Radyoterapi Uygulanmış Diş Minesine Farklı Remineralizasyon Ajanlarının ve Lazerin Çürüğe Karşı Direnci Artırmadaki Etkilerinin İncelenmesi

Abstract

Jalilli S. The Effect of Different Remineralization Agents and Laser on Radiated-Enamel Caries Resistance, Hacettepe University, Institute of Health Sciences, Restorative Dentistry Program Specialization Thesis, Ankara 2022. The aim of this in vitro study was to evaluate the effectiveness of different remineralization agents and laser before radiotherapy on enamel caries resistance. Eighty-one extracted caries-free human molar teeth were used for the study. 15 teeth were selected for EDS analysis, while 6 for scanning electron microscopy (SEM). The rest of 60 teeth were sectioned mesiodistally and embedded in acrylic blocks with their buccal enamel surfaces exposed. The prepared enamel samples were then randomly assigned into six groups (n=20): Grup I(C): Non irradiated control group, Group II (F): Fluoride varnish applied before radiotherapy, Group III (CPP-ACP): CPP-ACP applied during radiotherpy, Group IV (L): Er,Cr:YSGG laser irradiated before radiotherapy, Group V (L+F): Er,Cr:YSGG laser irradiated with fluoride varnish before radiotherapy, Group VI (L+CPP-ACP): Er,Cr:YSGG laser irradiated CPP-ACP with before radiotherapy. All groups were submitted to radiotherapy protocol (2Gy for 5 days) for 7 weeks. Specimens were then subjected to pH cycling. Surface microhardness measurements and SEM/EDS analysis were performed at three stages: before radiotherapy (T0), after remineralization agents/laser application following radiotherapy (T1) and after pH cycling (T2). Microhardness was performed using Vickers hardness tester. Chemical components were analyzed with energy dispersive spectroscopy (EDS). Surface morphology was observed with a scanning electron microscopy (SEM). The microhardness and mineral composition data were analyzed using two-way mixed ANOVA. While the microhardness values at (T1) (after radiotherapy and after remineralization agent/laser application following radiotherapy) were found to be statistically higher than baseline measurements (T0) (p<0.05), microhardness values at (T2) were significanly lower than (T1) values(p<0.05).While no statistically significant difference was detected between (T2) and (T1) microhardness values for L+F and L+CPP-ACP groups (p>0,05), (T2) microhardness values of C, F and CPP-ACP and L groups were significantly lower than their baseline values(T0) (p<0.05). While no difference was detected among the groups at (T0), F, CPP-ACP ve L+F groups showed significantly higher values than other groups at (T2) measurements (p<0.05) and combined usage of remineralization agent with laser caused significantly higher than their single use. After pH-cycle (T2), all groups showed similar data (p>0.05) except L+F group which showed the highest value (p<0.05). Radiotherapy and laser/remineralization agents caused significant differences in mineral composition of all tested groups. It can be concluded that the combined use of remineralization agents with laser seems to be more effective among the tested preventive strategies on enamel caries resistance. Keywords: Enamel, radiotherapy, flouride varnish, CPP-ACP, laser, microhardness, SEM/EDS mineral analysis, remineralization agent.