Research Article
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The effect of minimally invasive treatments on enamel microhardness and resistance to further demineralization

Year 2022, Volume: 25 Issue: 4, 285 - 290, 30.12.2022

Horieh Moosavi Fatemeh Rezaee Safoora Afshari Salehe Sekandari Farzaneh Ahrari

https://doi.org/10.7126/cumudj.1106247

Abstract

Objectives: The present study aimed to compare microhardness of inactive proximal lesions treated by resin infiltration, Er:YAG laser + resin infiltration and Bioactive glass, and investigate the resistance of treated lesions to further demineralization challenge.
Methods: In this in-vitro study, 30 human molars with inactive proximal lesions were selected and randomly divided into three groups of 10. In group 1 (resin infiltration), the lesions were treated by a resin infiltrant (Icon). In group 2, the surface was conditioned by an Er:YAG laser prior to resin infiltration. The specimens in group 3 were remineralized by bioactive glass. The treated specimens were kept in artificial saliva for 1 week and then immersed in a demineralization solution for 8 weeks. Surface microhardness was measured at baseline (T0), after remineralization (T1) and after exposure to the demineralization solution (T2), and the difference in microhardness between time points (ΔVHN) was calculated.
Results: Microhardness after demineralization (T2) was significantly lower than those of other intervals (P<0.05), but no significant difference was found between the T0 and T1 values (P>0.05). The statistical analysis revealed no significant difference either in ΔVHNT1-T0 or in ΔVHNT2-T1 among the study groups (P>0.05)
Conclusion: Pretreatment by the Er:YAG laser prior to resin infiltration was more effective that other treatments in enhancing microhardness and protecting the tooth against acidic challenge. However, the difference between groups did not reach a statistical significance, implying the need for further studies to achieve more conclusive results.

