Er:YAG laser in selective caries removal and dentin treatment with chitosan: a randomized clinical trial in primary molars

Author(s)

Santos, Rai Matheus Carvalho ; Scatolin, Renata Siqueira ; Salvador, Sergio Luiz de Souza ; Souza-Gabriel, Aline Evangelista ; Corona, Silmara Aparecida Milori

• Document type: Journal article
• Source: Lasers in Medical Science; v. 38, n. 1, p. 9-pg., 2023-09-12.

Abstract

This study evaluated the effect of chitosan on dentin treatment after selective removal of caries lesions with Er:YAG laser in reducing Streptococcus mutans, as well as its effect on the performed restorations. The sample consisted of children (aged 7 to 9 years) with active carious lesions and dentin cavitation located on the occlusal surface of deciduous molars. Eighty teeth were randomly distributed into 4 groups according to the caries removal method: Er:YAG laser (250 mJ/4 Hz) or bur and dentin surface treatment: 2.5% chitosan solution or distilled water. The bacterial load of caries-affected dentin was quantified by counting CFU/mg (n = 10). The teeth were restored and evaluated at 7 days, 6 months, and 12 months using modified USPHS criteria (n = 20). Microbiological data was analyzed by Mann-Whitney and clinical analyses were done using Kruskal-Wallis and Dunn test (a = 0.05). The results showed that the Er:YAG laser significantly reduced the amount of Streptococcus mutans (p = 0.0068). After dentin treatment with chitosan, there was a significant reduction in the amount of Streptococcus mutans for both removal methods (p = 0.0424). For the retention and secondary caries criteria, no significant differences were observed along the evaluated time (p > 0.05). The laser-treated group was rated "bravo" for discoloration (p = 0.0089) and marginal adaptation (p = 0.0003) after 6 and 12 months compared to baseline. The Er:YAG laser reduced the amount of Streptococcus mutans and the chitosan showed an additional antibacterial effect. After 1 year, the Er:YAG laser-prepared teeth, regardless of the dentin treatment, showed greater discoloration and marginal adaptation of the restorations. (AU)

• FAPESP's process: 16/14864-5 - Influence of the dentin rewetting with chitosan after selective removal of carious lesion by Er: YAG: longitudinal clinical analysis, photographic evaluation, marginal adaptation of the replica of the restoration and microbiological analysis
• Grantee: Raí Matheus Carvalho Santos
• Support Opportunities: Scholarships in Brazil - Master