Peter Rechmann, DDS, PhD, Daniel A. Charland, DDS,2 Beate M.T. Rechmann, Charles Q. Le, and John D.B. Featherstone, MSc, PhD
Lasers in Surgery and Medicine 45:302–310 (2013)
Background and Objectives: High caries prevalence in occlusal pits and fissures warrants novel prevention methods. An 86% reduction in dental enamel smooth surface demineralization in-vivo following short-pulsed 9.6 mm-CO2-laser irradiation was recently reported. The objective of this study was to conduct a blinded 12-monthpilot clinical trial of occlusal pit and fissure caries inhibition using the sameCO2-laser irradiation conditions.
Study Design/Materials and Methods: Twenty subjects, average age 14 years, were recruited. At baseline, second molars were randomized into test and control groups, assessed by International Caries Detection & Assessment System (ICDAS-II), SOPROLIFE lightinduced fluorescence evaluator in daylight and bluefluorescence mode and DIAGNOdent. An independent investigator irradiated test molars with a CO2-laser, wavelength 9.6 mm, pulse-duration 20 ms, pulserepetition-rate 20 Hz, beam diameter 800 mm, average fluence 4.5 0.5 J/cm2, 20 laser pulses per spot. At 3-, 6- and 12-month recall teeth were assessed by ICDAS, SOPROLIFE and DIAGNOdent. All subjects received fluoride varnish applications at baseline and 6-month recall.
Results: All subjects completed the 3-month, 19 the 6-month and 16 the 12-month recall. At all recalls average ICDAS scores had decreased for the test and increased for the control fissures (laser vs. control, 3-month: 0.10 0.14, 0.30 0.18, P > 0.05; 6-month:0.26 0.13, 0.47 0.16, P ¼ 0.001; 12-month: 0.31 0.15, 0.75 0.17, P < 0.0001; mean SE, unpaired t-test) being statistically significantly different at 6- and 12-month recalls. SOPROLIFE daylight evaluation revealed at 6- and 12-months statistically significant differences in changes between baseline and recall for test and control molars, respectively (laser vs. control, 6-month: 0.22 0.13, 0.17 0.09, P ¼ 0.02; 12-month: 0.28 0.19, 0.25
0.17, P ¼ 0.03). For SOPROLIFE blue-fluorescence evaluation mean changes in comparison to baseline for the control and the laser treated teeth were also statistically significant for the 6- and 12-month recall.
Conclusion: Specific microsecond short-pulsed 9.6 mm CO2-laser irradiation markedly inhibits caries progression in pits and fissures in comparison to fluoride varnish alone over 12 months.