Effect of CO2 Laser on Enamel White Spot Lesion Formation Around Orthodontic Brackets

NCT ID: NCT03114475

Last Updated: 2017-10-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-15

Study Completion Date

2017-09-30

Brief Summary

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This study aims to evaluate the clinical effect of CO2 laser on enamel resistance to white spot lesions formation around orthodontic brackets.

25 patients needing fixed orthodontic treatment will participate in the study, the CO2 laser will be applied in a split mouth design around orthodontic brackets in two contrast quarters of mouth in every patient and the other quarters will serve as a control. The white spot lesion formation will be monitored around the brackets during the orthodontic treatment after four and twelve weeks of irradiation with laser.

Detailed Description

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Prior to enrollment of each subject into the study, they will be examined completely to determine the orthodontic treatment plan. The operator will inform them about the aim of the study and ask them to provide a written informed consent.

Before brackets' bonding (T0) the operator will evaluate with intraoral clinical examination and take intraoral photographs and evaluate with DIAGNOdent. Then after brackets' placement on teeth, the CO2 laser will be applied to the area of enamel about 2 mm of width around orthodontic brackets in a split mouth design. To blind the intervention sides on patients the control sides will receive nontherapeutic light.

Then intraoral photographs will be taken and the teeth will be assessed with DIAGNOdent (T1).

All patients will be trained to brush their teeth with a tooth paste containing 1100 ppm of fluoride twice a day. After 4 weeks of irradiation (T2) the patients will be examined for white spot lesions formation by clinical examination using Geiger index, photographic examination using AutoCAD 2009 evaluating formation and area percentage of white spot lesions, and the degree of demineralization will be assessed with DIAGNOdent. The all exams will also be done after 12 weeks of irradiation (T3).

Conditions

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White Spot Lesion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Split mouth design, the mouth will be split into four quadrants. Two quadrants will receive the active treatment, whereas the opposing two quadrants will receive the placebo.
Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
The non-irradiated side of the mouth will receive a placebo light (i.e. not the laser beam).

Study Groups

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CO2 Laser Irradiation

This group of patients will be treated by splitting the dental arches into four quadrants: upper right, upper left, lower right and lower left. Two quadrants will receive the CO2 laser irradiation whereas the remaining two quadrants will receive no treatment (i.e. the placebo light).

Group Type EXPERIMENTAL

CO2 laser irradiation

Intervention Type RADIATION

CO2 laser irradiation will be applied onto the enamel surrounding the orthodontic bracket

Placebo

A placebo light will be used as if the patient is irradiated with the laser beam.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

No irradiation is going to be applied in the intervention. Just a red light will be used as placebo.

Interventions

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CO2 laser irradiation

CO2 laser irradiation will be applied onto the enamel surrounding the orthodontic bracket

Intervention Type RADIATION

Placebo

No irradiation is going to be applied in the intervention. Just a red light will be used as placebo.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult patients with permanent occlusion at age 15-25 years.
* No previous orthodontic treatment
* Good oral hygiene
* Need to orthodontic treatment with fixed appliances

Exclusion Criteria

* Patients with systemic diseases or syndromes
* Patients with existence of enamel fluorosis
* Patients with existence of amelogenesis imperfecta or hypocalcified enamel
* Patients with existence of restorations or crowns or carious lesions on the labial surfaces of teeth.
* Patients who received fluoride treatment within the last three months prior to being enrolled in the study.
Minimum Eligible Age

15 Years

Maximum Eligible Age

25 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Damascus University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tuqa Raghis, DDS

Role: PRINCIPAL_INVESTIGATOR

MSc student, Department of Orthodontics, University of Damascus Dental School

Ghiath Mahmoud, DDS MSc PhD

Role: STUDY_DIRECTOR

Senior Lecturer in Orthodontics, Department of Orthodontics, University of Damascus Dental School, Damascus, Syria

Locations

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Department of Orthodontics, University of Damascus Dental School

Damascus, , Syria

Site Status

Higher Institution for Laser Research and Applications

Damascus, , Syria

Site Status

Countries

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Syria

References

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Esteves-Oliveira M, Zezell DM, Meister J, Franzen R, Stanzel S, Lampert F, Eduardo CP, Apel C. CO2 Laser (10.6 microm) parameters for caries prevention in dental enamel. Caries Res. 2009;43(4):261-8. doi: 10.1159/000217858. Epub 2009 May 8.

