ÇÜRÜK DİRENCİNİN ARTTIRILMASINDA LAZER VE KAZEİN FOSFOPEPTİD AMORF KALSİYUM FOSFAT’IN BİRLİKTE KULLANIMIN ETKİSİNİN DEĞERLENDİRİLMESİ

Year 2018, Volume: 28 Issue: 1, 23 - 32, 28.03.2018

Şule Bayrak Elif İpek Yılmaz

https://doi.org/10.17567/ataunidfd.410361

Abstract

Amaç: Bu
çalışmanın amacı, erbiyumla takviyelenmiş yitriyum alüminyum garnet lazerin
kazein fosfopeptid amorf kalsiyum fosfat ile birlikte kullanımının daimi
dişlerin çürük oluşumuna karşı direncinin arttırılmasındaki etkilerinin
değerlendirilmesidir.

Gereç ve Yöntem: 30 adet daimi diş
kullanılarak elde edilen mine örnekleri rastgele 5 gruba ayrıldı; negatif
kontrol, asitlenmiş fosfat florit (pozitif kontrol), kazein fosfopeptid amorf kalsiyum fosfat, lazer, lazer+kazein fosfopeptid phosphopeptide amorf kalsiyum fosfat.
Gruplara göre yüzey tedavileri uygulandıktan sonra örnekler pH siklusuna tabi
tutuldu. Polarize ışık mikroskopisi ile çürük lezyon derinliği, tarayıcı
elektron mikroskopisi ile yüzeyde oluşan yapısal değişiklikler değerlendirildi.
Elde edilen verilerin istatistiksel
değerlendirilmesinde tek yönlü varyans analizi ve Tukey Çoklu Karşılaştırma testi kullanıldı.

Bulgular: Tüm
gruplar arasında en yüksek ortalama çürük lezyon derinliği negatif kontrol grubunda
(51,12±10,79), en düşük ortalama çürük lezyon derinliği ise asitlenmiş fosfat
florit (pozitif kontrol) grubunda (24,12±11,73) gözlendi. Lazerin tek başına ve
CPP-ACP ile birlikte uygulanması karşılaştırıldığında, gruplar arasında
istatistiksel olarak anlamlı bir farklılık saptanmadı
(p>0,05). Taramalı elektron mikroskobu incelemesinde ise tüm
gruplarda uygulanan yüzey hazırlama işlemlerine göre morfolojik değişimlerin
olduğu gözlendi.

Sonuç: İn vitro
olarak yapılan bu çalışma sonucunda, daimi dişlerin çürük direncinde erbiyumla
takviyelenmiş yitriyum alüminyum garnet lazerin, kazein fosfopeptid amorf kalsiyum fosfat ile birlikte kullanımın
tek başına kullanıma göre ilave bir katkı sağlamadığı belirlendi.

Anahtar
Kelimeler: Diş çürüğüne direnç, diş minesi, kazein fosfopeptid amorf kalsiyum
fosfat, lazer

EVALUATION OF COMBINED EFFECT OF LASER AND CASEIN
PHOSPHOPEPTIDE-AMORPHOUS CALCIUM PHOSPHATE APPLICATION ON INCREASING OF CARIES
RESISTANCE

Aim: The aim of this study was to
evaluate the effects of erbium-doped yttrium aluminum garnet laser combined
with casein
phosphopeptide-amorphous calcium phosphate treatments
on caries resistance of permanent teeth

Material and Methods: The enamel samples were obtained from 30 permanent teeth and randomly
divided into five groups; negative control, acidulated phosphate fluoride
(positive control), casein phosphorpeptide-amorphous calcium phosphate, laser,
laser+ casein phosphopeptide-amorphous calcium phosphate. The surface
treatments were applied; the samples were then submitted to pH cycle. Lesion
depth was measured by polarized light microscopy, and the morphological changes
on the sample surfaces were analyzed by scanning electron microscopy. The statistical analyses of obtained data were performed
using one-way analysis of variance and Tukey Multiple Comparison test.

