. Fox JL, Yu D, Otsuka M, Higuchi WI, Wong J, Powell GL. Initial dissolution rate studies on dental enamel after CO2 laser irradiation. J Dent Res. 1992 Jul;71(7):1389-98. [DOI:10.1177/00220345920710070701] [PMID]
17. Liu Y, Hsu CY, Teo CM, Teoh SH. Potential mechanism for the laser-fluoride effect on enamel demineralization. J Dent Res. 2013 Jan;92(1):71-5. [DOI:10.1177/0022034512466412] [PMID]
18. Farhadian N, Rezaei-Soufi L, Jamalian SF, Farhadian M, Tamasoki S, Malekshoar M, Javanshir B. Effect of CPP-ACP paste with and without CO2 laser irradiation on demineralized enamel microhardness and bracket shear bond strength. Dental Press J Orthod. 2017 Jul-Aug;22(4):53-60. [DOI:10.1590/2177-6709.22.4.053-060.oar] [PMID] []
19. Abufarwa M, Noureldin A, Azimaie T, Campbell PM, Buschang PH. Preventive effects of carbon dioxide laser and casein phosphopeptide amorphous calcium phosphate fluoride varnish on enamel demineralization: A comparative, in vitro study. J Investig Clin Dent. 2019 May;10(2):e12400. [DOI:10.1111/jicd.12400] [PMID]
20. Schmidlin PR, Dörig I, Lussi A, Roos M, Imfeld T. CO2 laser-irradiation through topically applied fluoride increases acid resistance of demineralised human enamel in vitro. Oral Health Prev Dent. 2007;5(3):201-8.
21. Tepper SA, Zehnder M, Pajarola GF, Schmidlin PR. Increased fluoride uptake and acid resistance by CO2 laser-irradiation through topically applied fluoride on human enamel in vitro. J Dent. 2004 Nov;32(8):635-41. [DOI:10.1016/j.jdent.2004.06.010] [PMID]
22. Chin-Ying SH, Xiaoli G, Jisheng P, Wefel JS. Effects of CO2 laser on fluoride uptake in enamel. J Dent. 2004 Feb;32(2):161-7. [DOI:10.1016/j.jdent.2003.10.004] [PMID]
23. Shahabi M, Moosavi H, Gholami A, Ahrari F. In vitro effects of several surface preparation methods on shear bond strength of orthodontic brackets to caries-like lesions of enamel. Eur J Paediatr Dent. 2012 Sep;13(3):197-202.
24. Jahanbin A, Basafa M, Moazzami M, Basafa B, Eslami N. Color Stability of Enamel following Different Acid Etching and Color Exposure Times. J Dent Res Dent Clin Dent Prospects. 2014 Spring;8(2):67-70.
25. Livas C, Kuijpers-Jagtman AM, Bronkhorst E, Derks A, Katsaros C. Quantification of white spot lesions around orthodontic brackets with image analysis. Angle Orthod. 2008 Jul;78(4):585-90. [DOI:10.2319/0003-3219(2008)078[0585:QOWSLA]2.0.CO;2] [PMID]
26. Esteves-Oliveira M, Pasaporti C, Heussen N, Eduardo CP, Lampert F, Apel C. Rehardening of acid-softened enamel and prevention of enamel softening through CO2 laser irradiation. J Dent. 2011 Jun;39(6):414-21. [DOI:10.1016/j.jdent.2011.03.006] [PMID]
27. Kawasaki K, Tanaka Y, Takagi O. Crystallographic analysis of demineralized human enamel treated by laser-irradiation or remineralization. Arch Oral Biol. 2000 Sep;45(9):797-804. [DOI:10.1016/S0003-9969(00)00034-0] [PMID]
28. Tagomori S, Morioka T. Combined effects of laser and fluoride on acid resistance of human dental enamel. Caries Res. 1989;23(4):225-31. [DOI:10.1159/000261182] [PMID]
29. Yassaei S, Motallaei MN. The Effect of the Er:YAG Laser and MI Paste Plus on the Treatment of White Spot Lesions. J Lasers Med Sci. 2020 Winter;11(1):50-5. [DOI:10.15171/jlms.2020.09] [PMID] []
30. Cochrane NJ, Saranathan S, Cai F, Cross KJ, Reynolds EC. Enamel subsurface lesion remineralisation with casein phosphopeptide stabilised solutions of calcium, phosphate and fluoride. Caries Res. 2008;42(2):88-97. [DOI:10.1159/000113161] [PMID]
31. Shetty S, Hegde MN, Bopanna TP. Enamel remineralization assessment after treatment with three different remineralizing agents using surface microhardness: An in vitro study. J Conserv Dent. 2014 Jan;17(1):49-52. [DOI:10.4103/0972-0707.124136] [PMID] []
32. Srinivasan N, Kavitha M, Loganathan SC. Comparison of the remineralization potential of CPP-ACP and CPP-ACP with 900 ppm fluoride on eroded human enamel: An in situ study. Arch Oral Biol. 2010 Jul;55(7):541-4. [DOI:10.1016/j.archoralbio.2010.05.002] [PMID]
33. Apel C, Birker L, Meister J, Weiss C, Gutknecht N. The caries-preventive potential of subablative Er:YAG and Er:YSGG laser radiation in an intraoral model: a pilot study. Photomed Laser Surg. 2004 Aug;22(4):312-7. [DOI:10.1089/1549541041797931] [PMID]
34. Apel C, Meister J, Schmitt N, Gräber HG, Gutknecht N. Calcium solubility of dental enamel following sub-ablative Er:YAG and Er:YSGG laser irradiation in vitro. Lasers Surg Med. 2002;30(5):337-41. [DOI:10.1002/lsm.10058] [PMID]
35. Yassaei S, Aghili H, Joshan N. Effects of removing adhesive from tooth surfaces by Er:YAG laser and a composite bur on enamel surface roughnessand pulp chamber temperature. Dent Res J (Isfahan). 2015 May-Jun;12(3):254-9.
36. Bailey DL, Adams GG, Tsao CE, Hyslop A, Escobar K, Manton DJ, Reynolds EC, Morgan MV. Regression of post-orthodontic lesions by a remineralizing cream. J Dent Res. 2009 Dec;88(12):1148-53. [DOI:10.1177/0022034509347168] [PMID]
37. Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT. MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomized controlled trial. Am J Orthod Dentofacial Orthop. 2011 Nov;140(5):660-8. [DOI:10.1016/j.ajodo.2010.10.025] [PMID]
38. Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker GD, Morgan MV, Reynolds C. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008 Apr;87(4): 344-8. [DOI:10.1177/154405910808700420] [PMID]

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