Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Farklı Remineralizasyon Ajanlarının Lazer ve Ozon Tedavisi ile Kombine Kullanımının Başlangıç Çürüklerine Etkisinin İn-Vitro Olarak İncelenmesi
An In-Vitro Investigation of the Effects of Different Remineralization Agents Combined with Laser and Ozone Therapy on the Initial Caries Lesions
Emine TAŞTANa, Eda GÜLERb, Fatma AYTAÇ BALc
aÖzel Denthol Diş Polikliniği, Tokat, TÜRKİYE
bOndokuz Mayıs Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi ABD, Samsun, TÜRKİYE
cBeykent Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2021;27(2):269-79
doi: 10.5336/dentalsci.2020-74741
Article Language: TR
Full Text
ÖZET
 Amaç: Bu in vitro çalışmanın amacı, başlangıç mine çürüğü olan dişler üzerinde florür, kazein fosfopeptid amorf kalsiyum fosfat (CPPACP), novamin ile lazer uygulaması ve ozon uygulamasının tek başına veya birlikte kullanımının, remineralizasyon etkinliğini değerlendirmektir. Gereç ve Yöntemler: Bu amaçla sığır dişleri toplanarak, başlangıç çürüğü elde edilmiştir. Her grupta 15 diş olacak şekilde 11 grup (florür, CPP-ACP, novamin, lazer, lazer+florür, lazer+CPP-ACP, lazer+novamin, ozon, ozon+florür, ozon+CPP-ACP, ozon+novamin) oluşturulmuştur. Tedavi etkinliği mikrosertlik ölçümü, taramalı elektron mikroskobu (SEM) görüntüleri ve enerji dağılımlı X-ışını spektroskopisi (EDX) mineral analizi yapılarak değerlendirilmiştir. Elde edilen verilerin istatistiksel analizi, tek yönlü ve 3 yönlü varyans analizi kullanılarak yapılmıştır (p<0,05). Bulgular: Mikrosertlik verileri karşılaştırıldığında en yüksek değer lazer+florür grubunda izlenirken, en düşük ozon grubunda gözlenmiştir. EDX analiziyle kalsiyum (Ca) ve fosfat (P) oranları değerlendirildiğinde en yüksek Ca değeri lazer+novamin grubunda izlenirken, en yüksek P değeri novamin, lazer+CPP-ACP, lazer+novamin ve ozon+novamin gruplarında bulunmuştur. SEM değerlendirmesi sonucunda, tüm grupların mine yüzeyleri sağlam ve demineralize örneğe göre morfolojik değişimler göstermiştir. Sonuç: Çalışmamızın sonuçlarına göre Er:YAG lazer ve kombine remineralize edici ajan uygulaması, başlangıç çürüğünün remineralizasyonunda etkili bir metot olarak bulunmuştur. Ozon uygulamasının başlangıç çürüğünün remineralizasyonundaki etkinliği ileri çalışmalarla araştırılmalıdır.

Anahtar Kelimeler: Demineralizasyon; mine, lazer; mine; ozon; remineralizasyon
ABSTRACT
 Objective: This in vitro study aimed to evaluate effectiveness of remineralization alone or combined use of fluoride, casein phosphopeptide amorphous calcium phosphate (CPP-ACP), novamin, laser and ozone application on enamel initial caries. Material and Methods: For this purpose, bovine teeth were collected and obtained initial caries lesions. 11 groups (fluoride, CPP-ACP, novamin, laser, laser+fluoride, laser+CPP-ACP, laser+novamin, ozone, ozone+fluoride, ozone+CPP-ACP, ozone+novamin) each group to be 15 teeth were established. Effectiveness of treatment was evaluated by micro-hardness measurement, scanning electron microscopy (SEM) images and energy dispersive X-ray spectroscopy (EDX). Statistical analysis of the resulting data was performed (p<0.05). Results: When compared microhardness data, the laser+fluoride group observed the highest value and the ozone group observed the lowest group. When compared the EDX analysis of calcium (Ca) and phosphate (P) ratio, the highest Ca value was observed in the laser+novamin group, the highest P value was observed in the novamin group, the laser+CPP-ACP group, the laser+novamin group and the ozone+novamin group. As a result of SEM evaluation, enamel surfaces of the entire groups showed morphological changes based on sound and demineralized sample. Conclusion: According to our results, combined Er:YAG laser and remineralizating agents application was found to be an effective method for the remineralization of initial caries. Remineralization effectiveness of the application of ozone in the initial caries should be investigated in the future studies.