Keywords

proximal caries remineralization Bioactive glass Er:YAG laser resin infiltration

Supporting Institution

Mashhad University of Medical Sciences

Project Number

940325

References

  • 1.El Meligy OA, Alamoudi NM, Ibrahim ST, Felemban OM, Al-Tuwirqi AA. Effect of resin infiltration application on early proximal caries lesions in vitro. Journal of dental sciences. 2021 Jan 1;16(1):296-303.
  • 2.Braga MM, Mendes FM, Ekstrand KR. Detection activity assessment and diagnosis of dental caries lesions. Dental Clinics of North America. 2010;54:479-93.
  • 3.Splieth CH, Kanzow P, Wiegand A, Schmoeckel J, Jablonski-Momeni A. How to intervene in the caries process: proximal caries in adolescents and adults-a systematic review and meta-analysis. Clin Oral Investig. 2020;24:1623-1636.
  • 4.Ahrari F, Akbari M, Mohammadi M, Fallahrastegar A, Najafi MN. The validity of laser fluorescence (LF) and near-infrared reflection (NIRR) in detecting early proximal cavities. Clin Oral Investig 2021;25(8):4817-24.
  • 5.Dai LL, Mei ML, Chu CH, Lo ECM. Mechanisms of Bioactive Glass on Caries Management: A Review. Materials (Basel). 2019;12(24):4183.
  • 6. Manoharan V, Arun Kumar S, Arumugam SB, Anand V, Krishnamoorthy S, Methippara JJ. Is Resin Infiltration a Microinvasive Approach to White Lesions of Calcified Tooth Structures?: A Systemic Review. Int J Clin Pediatr Dent. 2019;12:53-58.
  • 7.Liang Y, Deng Z, Dai X, Tian J, Zhao W. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig. 2018;22:2675–84.
  • 8.Dorri M, Dunne SM, Walsh T, Schwendicke F. Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth. Cochrane Database Syst Rev. 2015;2015:CD010431.
  • 9.Krois J, Göstemeyer G, Reda S, Schwendicke F. Sealing or infiltrating proximal carious lesions [published correction appears in J Dent. 2018 Sep;76:137-138]. J Dent. 2018;74:15-22.
  • 10.Ammari MM, Soviero VM, da Silva Fidalgo TK, et al. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis. J Dent. 2014;42:1217-1227.
  • 11.Chatzimarkou S, Koletsi D, Kavvadia K. The effect of resin infiltration on proximal caries lesions in primary and permanent teeth. A systematic review and meta-analysis of clinical trials. J Dent. 2018;77:8–17.
  • 12. Moosavi H, Ahrari F, Zanjani M. Effect of Er:YAG laser radiation on pull-out fracture load of esthetic posts luted to root canal dentin with various resin cements. Dent Res J (Isfahan) 2021;18:17.
  • 13.Moosavi H, Ghorbanzadeh S, Ahrari F. Structural and Morphological Changes in Human Dentin after Ablative and Subablative Er:YAG Laser Irradiation. J Lasers Med Sci 2016;7:86-91.
  • 14.Heravi F, Ahrari F, Mahdavi M, Basafa S. Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries. J Clin Exp Dent 2014;6(2):e121-6.
  • 15.Ahrari F, Poosti M, Motahari P. Enamel resistance to demineralization following Er:YAG laser etching for bonding orthodontic brackets. Dent Res J (Isfahan) 2012;9(4):472-7.
  • 16.Dehghani M, Ahrari F. The effect of surface treatment with Er: YAG laser on shear bond strength of orthodontic brackets to fiber-reinforced composite. J Clin Exp Dent 2014;6(4):e379-83.
  • 17.Zhang Y, Wang Y, Chen Y, Chen Y, Zhang Q, Zou J. The clinical effects of laser preparation of tooth surfaces for fissure sealants placement: a systematic review and meta-analysis. BMC Oral Health. 2019;19(1):1-12.
  • 18.Jones JR. Review of bioactive glass: from Hench to hybrids. Acta biomaterialia. 2013;9:4457-86.
  • 19.DAI JM, LI FH, Qiu XL, DONG X. Effects of Rein Infiltration and Bioactive Glass on Early Caries. Journal of Oral Science Research. 2019 May 28;35(5):453-6.
  • 20.Torres CR, Rosa PC, Ferreira NS, Borges AB. Effect of caries infiltration technique and fluoride therapy on microhardness of enamel carious lesions. Oper Dent. 2012;37:363-369.
  • 21.Paris S, Meyer-Lueckel H, Cölfen H, Kielbassa AM. Resin infiltration of artificial enamel caries lesions with experimental light curing resins. Dent Mater J. 2007;26:582-8.
  • 22.Ahrari F, Jalaly T, Zebarjad M. Tensile properties of orthodontic elastomeric ligatures. Indian J Dent Res 2010;21(1):23-9.
  • 23.Ghanbarzadeh M, Ahrari F, Akbari M, Hamzei H. Microhardness of demineralized enamel following home bleaching and laser-assisted in office bleaching. J Clin Exp Dent 2015;7:e405-9.
