Effect of the usage of Er,Cr:YSGG laser with and without different remineralization agents on the enamel erosion of primary teeth

Yilmaz N. , Baltaci E., Baygin O., Tüzüner T. , Ozkaya S. , Canakci A.

LASERS IN MEDICAL SCIENCE, vol.35, no.7, pp.1607-1620, 2020 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 7
  • Publication Date: 2020
  • Doi Number: 10.1007/s10103-020-03015-0
  • Title of Journal : LASERS IN MEDICAL SCIENCE
  • Page Numbers: pp.1607-1620


The aim of the present study was to evaluate the effects of different remineralization agents associated with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) (0.5 W power, 20 Hz frequency, 60% water, 40% air, 25 mJ pulse energy, 8.84 J/cm(2)fluence, 60 mu s pulse duration, 600 mu m tip diameter, and an approximate 1-1.5 mm distance to the target) laser irradiation on erosion induced by the consumption of carbonated drinks in human primary enamel. There were 8 groups and 10 primary teeth in each g0roup. The distribution was as follows: group 1, casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF); group 2, Er,Cr:YSGG laser+CPP-ACPF; group 3, fluor varnish; group 4, Er,Cr:YSGG Laser+fluoride varnish; group 5, ROCS (R) medical mineral gel; group 6, Er,Cr:YSGG laser + ROCS (R) medical mineral gel; group 7, Er,Cr:YSGG laser; and group 8, artificial saliva. The samples in the groups were submerged in artificial saliva and acid twice a day for 6 s at 6-h intervals and were then exposed to an erosion cycle 15 times. In the groups in which the Er,Cr:YSGG laser was applied in combination with the remineralization agents, the laser application was made first, and then the remineralization agents were applied for 4 min in each group. The Friedman and Wilcoxon signed-rank tests and the Bonferroni correction were used in statistical analyses, and the significance level was taken asp < 0.05. According to the results, all agents had a statistically significant difference (groups 1, 2, 3, 4, and 6:p = 0.005,p < 0.017; groups 5 and 7:p = 0.007,p < 0.017) between BL-RM periods. However, all agents had a statistically significant remineralization effect on primary teeth enamel (groups 1, 2, 3, 6, and 7:p = 0.005,p < 0.017; group 4:p = 0.011,p < 0.017) except that group 5 (p = 0.074,p < 0.017) between DM-RM periods. The coadministration of an agent with the laser did not make any difference at a statistical level (p = 0.804,p > 0.05). The results were supported by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. As a result of this study, CPP-ACPF had a notable impact in terms of the remineralization effect on eroded enamel, and the Er,Cr:YSGG laser alone may be an alternative method, which may be related to the modified hydroxyapatite structure, 38.5% H0.56Ca4.56O13P3Y0.44, that was determined in XRD analysis.