Remineralization effect of diode laser, nanoseal®, and zamzam water on initial enamel carious lesions induced around orthodontic brackets

Abstract

Purpose: This in vitro study was conducted to evaluate the remineralization effect of laser, Nanoseal®, and Zamzam water on initial enamel carious lesions of premolar induced around orthodontic brackets. Materials and Methods: A total of 40 premolars divided randomly into four groups were submitted to three phases: (1) placement of orthodontic brackets; (2) demineralizing solution; and (3) remineralization (Group L; teeth were irradiated with 980 nm diode laser for 30 s, Group N; Nanoseal® was applied to teeth according to manufacturer’s instructions, Group Z; teeth were immersed in Zamzam water for 3 days then rinsed with deionized water, and Group C; control with no treatment). In each phase, elemental analysis (calcium and phosphorus) was measured using a scanning electron microscope/energy dispersive X-ray analysis. The data were tested using the Bonferroni test and Tukey’s test. Results: There was a decrease in calcium ion content in Groups C and L in the third phase (−1.62% and − 0.1%, respectively) than the first one. On the other hand, an increase in calcium ion was shown in Groups Z and N (1.1 and 1.6%, respectively). An increase in phosphorus ion was obvious in all experimental groups ranging from 0.6% to 3.7%, with Group N having the highest increase of phosphorus ion from the first to the third phase. Conclusions: Using Nanoseal® and Zamzam water proved to be better than a diode laser for the treatment of initial carious lesions. The use of diode laser helps to remineralize enamel but in a lower percentage than other tested agents.