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Selective removal of carious lesion with Er:YAG laser followed by dentin biomodification with chitosan

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Abstract

The aim of this study was to evaluate the effect of Er:YAG laser for selective removal of carious lesion, followed by biomodification with chitosan gel where the subsurface microhardness, chemical composition, and morphological changes of the residual caries-affected dentin were examined. Artificial dentinal lesions were created by pH-cycling method (14 days) in 104 bovine specimens (5 × 5 mm). Specimens were randomly divided according to the carious removal method: bur (low-speed handpiece) or Er:YAG laser (250 mJ/4 Hz). Specimens were treated with 35% phosphoric acid and were subdivided into two groups according to dentin biomodification: without chitosan (control) and 2.5% chitosan. Forty specimens were restored with an adhesive system and composite resin. Subsurface microhardness tests were performed in sound dentin, caries-affected dentin, residual caries-affected dentin, and after the restoration. The other 64 specimens were subjected to SEM-EDS atomic analysis. Data were statistically analyzed (p < 0.05). After the Er:YAG laser excavation, the microhardness value of residual caries-affected dentin was higher (p < 0.05) than bur-treated dentin. A significant decrease in the amount of Ca, P, and Ca/P ratio was found after the removal of carious lesions with Er:YAG laser (p < 0.05). The biomodification with chitosan did not influence the microhardness and atomic percentage of Ca, P, and Ca/P ratio of residual caries-affected dentin (p > 0.05). SEM analysis showed morphological changes on residual caries-affected dentin (p > 0.05). The selective removal of carious dentin with Er:YAG laser increased microhardness of residual caries-affected dentin, changing its surface morphology and chemical composition. The biomodification with chitosan did not influence the structural and chemical composition of residual caries-affected dentin.

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Acknowledgements

The first author would like to thank the São Paulo Research Foundation (FAPESP) for the scholarship awarded (grant no. 2014/23654-9).

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Authors and Affiliations

  1. Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-904, Brazil

    Fabiana A. Curylofo-Zotti, Gabriela Solano Tanta, Aline E. Souza-Gabriel & Silmara A.M. Corona

  2. Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14049-900, Brazil

    Miriane Lucindo Zucoloto

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  1. Fabiana A. Curylofo-Zotti
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  2. Gabriela Solano Tanta
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  3. Miriane Lucindo Zucoloto
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  4. Aline E. Souza-Gabriel
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  5. Silmara A.M. Corona
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Correspondence to Fabiana A. Curylofo-Zotti.

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This study was funded by São Paulo Research Foundation (FAPESP—grant no. 2014/23654-9).

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Curylofo-Zotti, F.A., Tanta, G.S., Zucoloto, M.L. et al. Selective removal of carious lesion with Er:YAG laser followed by dentin biomodification with chitosan. Lasers Med Sci 32, 1595–1603 (2017). https://doi.org/10.1007/s10103-017-2287-6

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  • DOI: https://doi.org/10.1007/s10103-017-2287-6

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