Microhardness, Structure, and Morphology of Primary Enamel after Phosphoric Acid, Self-Etching Adhesive, and Er:YAG Laser Etching

Abstract

Background. Phosphoric acid is the traditional etching agent; self-etching adhesives and Er:YAG laser are alternative methods. Knowledge of deciduous enamel etching is required. Aim. To evaluate primary enamel microhardness, structure, and morphology after phosphoric acid, self-etching, and Er:YAG laser etching. Design. Seventy primary incisors were assigned to five groups (n=14): I (control), II (35% phosphoric acid), III (self-etching adhesive), IV (Er:YAG laser at 15 J/cm2), and V (Er:YAG laser at 19.1 J/cm2). Microhardness was evaluated by Vickers indentation. Chemical composition was analyzed by energy dispersive X-ray spectroscopy and morphological changes by scanning electron microscopy. One-way ANOVA, Kruskal-Wallis, Mann-Whitney U, and Pearson bivariate correlation were employed (α=0.05). Results. Vickers microhardness showed differences and no correlation with Ca/P ratio. Group II showed differences in carbon, oxygen, and phosphorus atomic percent and group V in Ca/P ratio. Morphological changes included exposed prisms, fractures, craters, and fusion. Conclusions. Enamel treated with phosphoric acid showed different chemical characterization among groups. Self-etching and Er:YAG laser irradiation at 19.1 J/cm2 showed similar microhardness and chemical characterization. Er:YAG laser irradiation at 15 J/cm2 maintained microhardness as untreated enamel. Er:YAG laser irradiation at 19.1 J/cm2 enhanced mineral content. Morphological retentive changes were specific to each type of etching protocol.