Effect of Er:YAG and Fluoride Varnishes for Preventing Primary Enamel Demineralisation

Purpose: To measure the demineralisation changes on human deciduous enamel produced by pH cycling after preventive treatment with Er:YAG laser irradiation, fluoride varnish application and a combination of the two. Materials and Methods: Sixty extracted human anterior primary teeth were assigned to six groups (n = 10). Group C: untreated; group L: Er:YAG laser; group TCP-NaF: Clinpro White (5% sodium fluoride and modified tricalcium phosphate); group CPP-ACP-NaF: MI varnish (5% sodium fluoride with casein phosphopeptide-amorphous and calcium phosphate); group L+TCP-NaF: Er:YAG + 5% sodium fluoride + modified tricalcium phosphate; group L+ CPP-ACP-NaF: Er:YAG + 5% sodium fluoride with casein phosphopeptide-amorphous and calcium phosphate. The samples were subjected to a 10-day pH-cycling regimen to create caries-like lesions, with 8 h in demineralising solution and 16 h in remineralising solution at 37°C. Enamel demineralisation was evaluated by laser fluorescence (DIAGNOdent) before and after pH cycling. The Mann-Whitney U-test and Wilcoxon tests were performed with statistical significance set at p ≤ 0.05. Results: The Wilcoxon test revealed statistically significant differences at baseline and after pH cycling in groups C (p = 0.02), L (p = 0.034) and L+TCP-NaF (p = 0.025) and the lowest percentage of healthy tooth substance compared to the other groups. Conclusions: The results suggest that the treatment protocols employed in groups TCP-NaF, CPP-ACP-NaF, and L+ CPP-ACP-NaF had similar effects in terms of preventing demineralisation, as reflected in a higher percentage of healthy dental structure maintained. Hence, these treatments are recommended for clinical use as an effective preventive measure. Keywords: YAG, laser fluorescence, primary teeth, remineralisation