Investigation of the effects of fluoride-free remineralization agents on enamel initial caries by using "ER, CR; YSGG laser"

The prevalence of dental caries is high in our society, and it is extremely important to diagnose dental caries at the initial stage and to treat it with the most effective remineralization technique and to eliminate the need for invasive treatment. This thesis study was planned to evaluate the remineralization efficacy of alternative agents to fluoride on initial enamel caries. For this purpose this in vitro study is planned and the single or synergistic application of the fluoride-free alternative remineralization agents, theobromine-containing toothpaste (Theodent,USA), calcium-phosphate compounds (CPP-ACP, Japan), Ca,P,Mg compounds (Remineralization Gel, R.O.C.S.,Russia) and Er,Cr:YSGG laser(2780nm) were performed and compared with positive (fluoride toothpaste)(Colgate,USA) and negative (distilled water) control. In this study, 10 groups were determined (n=7) and demineralized samples were involved to an 8-day pH cycle. Enamel samples were examined by surface microhardness test (Vickers) and the results were supported by SEM images. The Kruskal Wallis test was used to compare the microhardness recovery percentage values according to the groups and multiple comparisons were made with the Dunn test. Er,Cr:YSGG laser(2780nm) (p=0.003) group, R.O.C.S. Remineralization Gel group (p=0.019), Er,Cr:YSGG laser+CPP-ACP (p<0.001) group, Er,Cr:YSGG laser+fluoride (p=0.001) group and Er,Cr:YSGG laser+R.O.C.S. Remineralization Gel (p=0.036) group exhibited significant increase in microhardness values. The tested remineralization agents did not exhibit any statistically significant difference in regard with single or synergistic applications. The following conclusions of the study were; Er,Cr:YSGG laser (2780nm, 0.25W, 4.48J/cm2 , 20 Hz, without air/water cooling) can be used in the treatment of initial caries, R.O.C.S. Remineralization Gel gives effective results, single use of CPP- ACP and fluoride toothpaste are not able to be sufficient during this experimental period and could be supported by laser to have significant efficacy, and theobromine-containing toothpaste doesn't have any success in remineralization. Though the number of studies examining the remineralization efficiency on demineralized enamel is limited, the results of this study should be supported by further studies.