Effect of Er:YAG laser with or without fluoride on the prevention and progression of erosive tooth wear in primary enamel

Abstract

This study aimed to assess the effect of the Er:YAG laser, either alone or in combination with topical fluoride application, on the prevention and progression of erosive tooth wear in primary enamel. A total of 120 extracted human primary molars were flattened, polished, and divided based on substrate condition: sound or previously eroded with citric acid. The specimens were allocated into 12 experimental groups and received one of the following treatments: no treatment (control), topical application of acidulated phosphate fluoride (APF 1.23%), irradiation with Er: YAG laser using two different protocols (0.20 W and 0.40 W), or combinations of laser followed by fluoride application. All samples were then subjected to a five-day erosive remineralization cycling protocol, involving repeated acid exposure (pH 2.6) and immersion in artificial saliva. Enamel surface loss was assessed by optical profilometry, and morphological changes were evaluated by environmental scanning electron microscopy. The findings demonstrated that all interventions tested, including laser irradiation, fluoride application, and their combinations, were effective in reducing enamel loss when compared to untreated controls. However, no statistically significant differences were found between the various treatment protocols. The results suggest a promising protective effect of Er: YAG laser and fluoride treatments for preventing and controlling the progression of erosive tooth wear in primary enamel, highlighting the need for further research to confirm their efficacy.