Keywords: Demineralization; enamel; laser; ozone; remineralization
REFERENCES:
  1. Lenander-Lumikari M, Loimaranta V. Saliva and dental caries. Adv Dent Res. 2000;14:40-7. [Crossref]  [PubMed] 
  2. Gjorgievska ES, Nicholson JW, Slipper IJ, Stevanovic MM. Remineralization of demineralized enamel by toothpastes: a scanning electron microscopy, energy dispersive X-ray analysis, and three-dimensional stereo-micrographic study. Microsc Microanal. 2013;19(3):587-95. [Crossref]  [PubMed] 
  3. Roberson TM. Cariology: the lesion, etiology, prevention, and control. In: Roberson TM, Heymann H, Swift EJ, Sturdevant CM, eds. Sturdevant's Art and Science of Operative Dentistry. 5th ed. St.Louis, Missouri: Mosby Elsevier; 2006. p.65-135.
  4. Retief DH, Bradley EL, Holbrook M, Switzer P. Enamel fluoride uptake, distribution and retention from topical fluoride agents. Caries Res. 1983;17(1):44-51. [Crossref]  [PubMed] 
  5. Ambarkova V, Gorseta K, Jankolovska M, Glavina D, ?krinjarić I. [Effect of the fluoride gels and varnishes comparing to CPP-ACP complex on human enamel demineralization/remineralization]. Acta Stomatologica Croat. 2013;47(2):99-110. [Crossref] 
  6. Peric TO, Markovic DL, Radojevic VJ, Heinemann RM, Petrovic BB, Lamovec JS, et al. Influence of pastes containing casein phosphopeptide-amorphous calcium phosphate on surface of demineralized enamel. J Appl Biomater Funct Mater. 2014;30;12(3):234-9. [Crossref]  [PubMed] 
  7. Azarpazhooh A, Limeback H. Clinical efficacy of casein derivatives: a systematic review of the literature. J Am Dent Assoc. 2008;139(7):915-24; quiz 994-5. [Crossref]  [PubMed] 
  8. Mohanty P, Padmanabhan S, Chitharanjan AB. An in vitro evaluation of remineralization potential of Novamin(®) on artificial enamel sub-surface lesions around orthodontic brackets using Energy Dispersive X-Ray Analysis (EDX). J Clin Diagn Res. 2014;8(11):ZC88-91. [Crossref]  [PubMed]  [PMC] 
  9. Gutknecht N, Franzen R, Vanmeersch L, Lamperet F. Lasers in pediatric dentistry- a review. J Oral Laser Applications. 2005;5:207-18. [Link] 
  10. Ana PA, Tabchoury CP, Cury JA, Zezell DM. Effect of Er, Cr:YSGG laser and professional fluoride application on enamel demineralization and on fluoride retention. Caries Res. 2012;46(5):441-51. [Crossref]  [PubMed] 
  11. 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;1;6(2):e121-6. [Crossref]  [PubMed]  [PMC] 
  12. Holmes J. Clinical reversal of root caries using ozone, double-blind, randomised, controlled 18-month trial. Gerodontology. 2003;20(2):106-14. [Crossref]  [PubMed] 
  13. Baysan A, Lynch E. Effect of ozone on the oral microbiota and clinical severity of primary root caries. Am J Dent. 2004;17(1):56-60. [PubMed] 
  14. Knežević A, Tarle Z, Mandić VN, Prskalo K, Pandurić V, Janković B, et al. [Primary fissure carious lesion reversal using ozone]. Acta Stomatol Croat. 2007;41(1):31-8. [Link] 
  15. Duggal MS, Nikolopoulou A, Tahmassebi JF. The additional effect of ozone in combination with adjunct remineralisation products on inhibition of demineralisation of the dental hard tissues in situ. J Dent. 2012;40(11):934-40. [Crossref]  [PubMed] 
  16. Johansson E, van Dijken JW, Karlsson L, Andersson-Wenckert I. Treatment effect of ozone and fluoride varnish application on occlusal caries in primary molars: a 12-month study. Clin Oral Investig. 2014;18(7):1785-92. [Crossref]  [PubMed] 