Results: Mean lesion depth was
greatest in the nega- tive control group
(51.12±10.79), and lowest in the acidulated phosphate fluoride group fluoride (positive control)
(24.12±11.73). When compared the laser group and laser combined with casein phosphopeptide-amorphous calcium phosphate, no
statistically sig- nificant differences in mean lesion depth values were found
between groups (p>0.05). Scanning electron microscopy examination also
revealed obvious morphological changes in all groups.

Conclusion: As a result of this in-vitro study determined that
the combined application of aluminum erbium- doped yttrium garnet laser with
casein phosphorpeptide-amorphous calcium phosphate no showed an added
beneficial effect compared with erbium-doped yttrium aluminum garnet laser
alone on caries resistance of permanent teeth.

Keywords: Dental caries resistance,
dental enamel, casein
phosphopeptide-amorphous calcium phosphate, laser.

Keywords

Diş çürüğüne direnç, diş minesi, kazein fosfopeptid amorf kalsiyum fosfat

References

• 1. Zero DT. Dental Caries Process. Dent Clin North Am 1999;43:635-64.
• 2. Petersen PE. The World Oral Health Report 2003: Continuous Improvement of Oral Health in the 21st Century--the Approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31:3-23.
• 3. Selwitz RH, Ismail AI, Pitts NB. Dental Caries. Lancet 2007;369:51-9.
• 4. Uluçam S, Akal N, Fidan I, Cula S. Daimi Molar Dişlere Uygulanan Paslanmaz Çelik Kronların Dişeti Sağlığı Üzerine Etkisi. Gazi Üniv Diş Hek Fak Derg 2005;22:97-103.
• 5. Featherstone JD. Dental Caries: a Dynamic Disease Process. Aust Dent J 2008;53:286-91.
• 6. Featherstone JD. The Science and Practice of Caries Prevention. J Am Dent Assoc 2000;131:887-9.
• 7. Featherstone JD, Glena R, Shariati M, Shields CP. Dependence of In Vitro Demineralization of Apatite and Remineralization of Dental Enamel on Fluoride Concentration. J Dent Res 1990;69:620-5.
• 8. ten Cate JM. In Vitro Studies on the Effects of Fluoride on De- and Remineralization. J Dent Res 1990;69:614-9.
• 9. Featherstone JD. Prevention and Reversal of Dental Caries: Role of Low Level Fluoride. Community Dent Oral Epidemiol 1999;27:31-40.
• 10. Featherstone JD. Remineralization, the Natural Caries Repair Process: The Need for New Approaches. Adv Dent Res 2009;21:4-7.
• 11. Mascarenhas AK. Risk Factors for Dental Fluorosis: a Review of the Recent Literature. Pediatr Dent 2000;22:269-77.
• 12. Poggio C, Lombardini M, Dagna A, Chiesa M, Bianchi S. Protective Effect on Enamel Demineralization of a CPP-ACP Paste: an AFM In Vitro Study. J Dent 2009;37:949-54.
• 13. Yengopal V, Mickenautsch S. Caries Preventive Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP): A Meta-analysis. Acta Odontol Scand 2009;67:321-32.
• 14. Featherstone JD. Caries Detection and Prevention with Laser Energy. Dent Clin North Am 2000;44:955-69 . 15. Odabaş ME, Bodur H, Bariş E, Demir C. Clinical, Radiographic, and Histopathologic Evaluation of Nd: YAG Laser Pulpotomy on Human Primary Teeth. J Endod 2007;33:415-21.
