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AnonymousGuestHi all,
Was doing some searching for articles on lasers and anesthesia and found nothing. What I did come across were various articles (see below) regarding the increased acid resistance of enamel in teeth that had been lased both with and w/o fluoride. So I was wondering if anyone was doing anything similar in practice? A question to the microdentistry guys (risking showing my ignorance here)- Fuji Triage can be light cured -has there been any thought (in light of studies like those below) about lasing the Fuji Triage to help along the remineralization process?QUOTECalcium solubility of dental enamel following Er, Cr:YSGG laser irradiation
Apel, Christian, Graeber, Hans-Georg, Gutknecht, Norbert, Rheinisch-Westfaelische Technische Hochschule Aachen
Publication: Proc. SPIE Vol. 3910, p. 318-321, Lasers in Dentistry VI, John D. Featherstone; Peter Rechmann; Daniel Fried; Eds.
Publication Date: 3/2000
Abstract:
Ever since the laser was introduced in dental medicine, there has been a constant discussion about its use in caries prevention. Various studies have already illustrated the possible uses of CO2 and argon lasers in this field of dentistry. The aim of the present study was to examine the Er,Cr:YSGG laser with regard to potential in reducing the acid solubility of dental enamel. Thirty freshly extracted bovine incisor teeth were prepared for this purpose. The crowns of the teeth were covered with hard wax, leaving a standardized test area free. The test specimens were then divided into three groups. The test area was uniformly irradiated with 2.7 J/cm2 in the first test group and 6.5 J/cm2 in the second test group. The third test group was left untreated (control group). Demineralization of the teeth was performed over a period of 24 hours in acetate buffer solution (0.1 mol/l) with a pH value of 4.5 and a temperature of 37 degrees Celsius. The calcium content of the solution was subsequently determined by flame photometry. The results confirm a significantly lower calcium content in the test group exposed to radiation of 6.5 J/cm2 (p less than 0.025). Dental enamel seems to have increased acid resistance following irradiation with the Er,Cr:YSGG laser.©2002 SPIE–The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Comparison of three lasers on demineralization of human enamel
Powell, G. Lynn, Yu, Duncan, Higuchi, William I., Fox, Jeffrey L., Univ. of Utah
Publication: Proc. SPIE Vol. 1880, p. 188-192, Lasers in Orthopedic, Dental, and Veterinary Medicine II, Dov Gal; Stephen J. O’Brien; C. Thomas Vangsness; Joel M. White; Harvey A. Wigdor; Eds.
Publication Date: 7/1993
Abstract:
Previous studies have recorded the reduction of caries-like lesions or demineralization in extracted human teeth that had been irradiated with CO2 laser, Nd:YAG laser, and Argon laser. This study was conducted to evaluate the effects of three different cw lasers on acid resistance and demineralization of dental enamel. Human enamel was laser irradiated with either Argon, CO2, or Nd:YAG energy densities of 60 – 65 J/cm2 or 120 – 130 J/cm2. The amount of demineralization was determined in a rotating disk assembly (0.1 M acetate buffer, pH – 4.5) for 24 hours and the results determined and plotted against the non-lased control using microradiographs and computerized imaging. The amount of dissolution of tooth structure lost to demineralization in 4.5 pH acid bath in a 24 hour period was reduced from approximately 140 microns for the unlased control to approximately 90 microns for the Argon laser and 70 microns for the CO2 laser at 60 – 65 J/cm2. At 120 – 130 J/cm2 the results were: 120 microns for the Nd:YAG, 70 microns for the Argon, and 45 microns for the CO2 laser. This study shows that demineralization is reduced significantly in vitro when human enamel is exposed to Argon and CO2 laser irradiation.
Effect of a new carbon dioxide laser and fluoride on occlusal caries progression in dental enamel
Nobre dos Santos, Marines, Univ. Estadual de Campinas; Fried, Daniel, Rapozo-Hilo, Marcia L., Featherstone, John D., Univ. of California/San Francisco
Publication: Proc. SPIE Vol. 4610, p. 132-139, Lasers in Dentistry VIII, Peter Rechmann; Daniel Fried; Thomas Hennig; Eds.
Publication Date: 6/2002
Abstract:
The purpose of this study was to investigate the effect of a new TEA carbon dioxide (CO2) laser (.9.6 micrometers , 5-8 microsecond(s) pulse duration) combined with fluoride (F), on the inhibition of caries-like progression in occlusal surfaces in sound and demineralized enamel. Of 120 occlusal tooth surfaces (10 per group), 90 were partially demineralized in a 50% HAP/0.1 M Lactic acid/carbopol solution (pH 5.0). Samples were treated with/without the laser (2.0 j/cm2 or 3.0 J/cm2) and/or F (as APF). Caries-like progression was tested by 5 days of pH cycling. Results were assessed by cross-sectional quantitative microradiography. The percent inhibition of caries progression with laser and/or F ranged from 87-170%. This new TEA CO2 laser produced significant protective effect against lesion progression, and in combination with fluoride treatment lesion reversal occurred.
Robert Gregg DDSSpectatorHi Ron,
I’ve been trying to make the time to say something really smart and informative to your post here, but you pretty much cited everything.
Great post. Nice references.
I have been doing laser irradiation of fluoride with pulsed Nd:YAGs for 12 years or so. It has been long been a part of my “laser power bleaching” after I finish chairside to stablize the bleach and reduce any sensitivity. SHHHHUUUSHHH. Don’t tell anyone, it’s been a bleaching secret of mine all this time.
Not sure what you mean about lasing the Fuji Triage. Heck, I’m not sure what Fuji Triage IS!
Is it a glass ionomer? Are you thinking of lasing the flowable material beforelight curing, then polymerizing the Fugi?
The answer to your question is that I doubt many have thought of doing that. I haven’t. My partner Del probably has (but he’s the Ultimate Playmeister). I’ll ask him tomorrow…..
Would it work and provide a better fluoride uptake at the margin. Sounds good. Should work. Can’t seemto hurt. Sounds like an excellent research project
Bob
AnonymousGuestBob,
Actually, I was curious to see if the laser would cure the Fuji Triage http://www.gcamerica.com/gctriage.html(don’t have any in the office yet), If I could paint the triage in the grooves, paint on topical Fl2 and then lase it could be a quick really effective means of protecting teeth. And if the laser increased the ion exchange with the glass ionomer that would be an added bonus.
gwmilicichSpectatorRon
Triage has a very high F level (6 times that of Fuji 9)
Personally, I can’t see there being any benefit in hitting it with the laser. The reaction you are looking for is related to polyacrylic acid etching the enamel and creating a hybrid zone on teh surface incorporating teh Ca and Phosphates from both the tooth and the GIC, plus incorporating the F from the GIC.The colour is pink so when you hit it with a blue light, it absorbs the photonic energy , warms up and speeds up the chemical reaction that is occuring.
The laser would only be hitting 600micron spots rather than the whole restoration. By the time you ocvered it all, it would be set all on its own. Plus the Waterlase gets its knickers in a twist on GIC’s Too much metal content I think.
Other laser applications using F have not had the complexity of what is already happening when you put GIC onto the tooth and act as an adjunct to F uptake. I doubt this would be the case with GIC’s
Just my thoughts anyway, but I could be wrong.
Cheers
AnonymousGuestThanks Graeme,
That makes alot of sense. -
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