Effect of CO₂ Laser-Assisted Titanium Tetra-fluoride on Demineralization of Enamel Around Orthodontic Brackets

Introduction: One of the clinical problems following orthodontic treatment is white spot lesions around orthodontic brackets due to enamel demineralization. Confronting enamel demineralization during fixed treatments has long been a challenge for orthodontists. The aim of this in vitro study was to evaluate the effect of CO₂ laser and Titanium Tetra-fluoride (TiF4) application on the prevention of enamel demineralization around orthodontic brackets. Methods: Eighty permanent premolars were selected and bonded with brackets. They were randomly divided into four groups (n=20): topical titanium tetra-fluoride gel 4% (TiF4), CO₂ laser (10.6 μm wavelength for 10 seconds, peak power=291 W), fluoride+laser (F+L) and control (C). All specimens were demineralized for 10 days in a 0.2 M acetate buffer solution. The mean lesion depths were determined by using polarized light microscopy. Results: The mean depth of lesion was the highest in the C group and then decreased in the TiF4, CO₂ laser, and F+L groups, respectively. The difference between all groups was significant (P<0.05), except for the CO₂ laser and F+L groups. Conclusion: The lowest amount of demineralization around the orthodontic brackets was observed in the L+F group, followed by the CO₂ laser, TiF4, and control groups, respectively.