• 16. Chimello DT, Serra MC, Rodrigues AL Jr, Pécora JD, Corona SA. Influence of Cavity Preparation with Er:YAG Laser on Enamel Adjacent to Restorations Submitted to Cariogenic Challenge In Situ: A Polarized Light Microscopic Analysis. Lasers Surg Med 2008;40:634-43.
• 17. Hossain M, Yamada Y, Masuda-Murakami Y, Nakamura Y. Removal of Organic Debris with Er:YAG Laser Irradiation and Microleakage of Fissure Sealants In Vitro. Lasers Med Sci 2012;27:895-902.
• 18. Tanboğa İ, Eren F, Altınok B, Peker S, Garip Berker Y, Özyöney G. Kök Kanal Tedavisinde ER:YAG Lazerin Smear Tabakası Üzerine Etkisi: SEM Çalışması. Atatürk Üniv Diş Hek Fak Derg 2011;21:74-81.
• 19. Liu JF, Liu Y, Stephen HC. Optimal Er:YAG Laser Energy for Preventing Enamel Demineralization. J Dent 2006;34:62-6.
• 20. Yamamoto H, Sato K. Prevention of Dental Caries by Acousto-optically Q-switched Nd:YAG Laser Irradiation. J Dent Res 1980;59:137.
• 21. Fowler BO, Kuroda S. Changes in Heated and in Laser-Irradiated Human Tooth Enamel and Their Probable Effects on Solubility. Calcif Tissue Int 1986;38:197-208.
• 22. Anderson JR, Ellis RW, Blankenau RJ, Beiraghi SM, Westerman GH. Caries Resistance in Enamel by Laser Irradiation and Topical Fluoride Treatment. J Clin Laser Med Surg 2000;18:33-6.
• 23. Hsu C, Jordan T, Dederich D, Wefel J. Effects of Low-energy CO2 Laser Irradiation and the Organic Matrix on Inhibition of Enamel Demineralization. J Dent Res 2000;79:1725-30.
• 24. Apel C, Meister J, Schmitt N, Gräber HG, Gutknecht N. Calcium Solubility of Dental Enamel Following Sub-ablative Er:YAG and Er:YSGG Laser Irradiation In Vitro. Lasers Surg Med 2002;30:337-41.
• 25. Apel C, Birker L, Meister J, Weiss C, Gutknecht N. The Caries-Preventive Potential of Subablative Er:YAG and Er:YSGG Laser Radiation in an Intraoral Model: A Pilot Study. Photomed Laser Surg 2004;22:312-7.
• 26. Cecchini RC, Zezell DM, de Oliveira E, de Freitas PM, Eduardo Cde P. Effect of Er:YAG Laser on Enamel Acid Resistance: Morphological and Atomic Spectrometry Analysis. Lasers Surg Med 2005;37:366-72.
• 27. Zezell DM, Boari HG, Ana PA, Eduardo Cde P, Powell GL. Nd:YAG Laser in Caries Prevention: A Clinical Trial. Lasers Surg Med 2009;41:31-5.
• 28. Hossain M, Nakamura Y, Kimura Y, Yamada Y, Ito M, Matsumoto K. Caries-preventive Effect of Er:YAG Laser Irradiation with or without Water Mist. J Clin Laser Med Surg 2000;18:61-5. 29. Apel C, Meister J, Götz H, Duschner H, Gutknecht N. Structural Changes in Human Dental Enamel After Subablative Erbium Laser Irradiation and Its Potential Use for Caries Prevention. Caries Res 2005;39:65-70. 30. Rodrigues LK, Nobre Dos Santos M, Featherstone JD. In Situ Mineral Loss Inhibition by CO2 Laser and Fluoride. J Dent Res 2006;85:617-21.
• 31. Tepper SA, Zehnder M, Pajarola GF, Schmidlin PR. Increased Fluoride Uptake and Acid Resistance by CO2 Laser Irradiation Through Topically Applied Fluoride on Human Enamel In Vitro. J Dent 2004;32:635-41.
• 32. Sobral MA, Lachowski KM, de Rossi W, Braga SR, Ramalho KM. Effect of Nd:YAG Laser and Acidulated Phosphate Fluoride on Bovine and Human Enamel Submitted to Erosion/Abrasion or Erosion Only: An In Vitro Preliminary Study. Photomed Laser Surg 2009;27:709-13.