  17. Avşar A, Tuloglu N. Effect of different topical fluoride applications on the surface roughness of a colored compomer. J Appl Oral Sci. 2010;18(2):171-7. [Crossref]  [PubMed]  [PMC] 
  18. Ittahagarun A, King N, Cheung YM. The effect of nano-hydroxyapatite containing toothpaste on artificial enamel carious lesion progression: an in vitro pH cycling study. Hong Kong Dental J. 2010;7(2):61-6. [Link] 
  19. Bayrak S, Yılmaz EI. Çürük direncinin arttırılmasında lazer ve kazein fosfopeptid amorf kalsiyum fosfatın birlikte kullanımın etkisinin değerlendirilmesi. J Dent Fac Atatürk Uni. 2018;28(1):23-32. [Crossref] 
  20. Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res. 1997;76(9):1587-95. [Crossref]  [PubMed] 
  21. Burwell AK, Litkowski LJ, Greenspan DC. Calcium sodium phosphosilicate (NovaMin): remineralization potential. Adv Dent Res. 2009;21(1):35-9. [Crossref]  [PubMed] 
  22. Faller RV, Eversole SL, Yan J. Anticaries potential of a stabilized stannous-containing sodium fluoride dentifrice. Am J Dent. 2010;23 Spec No B:32B-38B. [PubMed] 
  23. Karlinsey RL, Mackey AC, Walker TJ, Frederick KE, Blanken DD, Flaig SM, Walker ER. In vitro remineralization of human and bovine white-spot enamel lesions by NaF dentifrices: a pilot study. J Dent Oral Hyg. 2011;3(2):22-9. [PubMed]  [PMC] 
  24. Huang Y, Duan Y, Qian Y, Huang R, Yang Z, Li Y, et al. Remineralization efficacy of a toothpaste containing 8% arginine and calcium carbonate on enamel surface. Am J Dent. 2013;26(5):291-7. [PubMed] 
  25. Chen CC, Huang ST. The effects of lasers and fluoride on the acid resistance of decalcified human enamel. Photomed Laser Surg. 2009;27(3):447-52. [Crossref]  [PubMed] 
  26. Chin-Ying SH, Xiaoli G, Jisheng P, Wefel JS. Effects of CO2 laser on fluoride uptake in enamel. J Dent. 2004;32(2):161-7. [Crossref]  [PubMed] 
  27. Asl-Aminabadi N, Najafpour E, Samiei M, Erfanparast L, Anoush S, Jamali Z, et, al. Laser-casein phosphopeptide effect on remineralization of early enamel lesions in primary teeth. J Clin Exp Dent. 2015;1;7(2):e261-7. [Crossref]  [PubMed]  [PMC] 
  28. Nie L, Li X, Hu DY. [Effect of ozone on the remineralization of enamel in vitro]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2007;42(2):102-5. [PubMed] 
  29. Barbour ME, Rees JS. The laboratory assessment of enamel erosion: a review. J Dent. 2004;32(8):591-602. [Crossref]  [PubMed] 
  30. Hegde MN, Moany A. Remineralization of enamel subsurface lesions with casein phosphopeptide-amorphous calcium phosphate: a quantitative energy dispersive X-ray analysis using scanning electron microscopy: an in vitro study. J Conserv Dent. 2012;15(1):61-7. [Crossref]  [PubMed]  [PMC] 
  31. Lei J, Guo J, Fu D, Wang Y, Du X, Zhou L, et al. Influence of three remineralization materials on physicochemical structure of demineralized enamel. Journal of Wuhan University of Technology-Mater. Sci. Ed. 2014;29(2):410-16. [Crossref] 
  32. Gjorgievska ES, Nicholson JW. A preliminary study of enamel remineralization by dentifrices based on Recalden (CPP-ACP) and Novamin (calcium-sodium-phosphosilicate). Acta Odontol Latinoam. 2010;23(3):234-9. [PubMed] 
