Determination of safe parameters of the CO2 laser ('lambda'=10,6 'mu'm) and its association with fluoridated products on dental enamel demineralization progression: in vitro estudies

Author(s)

Carolina Steiner Oliveira

• Document type: Master's Dissertation
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2006-07-02

Examining board members

Marinês Nobre dos Santos; Lidiany Karla Azevedo Rodrigues; Maria Beatriz Duarte Gavião

• Advisor: Marinês Nobre dos Santos

Abstract

The irradiation of dental enamel by CO2 laser, especialIy if combined with fluoride, can increase the enamel acid resistance. Thus, this thesis, comprised by 2 manuscripts, aimed: to establish the lowest energy fluency of a pulsed 10.6 Ilm C02 laser that, when applied on enamel surface, is able to cause chemical and morphological changes and reduces its acid resistance reactivity, without causing pulpal harm; to assess, in vitro, the combined effects of a 10.6 Ilm CO2 laser, fluoridated dentifrice and fluoridated mouthrinse in the reduction of lesion progression in human carious dental enamel. In study I, during the irradiation of human teeth with 1.5-11.5J/cm2, intrapulpal thermal effects were evaluated by a thermocouple. Moreover, chemical and morphological modifications were assessed on enamel surface, through FT-Raman and MEV analysis, respectively. The teeth were submitted to a pH-cyc1ing model and the enamel mineralloss was determined by crosssectional microhardness. The.Raman spectra obtained were assessed by the paired t test and thermal and microhardness variables were analyzed by ANOV A and Tukey tests, alI with 5% of statistical significance. In study 2, slabs of previously demineralized dental enamel were randomly assigned to nine groups (n = 10) and treated withlwithout CO2 laser and withlwithout fluoridated dentifrice and withlwithout fluoridated mouthrinse, making all possible associations between these treatments. After pH-cyc1ing, fluoride concentrations were determined in the de and remineraliziRg solutions and qualitative polarized light analysis was performed. In addition, cross-sectional microhardness test was dOJ;1e to quantify changes in mineral content. In the first study, for alI irradiated groups, intrapulpal temperature changes were below 3°C. FT-Raman spectroscopy and scanning electron microscopy indicated that fluencies as low as 6.0 J/cm2 were sufficient to induce chemical and morphological changes in enamel. Laser-induced inhibitory effects on enamel demineralization were observed in fluencies of 10.0 and 11.5 J/cm2. In the second study, alI treatments were able to decrease mineralloss when compared to control group (p < 0.05). AdditionalIy, except for the association of laser with fluoridated mouthrinse, all combined treatments have caused enamel remineralization. In conclusion, the results of these studies suggest that the lowest laser fluency capable of producing chemical and morphological changes to reduce acid reactivity of enamel without exposing pulp vitality to danger is 10.0 J/cmZ and that pulsed COz laser irradiation alone or combined with fluoridated products produced an effective protection against demineralization progression in dental enamel in vitro (AU)