Combined effect of Er,Cr:YSGG laser and casein phosphopeptide amorphous calcium phosphate on the prevention of enamel demineralization: An in-vitro study

Abstract

Objectives: To compare the effect of use of laser, casein phosphopeptide–amorphous calcium phosphate (CPP–ACP), and their combination on prevention of enamel demineralization using polarized light microscopy to assess lesion depth. Materials and Methods: Eighty premolars were randomly allocated to four equal groups (n ¼ 20): Group I: Control group, no preventive measures. Group II: CPP–ACP. Group III: Er,Cr:YSGG laser. Group IV: Er,Cr:YSGG laser followed by CPP–ACP. Specimens were subjected to thermocycling and brushing protocols equivalent to 1 year intraorally. Then, all teeth were subjected to acid challenge. Teeth were then sectioned longitudinally and examined under a polarized light microscope and lesion depth was measured. Results: Group IV resulted in the least lesion depth with a significant difference between it and all other groups. CPP–ACP alone and laser alone also showed a significant difference in white spot lesion (WSL) depth compared to the control group; however, no significant difference was found between them. Conclusions: The combined use of laser and CPP–ACP showed the best prevention against WSL development. The use of CPP–ACP or laser alone also resulted in a significant reduction in lesion depth but was significantly less than their combined use, with no significant difference between them.