Reference Type BACKGROUND
PMID: 19439947 (View on PubMed)

Esteves-Oliveira M, Pasaporti C, Heussen N, Eduardo CP, Lampert F, Apel C. Prevention of toothbrushing abrasion of acid-softened enamel by CO(2) laser irradiation. J Dent. 2011 Sep;39(9):604-11. doi: 10.1016/j.jdent.2011.06.007. Epub 2011 Jun 30.

Reference Type BACKGROUND
PMID: 21741428 (View on PubMed)

Gomez J. Detection and diagnosis of the early caries lesion. BMC Oral Health. 2015;15 Suppl 1(Suppl 1):S3. doi: 10.1186/1472-6831-15-S1-S3. Epub 2015 Sep 15.

Reference Type BACKGROUND
PMID: 26392124 (View on PubMed)

Miresmaeili A, Farhadian N, Rezaei-soufi L, Saharkhizan M, Veisi M. Effect of carbon dioxide laser irradiation on enamel surface microhardness around orthodontic brackets. Am J Orthod Dentofacial Orthop. 2014 Aug;146(2):161-5. doi: 10.1016/j.ajodo.2014.04.023.

Reference Type BACKGROUND
PMID: 25085298 (View on PubMed)

Rechmann P, Fried D, Le CQ, Nelson G, Rapozo-Hilo M, Rechmann BM, Featherstone JD. Caries inhibition in vital teeth using 9.6-mum CO2-laser irradiation. J Biomed Opt. 2011 Jul;16(7):071405. doi: 10.1117/1.3564908.

Reference Type BACKGROUND
PMID: 21806251 (View on PubMed)

Rechmann P, Charland DA, Rechmann BM, Le CQ, Featherstone JD. In-vivo occlusal caries prevention by pulsed CO2 -laser and fluoride varnish treatment--a clinical pilot study. Lasers Surg Med. 2013 Jul;45(5):302-10. doi: 10.1002/lsm.22141. Epub 2013 Jun 4.

Reference Type BACKGROUND
PMID: 23737079 (View on PubMed)

Seino PY, Freitas PM, Marques MM, de Souza Almeida FC, Botta SB, Moreira MS. Influence of CO2 (10.6 mum) and Nd:YAG laser irradiation on the prevention of enamel caries around orthodontic brackets. Lasers Med Sci. 2015 Feb;30(2):611-6. doi: 10.1007/s10103-013-1380-8. Epub 2013 Jun 30.

Reference Type BACKGROUND
PMID: 23812850 (View on PubMed)

Souza-Gabriel AE, Colucci V, Turssi CP, Serra MC, Corona SA. Microhardness and SEM after CO(2) laser irradiation or fluoride treatment in human and bovine enamel. Microsc Res Tech. 2010 Oct;73(11):1030-5. doi: 10.1002/jemt.20827.

Reference Type BACKGROUND
PMID: 20146349 (View on PubMed)

Stangler LP, Romano FL, Shirozaki MU, Galo R, Afonso AM, Borsatto MC, Matsumoto MA. Microhardness of enamel adjacent to orthodontic brackets after CO2 laser irradiation and fluoride application. Braz Dent J. 2013 Sep-Oct;24(5):508-12. doi: 10.1590/0103-6440201302292.

Reference Type BACKGROUND
PMID: 24474294 (View on PubMed)

Steiner-Oliveira C, Rodrigues LK, Soares LE, Martin AA, Zezell DM, Nobre-dos-Santos M. Chemical, morphological and thermal effects of 10.6-microm CO2 laser on the inhibition of enamel demineralization. Dent Mater J. 2006 Sep;25(3):455-62. doi: 10.4012/dmj.25.455.

Reference Type BACKGROUND
PMID: 17076314 (View on PubMed)

Raghis T, Mahmoud G, Abdullah A, Hamadah O. Enamel resistance to demineralisation around orthodontic brackets after CO2 laser irradiation: a randomised clinical trial. J Orthod. 2018 Dec;45(4):234-242. doi: 10.1080/14653125.2018.1504410. Epub 2018 Aug 2.

Reference Type DERIVED
PMID: 30071781 (View on PubMed)

Other Identifiers

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UDDS-Ortho-01-2017

Identifier Type: -

Identifier Source: org_study_id