Investigation of the effects of different remineralization agents and er:Yag laser use on enamel remineralization

Aim: The purpose of this study was to evaluate the remineralization effects of different remineralization agents containing fluorid, CPP-ACP, arginine, theobromine and combined use of Er:YAG laser irradiation on artificial enamel lesions. Materials and Methods: In this study, 130 enamel samples were obtained from 65 premolar teeth extracted for orthodontic reasons and the samples were randomly divided into 10 groups [Group F (1450 ppm NaF containing dentrifrice), Group CPP-ACP (%10 CPP-ACP), Group A (%8 arginine containing dentrifrice), Group T (theobromine containing dentrifrice), Group L (Er:YAG laser), Group LF (laser+fluorid), Group L-CPP-ACP (laser+CPP-ACP), Group LA (laser+arginine), Group LT (laser+theobromine), Group10 (control, no treatment)]. Samples were placed in demineralization solution to produce artificial caries lesions. After the Er:YAG laser was applied to the laser groups, toothpaste solutions were prepared and all samples were subjected to 10 days of pH-cycling. In order to determine the effectiveness of the groups, Surface hardness were measured by using the microhardness test at all levels: at the beginning, after demineralization and after pH cycling, and at the end of the experiment, surface morphology of one sample of each group was evaluated by SEM. The obtained data were analyzed using IBM SPSS Statistics Version 25 program. Results: The highest microhardness values were observed in groups which fluoride and arginine containing toothpastes were applied. When these groups were compared with the control group, the microhardness values were statistically significantly higher, but there was no statistically significant difference between the remaining groups and the control group. It was determined that microhardness values of the L-CPP-ACP group increased compared to the CPP-ACP group, but this increase was not statistically significant. As a result of SEM evaluation of enamel surfaces, all groups showed morphological changes compared to the control group. Conclusion: In the limitations of this study compared remineralization effect on artificial caries lesions, fluoride-containing agents showed the highest efficacy. Although there was an increase in microhardness values after remineralization in laser, theobromine, CPP-ACP and combination groups. This effect was not statistically different from the control group. The combined use of laser with the agents did not provide additional effect on remineralization. Fluorine-containing agents also showed high values when used with laser. Consequently, it can be said that fluorine maintains its feature as the most effective remineralization agent today. Keywords: Arginine, CPP-ACP, Er: YAG laser, Fluoride, Preventive dentistry, Remineralization, Theobromine.