Enamel demineralization around dental restoration. Effect of Er:YAG laser parameters employed to cavity preparation

Author(s)

Vivian Colucci

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Ribeirão Preto (PCARP/BC)
• Defense date: 2010-02-01

Examining board members

Silmara Aparecida Milori Corona; Welingtom Dinelli; Mariane Goncalves; Heitor Marques Honório; Andréa Candido dos Reis

• Advisor: Silmara Aparecida Milori Corona

Abstract

The current study, composed by two experiments, sought to evaluate in vitro the effect of Er:YAG laser parameters on human and bovine enamel demineralization after cariogenic challenges and to check, through an in situ model, the effect of different Er:YAG laser parameters on development of caries-like lesions adjacent to dental restorations. In the in vitro study, sound human third molars and bovine incisors were cut to select 50 specimens of each substrate, which were randomly allocated into 10 groups: 9 experimental groups prepared with Er:YAG laser with 300mJ output (frequency of 2Hz, 4Hz or 6Hz, water flow rate of 2.0mL/min, 5.0mL/min or 8.0mL/min) and 1 control group (High speed handpiece). After cavity preparation, the specimens were restored with composite resin and submitted to the cariogenic challenge. Afterwards, they were sectioned to obtain the microhardness measurements and images of light polarized microscopy. In the in situ study, 150 bovine enamel slabs were randomly allocated among 15 volunteers. These specimens were subdivided into 10 groups, as described above to the in vitro study. 9 experimental groups were prepared with Er:YAG laser under different parameters combination. The control group was prepared with high speed handpiece associated to a diamond bur. The prepared cavity was restored with a composite resin and the slabs were mounted on palatal appliance to be installed in the volunteers to the realization of the cariogenic challenge. After this, the specimens were sectioned to the longitudinal microhardness measurements and to the qualitative light polarized microscopy. The data obtained by means of microhardness test were statistically analyzed. For the in vitro study was performed Analisys of Variance and Tukeys test, which demonstrated that, regardless the tested substrate, the specimens prepared with high speed handpiece showed lower microhardness means than those prepared with the Er:YAG laser for all tested parameters, which were statistically similar (p>0,05). The light polarized microscopy images demonstrated that the groups irradiated with Er:YAG laser with 2Hz frequency showed a tendency to be less susceptible to the demineralization. For the in situ study was performed the Friedman test, which demonstrated that there are statistical difference among the cavity preparation methods according to the microhardness measurements. To indentify the differences among groups it was performed the Wilcoxon paread test and it was observed that the group prepared with Er:YAG laser with 2Hz of frequency and 2.0mL/min of water flow rate showed the highest microhardness means, followed by that prepared with Er:YAG laser with 2Hz of frequency and 5.0mL/min of water flow rate and Er:YAG laser with 2Hz of frequency and 8.0mL/min of water flow rate, respectively. The groups prepared with Er:YAG laser with 4Hz and 6Hz of frequency, with water flow rates of 2.0, 5.0 and 8.0mL/min showed microhardness means lower than that the groups cited above and statistical similarity among them. All groups prepared with Er:YAG laser demonstrated microhardness means higher than that prepared with high speed handpiece, what showed the lowest microhardness means. The light polarized microscopy images confirmed the results obtained with the microhardness test. Thus, it may be concluded that the bovine substrate constitutes an alternative to the human substrate in studies that evaluates the Er:YAG laser and caries-like lesions progression, that the Er:YAG laser was capable to control the development of caries-like lesions around composite resin restorations and that the parameters employed to the cavity preparation could influence on acid resistance of the irradiated substrate. (AU)

• FAPESP's process: 06/05691-8 - Effect of the Er:YAG laser parameters on enamel submitted to cariogenic challenge: an in vitro and in situ study
• Grantee: Vivian Colucci
• Support Opportunities: Scholarships in Brazil - Doctorate