  • 24.Ahrari F, Hasanzadeh N, Rajabi O, Forouzannejad Z. Effectiveness of sodium bicarbonate combined with hydrogen peroxide and CPP-ACPF in whitening and microhardness of enamel. J Clin Exp Dent 2017;9(3):e344-e50.
  • 25.Paris S, Schwendicke F, Seddig S, MüllerW-D, Dörfer C, Meyer-Lueckel H. Micro-hardness and mineral loss of enamel lesions after infiltration with various resins: Influence of infiltrant composition and application frequency in vitro. J Dent. 2013;41:543-8.
  • 26.OAESE M, Ibrahim ST, Alamoudi NM. Resin infiltration of non-cavitated proximal caries lesions: a literature review. J Oral Hyg Health. 2018;6(1):235-43.
  • 27.Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries research. 2010;44(1):47-54.
  • 28.Polat YK, Ilday NO. The effects of different anticavity agents and Er: YAG laser usage on enamel surface microhardness. Oral Health Prev Dent. 2020;18(1):601-6.
  • 29.Ahrari F, Basafa M, Fekrazad R, Mokarram M, Akbari M. The efficacy of Er,Cr:YSGG laser in reconditioning of metallic orthodontic brackets. Photomed Laser Surg 2012;30:41-6.
  • 30.Zarabian T, Azadi Mood S, Kiomarsi N, Noorollahian H, Hakimiha N. Microshear Bond Strength of a Self-adhesive Composite to Erbium Laser-Treated Primary Enamel. J Lasers Med Sci. 2020;11:181-186.
  • 31.Manhart J, Huth KC, Chen HY, Hickel R. Influence of the pretreatment of occlusal pits and fissures on the retention of a fissure sealant. Am J Dent. 2004;17:12-18.
  • 32.Lupi-Pegurier L, Bertrand MF, Muller-Bolla M, Rocca JP, Bolla M. Comparative study of microleakage of a pit and fissure sealant placed after preparation by Er:YAG laser in permanent molars. J Dent Child (Chic). 2003;70:134-8.
  • 33.Ahrari F, Fekrazad R, Kalhori KA, Ramtin M. Reconditioning of ceramic orthodontic brackets with an Er,Cr:YSGG laser. Lasers Med Sci 2013;28:223-8.
  • 34.Dehghani M, Ahrari F. The effect of surface treatment with Er: YAG laser on shear bond strength of orthodontic brackets to fiber-reinforced composite. J Clin Exp Dent 2014;6:e379-83.
  • 35.Xu YT, Wu Q, Chen YM, Smales RJ, Shi SY, Wang MT. Antimicrobial effects of a bioactive glass combined with fluoride or triclosan on Streptococcus mutans biofilm. Arch Oral Biol. 2015;60:1059-65.
  • 36.Geraldo-Martins VR, Lepri CP, Palma-Dibb RG. Influence of Er,Cr:YSGG laser irradiation on enamel caries prevention. Lasers Med Sci. 2013;28:33-9.
  • 37.Ali, S.; Farooq, I.; Iqbal, K. A review of the effect of various ions on the properties and the clinical applications of novel bioactive glasses in medicine and dentistry. Saudi Dent. J. 2014, 26, 1–5.
  • 38.Qi Y-p, Li N, Niu L-n, Primus CM, Ling J-Q, Pashley DH, et al. Remineralization of artificial dentinal caries lesions by biomimetically modified mineral trioxide aggregate. Acta Biomaterialia. 2012;8:836-42.
  • 39.Ebrahimi M, Mehrabkhani M, Ahrari F, Parisay I, Jahantigh M. The effects of three remineralizing agents on regression of white spot lesions in children: A two-week, single-blind, randomized clinical trial. J Clin Exp Dent 2017;9:e641-e48.
  • 40.Heravi F, Ahrari F, Tanbakuchi B. Effectiveness of MI Paste Plus and Remin Pro on remineralization and color improvement of postorthodontic white spot lesions. Dent Res J (Isfahan) 2018;15:95-103.
  • 41.Moghaddas MJ, Moosavi H, Yaghoubirad S, Chiniforush N. The Effect of the Bioactive Glass and the Er:YAG Laser on the Remineralization of the Affected Dentin: A Comparative In Vitro Study. J Lasers Med Sci. 2020;11(2):160-166.
  • 42.Kim HJ, Mo SY, Kim DS. Effect of bioactive glass-containing light-curing varnish on enamel remineralization. Materials. 2021;14(13):3745.
  • 43.Dai LL, Mei ML, Chu CH, Lo ECM. Remineralizing effect of a new strontium-doped bioactive glass and fluoride on demineralized enamel and dentine. J Dent. 2021;108:103633.
  • 44.Sharda S, Gupta A, Goyal A, Gauba K. Remineralization potential and caries preventive efficacy of CPP-ACP/Xylitol/Ozone/Bioactive glass and topical fluoride combined therapy versus fluoride mono-therapy - a systematic review and meta-analysis. Acta Odontol Scand. 2021;79:402-417.