• 33. Moslemi M, Fekrazad R, Tadayon N, Ghorbani M, Torabzadeh H, Shadkar MM. Effects of ER,Cr:YSGG Laser Irradiation and Fluoride Treatment on Acid Resistance of the Enamel. Pediatr Dent 2009;31:409-13.
• 34. ten Cate JM, Duijsters PP. Alternating Demineralization and Remineralization of Artificial Enamel Lesions. Caries Res 1982;16:201-10.
• 35. Longbottom C, Ekstrand K, Zero D. Traditional Preventive Treatment Options. Monogr Oral Sci 2009;21:149-55.
• 36. Reynolds EC, Cai F, Shen P, Walker GD. Retention in Plaque and Remineralization of Enamel Lesions by Various Forms of Calcium in a Mouthrinse or Sugar-Free Chewing Gum. J Dent Res 2003;82:206-11.
• 37. Karaman S, Durucan G. Pedodontide Koruyucu Tedaviler. Selçuk Üniv Diş Hek Fak Derg 1996;6:84-91.
• 38. Pai N, McIntyre J, Tadic N, Laparidis C. Comparative Uptake of Fluoride Ion into Enamel from Various Topical Fluorides In Vitro. Aust Dent J 2007;52:41-6.
• 39. Saxegaard E, Rölla G. Fluoride Acquisition on and in Human Enamel During Topical Application In Vitro. Scand J Dent Res 1988;96:523-35.
• 40. American Dental Association Council on Scientific Affairs. Professionally Applied Topical Fluoride: Evidence-Based Clinical Recommendations. J Am Dent Assoc 2006;137:1151-9.
• 41. Lennon AM, Pfeffer M, Buchalla W, Becker K, Lennon S, Attin T. Effect of a Casein/calcium Phosphate-containing Tooth Cream and Fluoride on Enamel Erosion In Vitro. Caries Res 2006;40:154-7.
• 42. Keçik D, Cehreli SB, Sar C, Unver B. Effect of Acidulated Phosphate Fluoride and Casein phosphopeptide-amorphous Calcium Phosphate Application on Shear Bond Strength of Orthodontic Brackets. Angle Orthod 2008;78:129-33.
• 43. Pai D, Bhat SS, Taranath A, Sargod S, Pai VM. Use of Laser Fluorescence and Scanning Electron Microscope to Evaluate Remineralization of Incipient Enamel Lesions Remineralized by Topical Application of Casein Phosphopeptide Amorphous Calcium Phosphate (CPP-ACP) Containing Cream. J Clin Pediatr Dent 2008;32:201-6. 44. Bayrak S, Tunc ES, Sonmez IS, Egilmez T, Ozmen B. Effects of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) Application on Enamel Microhardness After Bleaching. Am J Dent 2009;22:393-6.
• 45. Elsayad I, Sakr A, Badr Y. Combining Casein Phosphopeptide-Amorphous Calcium Phosphate with Fluoride: Synergistic Remineralization Potential of Artificially Demineralized Enamel or Not? J Biomed Opt 2009;14:044039.
• 46. Rehder Neto FC, Maeda FA, Turssi CP, Serra MC. Potential Agents to Control Enamel Caries-like Lesions. J Dent 2009;37:786-90.
• 47. Bevilácqua FM, Zezell DM, Magnani R, da Ana PA, Eduardo Cde P. Fluoride Uptake and Acid Resistance of Enamel Irradiated with Er:YAG Laser. Lasers Med Sci 2008;23:141-7.
• 48. Santaella MR, Braun A, Matson E, Frentzen M. Effect of Diode Laser and Fluoride Varnish on Initial Surface Demineralization of Primary Dentition Enamel: An In Vitro Study. Int J Paediatr Dent 2004;14:199-203.
• 49. Nelson DG, Jongebloed WL, Featherstone JD. Laser Irradiation of Human Dental Enamel and Dentine. N Z Dent J 1986;82:74-7.
