Screening of CO(2) laser (10.6 μm) parameters for prevention of enamel erosion

The aim of this study was to screen CO(2) laser (10.6 μm) parameters to increase enamel resistance to a continuous-flow erosive challenge.

A new clinical CO(2) laser providing pulses of hundreds of microseconds, a range known to increase tooth acid-resistance, has been introduced in the market.

Different laser parameters were tested in 12 groups (n=20) with varying fluences from 0.1 to 0.9 J/cm(2), pulse durations from 80 to 400 μs and repetition rates from 180 to 700 Hz. Non-lased samples (n=30) served as controls. All samples were eroded by exposure to hydrochloric acid (pH 2.6) under continuous acid flow (60 μL/min). Calcium and phosphate release into acid was monitored colorimetrically at 30 sec intervals up to 5 min and at 1 min intervals up to a total erosion time of 15 min. Scanning electron microscopic (SEM) analysis was performed in lased samples (n=3). Data were statistically analysed by one-way ANOVA (p<0.05) and Dunnett's post-hoc tests.

Calcium and phosphate release were significantly reduced by a maximum of 20% over time in samples irradiated with 0.4 J/cm(2) (200μs) at 450 Hz. Short-time reduction of calcium loss (≤1.5 min) could be also achieved by irradiation with 0.7 J/cm(2) (300μs) at 200 and 300 Hz. Both parameters revealed surface modification.

A set of CO(2) laser parameters was found that could significantly reduce enamel mineral loss (20%) under in vitro erosive conditions. However, as all parameters also caused surface cracking, they are not recommended for clinical use.