Effects of Lasers and Fluoride Varnish on Microhardness and Calcium and Phosphorus Content of Demineralized Enamel

Objectives: This study assessed the effects of blue and Er:YAG lasers, fluoride varnish, and their combination on microhardness, and calcium and phosphorus content of demineralized enamel. Materials and Methods: The primary Vickers microhardness of 28 third molars was measured and their enamel calcium and phosphorous content was quantified by energy-dispersive X-ray spectroscopy. They were then randomly assigned to five groups of 5% sodium fluoride (NaF) varnish, 445nm blue laser, Er:YAG laser, 5% NaF + 445nm blue laser, and 5% NaF + Er:YAG laser. The teeth then underwent pH-cycling to induce caries-like lesions. The surface microhardness of the teeth and the calcium and phosphorous content of demineralized enamel were measured again. Data were analyzed by one-way ANOVA and Tukey's test (alpha=0.05). Results: NaF, NaF-diode laser, and NaF-Er:YAG laser groups experienced a significant increase in microhardness of demineralized enamel close to the baseline value (P<0.05). The efficacy of NaF-blue laser and NaF-Er:YAG laser was higher than NaF . In blue and Er:YAG laser groups, the mean final microhardness was significantly lower than the baseline microhardness. The percentage of phosphorus in all groups was similar to that of sound enamel. The percentage of calcium in NaF group was significantly lower than that of sound enamel and all other groups. The calcium content in other groups was similar to that of sound enamel. Conclusion: Fluoride varnish had a synergistic effect with Er:YAG and blue lasers to increase the demineralized enamel microhardness; blue and Er:YAG lasers alone were less effective.