• 50. Chiang YC, Lee BS, Wang YL, Cheng YA, Chen YL, Shiau JS, Wang DM, Lin CP. Microstructural Changes of Enamel, Dentin-enamel Junction, and Dentin Induced by Irradiating Outer Enamel Surfaces with CO2 Laser. Lasers Med Sci 2008;23:41-8.
• 51. Coluzzi DJ. Fundamentals of Dental Lasers: Science and Instruments. Dent Clin North Am 2004;48:751-70.
• 52. Van As G. Erbium Lasers in Dentistry. Dent Clin North Am 2004;48:1017-159.
• 53. Apel C, Meister J, Ioana RS, Franzen R, Hering P, Gutkanecht N. The Ablation Threshold of Er:YAG and Er:YSGG Laser Radiation in Dental Enamel. Lasers Med Sci 2002;17:246-52.
• 54. Zach L, Cohen G. Pulp Response to Externally Applied Heat. Oral Surg Oral Med Oral Pathol 1965;19:515-30.
• 55. Featherstone JD, Barrett-Vespone NA, Fried D, Kantorowitz Z, Seka W. CO2 Laser Inhibitor of Artificial Caries-like Lesion Progression in Dental Enamel. J Dent Res 1998;77:1397-403.
• 56. Ogaard B, Arends J, Schuthof J, Rølla G, Ekstrand J, Oliveby A. Action of Fluoride on Initiation of Early Enamel Caries In Vivo. A Microradiographical Investigation. Caries Res 1986;20:270-7.
• 57. Delbem AC, Cury JA. Effect of Application Time of APF and NaF Gels on Microhardness and Fluoride Uptake of In Vitro Enamel Caries. Am J Dent 2002;15:169-72.
• 58. Garcia-Godoy F, Hicks MJ, Flaitz CM, Berg JH. Acidulated Phosphate Fluoride Treatment and Formation of Caries-like Lesions in Enamel: Effect of Application Time. J Clin Pediatr Dent 1995;19:105-10.
• 59. Sudjalim TR, Woods MG, Manton DJ, Reynolds EC. Prevention of Demineralization Around Orthodontic Brackets In Vitro. Am J Orthod Dentofacial Orthop 2007;131:705.e1-9.
• 60. Sudjalim TR, Woods MG, Manton DJ. Prevention of White Spot Lesions in Orthodontic Practice: a Contemporary Review. Aust Dent J 2006;51:284-9.
• 61. Uysal T, Amasyali M, Koyuturk AE, Ozcan S. Effects of Different Topical Agents on Enamel Demineralization Around Orthodontic Brackets: an In Vivo and In Vitro Study. Aust Dent J 2010;55:268-74.
• 62. Oshiro M, Yamaguchi K, Takamiza T, Inage H, Watanable T, Irokawa A, Ando S, Miyazakg M. Effect of CPP-ACP Paste on Tooth Mineralization: an FE-SEM Study. J Oral Sci 2007;49:115-20.
• 63. Ying D, Chuah G, Hsu C. Effect of Er:YAG Laser and Organic Matrix on Porosity Changes in Human Enamel. J Dent 2004;32:41-6.
• 64. Bachmann L, Craievich AF, Zezell DM. Crystalline Structure of Dental Enamel After Ho:YLF Laser Irradiation. Arch Oral Biol 2004;49:923-9.
• 65. Meurman JH, Hemmerlé J, Voegel JC, Rauhamaa-Mäkinen R, Luomanen M. Transformation of Hydroxyapatite to Fluorapatite by Irradiation with High-energy CO2 Laser. Caries Res 1997;31:397-400.
• 66. Delbem AC, Curry JA, Nakassima CK, Gouveia VG, Theodora LH. Effect of Er:YAG Laser on CaF2 formation and Its Anti-Cariogenic Action on Human Enamel: An In Vitro Study. J Clin Laser Med Surg 2003;21:197-201.
• 67. 67.Rodríguez-Vilchis LE, Contreras-Bulnes R, Sánchez-Flores I, Samano EC. Acid Resistance and Structural Changes of Human Dental Enamel Treated with Er:YAG Laser. Photomed Laser Surg 2010;28:207-11.