Year 2022, Volume: 25 Issue: 4, 285 - 290, 30.12.2022

Horieh Moosavi Fatemeh Rezaee Safoora Afshari Salehe Sekandari Farzaneh Ahrari

https://doi.org/10.7126/cumudj.1106247

Abstract

Project Number

940325

References

  • 1.El Meligy OA, Alamoudi NM, Ibrahim ST, Felemban OM, Al-Tuwirqi AA. Effect of resin infiltration application on early proximal caries lesions in vitro. Journal of dental sciences. 2021 Jan 1;16(1):296-303.
  • 2.Braga MM, Mendes FM, Ekstrand KR. Detection activity assessment and diagnosis of dental caries lesions. Dental Clinics of North America. 2010;54:479-93.
  • 3.Splieth CH, Kanzow P, Wiegand A, Schmoeckel J, Jablonski-Momeni A. How to intervene in the caries process: proximal caries in adolescents and adults-a systematic review and meta-analysis. Clin Oral Investig. 2020;24:1623-1636.
  • 4.Ahrari F, Akbari M, Mohammadi M, Fallahrastegar A, Najafi MN. The validity of laser fluorescence (LF) and near-infrared reflection (NIRR) in detecting early proximal cavities. Clin Oral Investig 2021;25(8):4817-24.
  • 5.Dai LL, Mei ML, Chu CH, Lo ECM. Mechanisms of Bioactive Glass on Caries Management: A Review. Materials (Basel). 2019;12(24):4183.
  • 6. Manoharan V, Arun Kumar S, Arumugam SB, Anand V, Krishnamoorthy S, Methippara JJ. Is Resin Infiltration a Microinvasive Approach to White Lesions of Calcified Tooth Structures?: A Systemic Review. Int J Clin Pediatr Dent. 2019;12:53-58.
  • 7.Liang Y, Deng Z, Dai X, Tian J, Zhao W. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig. 2018;22:2675–84.
  • 8.Dorri M, Dunne SM, Walsh T, Schwendicke F. Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth. Cochrane Database Syst Rev. 2015;2015:CD010431.
  • 9.Krois J, Göstemeyer G, Reda S, Schwendicke F. Sealing or infiltrating proximal carious lesions [published correction appears in J Dent. 2018 Sep;76:137-138]. J Dent. 2018;74:15-22.
  • 10.Ammari MM, Soviero VM, da Silva Fidalgo TK, et al. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis. J Dent. 2014;42:1217-1227.
  • 11.Chatzimarkou S, Koletsi D, Kavvadia K. The effect of resin infiltration on proximal caries lesions in primary and permanent teeth. A systematic review and meta-analysis of clinical trials. J Dent. 2018;77:8–17.
  • 12. Moosavi H, Ahrari F, Zanjani M. Effect of Er:YAG laser radiation on pull-out fracture load of esthetic posts luted to root canal dentin with various resin cements. Dent Res J (Isfahan) 2021;18:17.
  • 13.Moosavi H, Ghorbanzadeh S, Ahrari F. Structural and Morphological Changes in Human Dentin after Ablative and Subablative Er:YAG Laser Irradiation. J Lasers Med Sci 2016;7:86-91.
  • 14.Heravi F, Ahrari F, Mahdavi M, Basafa S. Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries. J Clin Exp Dent 2014;6(2):e121-6.
  • 15.Ahrari F, Poosti M, Motahari P. Enamel resistance to demineralization following Er:YAG laser etching for bonding orthodontic brackets. Dent Res J (Isfahan) 2012;9(4):472-7.
  • 16.Dehghani M, Ahrari F. The effect of surface treatment with Er: YAG laser on shear bond strength of orthodontic brackets to fiber-reinforced composite. J Clin Exp Dent 2014;6(4):e379-83.
  • 17.Zhang Y, Wang Y, Chen Y, Chen Y, Zhang Q, Zou J. The clinical effects of laser preparation of tooth surfaces for fissure sealants placement: a systematic review and meta-analysis. BMC Oral Health. 2019;19(1):1-12.
  • 18.Jones JR. Review of bioactive glass: from Hench to hybrids. Acta biomaterialia. 2013;9:4457-86.
  • 19.DAI JM, LI FH, Qiu XL, DONG X. Effects of Rein Infiltration and Bioactive Glass on Early Caries. Journal of Oral Science Research. 2019 May 28;35(5):453-6.
  • 20.Torres CR, Rosa PC, Ferreira NS, Borges AB. Effect of caries infiltration technique and fluoride therapy on microhardness of enamel carious lesions. Oper Dent. 2012;37:363-369.
  • 21.Paris S, Meyer-Lueckel H, Cölfen H, Kielbassa AM. Resin infiltration of artificial enamel caries lesions with experimental light curing resins. Dent Mater J. 2007;26:582-8.
  • 22.Ahrari F, Jalaly T, Zebarjad M. Tensile properties of orthodontic elastomeric ligatures. Indian J Dent Res 2010;21(1):23-9.
  • 23.Ghanbarzadeh M, Ahrari F, Akbari M, Hamzei H. Microhardness of demineralized enamel following home bleaching and laser-assisted in office bleaching. J Clin Exp Dent 2015;7:e405-9.
  • 24.Ahrari F, Hasanzadeh N, Rajabi O, Forouzannejad Z. Effectiveness of sodium bicarbonate combined with hydrogen peroxide and CPP-ACPF in whitening and microhardness of enamel. J Clin Exp Dent 2017;9(3):e344-e50.
