Enamel resistance to demineralisation around orthodontic brackets after CO₂ laser irradiation: a randomised clinical trial

ABSTRACT

Objective: To evaluate the clinical effect of 10.6 µm CO₂ laser irradiation on the formation of demineralised lesions (DLs) around orthodontic brackets. Design: A two-arm, split-mouth, randomised clinical trial (RCT). Setting: The Orthodontic Department, Faculty of Dentistry, Damascus University, Syria. Participants: Twenty-six patients with a total of 520 teeth were recruited into the trial. Method: Two reversed quadrants of the dental arches in each patient were randomly allocated to CO₂ laser application around the orthodontic brackets. The other two quadrants received a control non-therapeutic light. There was blinding of both patients and assessors in the study. The primary outcome was the presence or absence of at least one new DL observed by clinical and photographic examinations. Secondary outcomes included the degree and area of DLs measured on digital images and DIAGNOdent assessment. Teeth were examined before bonding (T0), after bonding and laser irradiation (T1), after 1 month (T2), 2 months (T3) and 6 months (T4). Results: The presence of at least new DL was significantly lower in the laser group when observed at 2 and 6 months (P < .0001), the DLs degree and area were also significantly lower in the laser group at 2 and 6 months (P ≤ .005), and DIAGNOdent values were significantly lower in the laser group (P < .0001) at all observation times. Conclusions: Enamel irradiation with a CO₂ laser (at the wavelength of 10.6 µm) has an inhibitory effect on DL formation during orthodontic treatments. Registration: The trial was registered at ClinicalTrials.gov, number NCT03114475.

KEYWORDS:

• CO₂ laser
• demineralisation
• prevention
• demineralised lesions
• orthodontic brackets

Acknowledgements

The authors thank each of Dr KJ for her great efforts in proofreading the manuscript, Dr AMA for her assistance in the clinical and DIAGNOdent assessment (Assessor A), and Dr MA for accomplishing digital photograph evaluation and DL area calculation (Assessor B). TR, GM and OH designed the clinical trial. TR assessed the patients for inclusion criteria, obtained the informed consent, took digital photographs, and applied CO₂ laser beam. OH determined the appropriate laser parameters and set the CO₂ laser device. TR organised the results in tables. GM accomplished the statistical analysis. TR and GM performed the interpretation of the results. TR, GM and OH drafted the manuscript. KJ read and formatted the final manuscript, AA addressed the statistical analysis, TR, GM, OH, and AA read and accepted the revised manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This trial was funded by the Faculty of Dentistry of /Damascus University.