Evaluating Surface Microhardness in Silver Diamine Fluoride-treated Primary Dentin Post-laser Irradiation: An In Vitro Study of Three Laser Modalities

激光照射后银二胺氟化物处理乳牙本质表面显微硬度的评价:三种激光模式的体外研究

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Abstract

AIM AND BACKGROUND: To compare surface microhardness of silver diamine fluoride (SDF)-treated dentin with CO(2) laser, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, and diode laser in extracted carious primary molars. The use of different lasers in combination with fluoride has been shown to have a synergistic effect on caries prevention by increasing fluoride uptake in the enamel. Following laser treatment, fluoride is not only deposited on the enamel and dentin but is also incorporated into the enamel and dentin crystalline structure. MATERIALS AND METHODS: A total of 48 extracted carious primary molars were randomly divided into four groups: group I: silver diamine fluoride (SDF) group (received only SDF application), group II: received SDF followed by CO(2) laser, group III: received SDF followed by Nd:YAG laser, group IV: received SDF followed by diode laser. Then the samples were tested for the Vickers microhardness test. The data so obtained were subjected to statistical analysis. RESULTS: The mean microhardness values for group I (baseline SDF), group II (CO(2) laser), group III (Nd:YAG laser), and group IV (diode laser) were 272.53 ± 13.18, 321.2 ± 3.46, 294.92 ± 25.32, and 293.64 ± 17.57, respectively. Group II exhibited the largest mean difference, with an increase of 48.67 microhardness. CONCLUSION: Combining silver diamine fluoride (SDF) with CO₂ laser treatment significantly increases dentin microhardness, enhancing remineralization and caries resistance. This minimally invasive approach supports CO₂ lasers as a safe, effective adjunct to SDF in pediatric dentistry. Its subablative energy preserves surrounding tissues, aligning with evidence-based, conservative treatment practices. CLINICAL SIGNIFICANCE: Combining SDF with lasers, especially CO(2) lasers, boosts remineralization and fluoride retention, effectively preventing caries progression.Laser treatments, such as CO(2), increase dentin microhardness, providing structural reinforcement that enhances the longevity and durability of dental tissues and restorations.Using subablative energy from CO(2) lasers minimizes the risk of thermal damage to surrounding tissues, offering a safer and more precise treatment option for sensitive areas. HOW TO CITE THIS ARTICLE: Mareddy AR, Reddy VN, Rehaman T, et al. Evaluating Surface Microhardness in Silver Diamine Fluoride-treated Primary Dentin Post-laser Irradiation: An In Vitro Study of Three Laser Modalities. Int J Clin Pediatr Dent 2025;18(9):1071-1076.

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