Effects of Nd:YAG laser on dental enamel

Caries prevention should be an important goal of the dentistry practitioner. In addition to traditional preventive techniques, laser beam has been a recent suggestion. This study aimed to evaluate Nd:YAG laser treatment effects on dental enamel surfaces, irradiated at different energy levels, by scanning electron microscopy (SEM) observations and surface micro-hardness tests to evaluate if caries prevention can be achieved by laser treatment. Forty human teeth were divided in four groups of 10 specimens each: in three groups the enamel surface was treated with three different laser beam energy levels, 60, 120 and 160 mJ, in one group the enamel was not lased. Five samples from each group were subjected to the Vickers microhardness test and five samples underwent SEM investigation. Results of the microhardness test demonstrated no significant differences between treated and non-treated dental enamel samples. SEM observation demonstrated a rougher enamel surface in all treated groups: the 60 mJ treated group showed tooth surfaces with vertical scratches, the 120 mJ treated group showed the enamel surface covered by craters and cracks, and the 160 mJ treated group showed a completely changed enamel structure with columns separated by voids and with a glass-like surface. These investigations demonstrated that dental enamel laser treatment at low energy levels (not >60 mJ) produces a protective glass-like surface, without the loss of its integrity and could be an advisable technique to prevent caries. Higher energy laser treatment leads to modifications of the enamel morphology such as craters and cracks, even if it does not cause any change in enamel hardness characteristics, which could be more useful in conservative dentistry.