  33. Narayana SS, Deepa VK, Ahamed S, Sathish ES, Meyappan R, Satheesh Kumar KS, et al. Remineralization efficiency of bioactive glass on artificially induced carious lesion an in-vitro study. J Indian Soc Pedod Prev Dent. 2014;32(1):19-25. [Crossref]  [PubMed] 
  34. Rose RK. Effects of an anticariogenic casein phosphopeptide on calcium diffusion in streptococcal model dental plaques. Arch Oral Biol. 2000;45(7):569-75. [Crossref]  [PubMed] 
  35. Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC. Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2001;80(12):2066-70. [Crossref]  [PubMed] 
  36. Oshiro M, Yamaguchi K, Takamizawa T, Inage H, Watanabe T, Irokawa A, et al. Effect of CPP-ACP paste on tooth mineralization: an FE-SEM study. J Oral Sci. 2007;49(2):115-20. [Crossref]  [PubMed] 
  37. 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(2):95-103. [Crossref]  [PubMed]  [PMC] 
  38. Reynolds EC, Cain CJ, Webber FL, Black CL, Riley PF, Johnson IH, et al. Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res. 1995;74(6):1272-9. [Crossref]  [PubMed] 
  39. Reynolds EC, Cai F, Shen P, Walker GD. Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res. 2003;82(3):206-11. [Crossref]  [PubMed] 
  40. Reynolds EC. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist. 1998;18(1):8-16. [Crossref]  [PubMed] 
  41. Ying D, Chuah GK, Hsu CY. Effect of Er:YAG laser and organic matrix on porosity changes in human enamel. J Dent. 2004;32(1):41-6. [Crossref]  [PubMed] 
  42. Cecchini RC, Zezell DM, de Oliveira E, de Freitas PM, Eduardo C de P. Effect of Er:YAG laser on enamel acid resistance: morphological and atomic spectrometry analysis. Lasers Surg Med. 2005;37(5):366-72. [Crossref]  [PubMed] 
  43. Bevilácqua FM, Zezell DM, Magnani R, da Ana PA, Eduardo C de P. Fluoride uptake and acid resistance of enamel irradiated with Er:YAG laser. Lasers Med Sci. 2008;23(2):141-7. [Crossref]  [PubMed] 
  44. Chang NN, Jew JM, Simon JC, Chen KH, Lee RC, Fried WA, et al. Influence of multi-wavelength laser irradiation of enamel and dentin surfaces at 0.355, 2.94, and 9.4 μm on surface morphology, permeability, and acid resistance. Lasers Surg Med. 2017;49(10):913-27. [Crossref]  [PubMed]  [PMC] 
  45. Liu Y, Hsu CY, Teo CM, Teoh SH. Subablative Er:YAG laser effect on enamel demineralization. Caries Res. 2013;47(1):63-8. [Crossref]  [PubMed] 
  46. Zezell DM, Ana PA, Albero FG, Cury JA, Bachmann L. Effect of infrared lasers on chemical and crystalline properties of enamel. Caries Res. 2009;43:192. [Link] 
  47. Taube F, Ylmén R, Shchukarev A, Nietzsche S, Norén JG. Morphological and chemical characterization of tooth enamel exposed to alkaline agents. J Dent. 2010;38(1):72-81. [Crossref]  [PubMed] 
  48. Ana PA, Bachmann L, Zezell DM. Lasers effects on enamel for caries prevention. Laser Physics. 2006;16(5):865-75. [Crossref] 
  49. Stern RH, Vahl J, Sognnaes RF. Lased enamel: ultrastructural observations of pulsed carbon dioxide laser effects. J Dent Res. 1972;51(2):455-60. [Crossref]  [PubMed] 
  50. Tahmassebi JF, Chrysafi N, Duggal MS. The effect of ozone on progression or regression of artificial caries-like enamel lesions in vitro. J Dent. 2014;42(2):167-74. [Crossref]  [PubMed] 

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www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com