  • 25.Paris S, Schwendicke F, Seddig S, MüllerW-D, Dörfer C, Meyer-Lueckel H. Micro-hardness and mineral loss of enamel lesions after infiltration with various resins: Influence of infiltrant composition and application frequency in vitro. J Dent. 2013;41:543-8.
  • 26.OAESE M, Ibrahim ST, Alamoudi NM. Resin infiltration of non-cavitated proximal caries lesions: a literature review. J Oral Hyg Health. 2018;6(1):235-43.
  • 27.Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries research. 2010;44(1):47-54.
  • 28.Polat YK, Ilday NO. The effects of different anticavity agents and Er: YAG laser usage on enamel surface microhardness. Oral Health Prev Dent. 2020;18(1):601-6.
  • 29.Ahrari F, Basafa M, Fekrazad R, Mokarram M, Akbari M. The efficacy of Er,Cr:YSGG laser in reconditioning of metallic orthodontic brackets. Photomed Laser Surg 2012;30:41-6.
  • 30.Zarabian T, Azadi Mood S, Kiomarsi N, Noorollahian H, Hakimiha N. Microshear Bond Strength of a Self-adhesive Composite to Erbium Laser-Treated Primary Enamel. J Lasers Med Sci. 2020;11:181-186.
  • 31.Manhart J, Huth KC, Chen HY, Hickel R. Influence of the pretreatment of occlusal pits and fissures on the retention of a fissure sealant. Am J Dent. 2004;17:12-18.
  • 32.Lupi-Pegurier L, Bertrand MF, Muller-Bolla M, Rocca JP, Bolla M. Comparative study of microleakage of a pit and fissure sealant placed after preparation by Er:YAG laser in permanent molars. J Dent Child (Chic). 2003;70:134-8.
  • 33.Ahrari F, Fekrazad R, Kalhori KA, Ramtin M. Reconditioning of ceramic orthodontic brackets with an Er,Cr:YSGG laser. Lasers Med Sci 2013;28:223-8.
  • 34.Dehghani M, Ahrari F. The effect of surface treatment with Er: YAG laser on shear bond strength of orthodontic brackets to fiber-reinforced composite. J Clin Exp Dent 2014;6:e379-83.
  • 35.Xu YT, Wu Q, Chen YM, Smales RJ, Shi SY, Wang MT. Antimicrobial effects of a bioactive glass combined with fluoride or triclosan on Streptococcus mutans biofilm. Arch Oral Biol. 2015;60:1059-65.
  • 36.Geraldo-Martins VR, Lepri CP, Palma-Dibb RG. Influence of Er,Cr:YSGG laser irradiation on enamel caries prevention. Lasers Med Sci. 2013;28:33-9.
  • 37.Ali, S.; Farooq, I.; Iqbal, K. A review of the effect of various ions on the properties and the clinical applications of novel bioactive glasses in medicine and dentistry. Saudi Dent. J. 2014, 26, 1–5.
  • 38.Qi Y-p, Li N, Niu L-n, Primus CM, Ling J-Q, Pashley DH, et al. Remineralization of artificial dentinal caries lesions by biomimetically modified mineral trioxide aggregate. Acta Biomaterialia. 2012;8:836-42.
  • 39.Ebrahimi M, Mehrabkhani M, Ahrari F, Parisay I, Jahantigh M. The effects of three remineralizing agents on regression of white spot lesions in children: A two-week, single-blind, randomized clinical trial. J Clin Exp Dent 2017;9:e641-e48.
  • 40.Heravi F, Ahrari F, Tanbakuchi B. Effectiveness of MI Paste Plus and Remin Pro on remineralization and color improvement of postorthodontic white spot lesions. Dent Res J (Isfahan) 2018;15:95-103.
  • 41.Moghaddas MJ, Moosavi H, Yaghoubirad S, Chiniforush N. The Effect of the Bioactive Glass and the Er:YAG Laser on the Remineralization of the Affected Dentin: A Comparative In Vitro Study. J Lasers Med Sci. 2020;11(2):160-166.
  • 42.Kim HJ, Mo SY, Kim DS. Effect of bioactive glass-containing light-curing varnish on enamel remineralization. Materials. 2021;14(13):3745.
  • 43.Dai LL, Mei ML, Chu CH, Lo ECM. Remineralizing effect of a new strontium-doped bioactive glass and fluoride on demineralized enamel and dentine. J Dent. 2021;108:103633.
  • 44.Sharda S, Gupta A, Goyal A, Gauba K. Remineralization potential and caries preventive efficacy of CPP-ACP/Xylitol/Ozone/Bioactive glass and topical fluoride combined therapy versus fluoride mono-therapy - a systematic review and meta-analysis. Acta Odontol Scand. 2021;79:402-417.
There are 44 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Horieh Moosavi 0000-0001-7386-457X

Fatemeh Rezaee 0000-0003-1078-0576

Safoora Afshari 0000-0003-4540-9400

Salehe Sekandari 0000-0001-8190-915X

Farzaneh Ahrari 0000-0003-1257-8881

Project Number 940325
Publication Date December 30, 2022
Submission Date May 6, 2022
Published in Issue Year 2022Volume: 25 Issue: 4

Cite

EndNote Moosavi H, Rezaee F, Afshari S, Sekandari S, Ahrari F (December 1, 2022) The effect of minimally invasive treatments on enamel microhardness and resistance to further demineralization. Cumhuriyet Dental Journal 25 4 285–290.
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