COMBINED EFFECTS OF LASER IRRADIATION AND CHEMICAL INHIBITORS ON THE DISSOLUTION OF DENTAL ENAMEL

It has previously been shown that the susceptibility of human teeth to acid dissolution can be reduced by the presence of various chemical agents in the dissolution medium or by pretreatment of the teeth with laser irradiation. Now synergism between these two approaches to improving acid resistance has been demonstrated. Extracted human teeth were irradiated with a continuous-wave carbon dioxide laser at a wavelength of 10.6 mum. Energy doses of either 65 or 130 J/cm2 given over periods of 2 or 4 s, respectively, were applied and the teeth subjected to a severe acid challenge (0.1 M acetate buffer, pH 4.5, no calcium or phosphate common ion present) for 24 h. Mineral loss was assessed by measurement of mineral density profiles with quantitative microradiography. Experiments were carried out in the presence or absence of three chemical inhibitors with distinctly different mechanisms of action: ethane-1-hydroxy-1,1-diphosphonic acid, fluoride, and dodecylamine HCI. Laser irradiation alone was found to lead to increased resistance of the teeth to acid challenge, with the higher energy dose being more effective than the lower dose. Each of the chemical inhibitors was effective on both lased and unlased teeth, with the percent reduction of dissolution greater when the inhibitors were applied to teeth lased with an energy dose of 130 J/cm2 which were already more resistant to acid challenge than were unlased teeth or teeth lased with a dose of 65 J/cm2 Thus, the inhibitors and the higher energy laser treatment were synergistic, with the combination of laser treatment and each of the inhibitors resulting in almost complete inhibition of dissolution for the entire 24 h of acid challenge as compared with a loss of about 140 mum of enamel from the surface of the control teeth.