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21 February 2011Enhancing caries resistance in occlusal fissures with a short-pulsed CO2 9.6-μm laser: an in vitro pH-cycling study, preliminary results
Treatment of occlusal surfaces with a short-pulsed CO2 9.6 μm wavelength laser has previously been proposed as a
method for caries prevention. A sample of 20 extracted human molars were measured before and after demineralizationremineralization
pH-cycling with ICDAS II visual inspection, DIAGNOdent, quantitative light-induced fluorescence
(QLF), SoproLife in daylight and blue light-induced fluorescence mode, optical coherence tomography (OCT) and
polarized Raman spectroscopy (PRS). Per tooth, one fissure was subjected to laser treatment using a short-pulsed CO2
laser at 9.6 μm wavelength with a fluence of 3.5 J/cm2, 20 Hz pulse repetition rate, 20 μs pulse duration, angulated
handpiece, and focus diameter of 600 μm, while the other fissure was left untreated as control. The teeth were subjected
to a demineralization-remineralization pH-cycling for 9 days.
Cross-sectional micro-hardness testing was done as a gold standard to compare results with findings from the other
detection methods used. Due to the small sample size reported, the trend observed was that laser treated fissures
demonstrated a smaller relative mineral loss ▵Z than the controls. QLF findings followed a similar trend.
Using a rotary catheter probe, OCT measurements were acquired from the various fissures to generate circularly mapped
OCT depth images. PRS measurements of parallel- and cross-polarized spectra were acquired with a Raman microscope
system. Preliminary OCT images showed differences in the initial air-tooth interface, with PRS results indicating a
change in the surface property along with biochemical alterations after pH-cycling. Following pH-cycling, an increase in
the OCT subsurface light backscattering intensity in the control fissures was observed compared to the laser test fissures.
Porphyrin based fluorescence methods like DIAGNOdent and SoproLife, respectively demonstrated only additional light
scattering due to the demineralization process.
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Daniel Charland, Crystal Fulton, Beate Rechmann, Mark Hewko, John Featherstone, Lin-P'ing Choo-Smith, Peter Rechmann, "Enhancing caries resistance in occlusal fissures with a short-pulsed CO2 9.6 μm laser: an in vitro pH-cycling study, preliminary results," Proc. SPIE 7884, Lasers in Dentistry XVII, 78840G (21 February 2011); https://doi.org/10.1117/12.881705