A clinical comparison of the caries inhibitory potential of aluminum gallium arsenide LASER in conjunction with a remineralization paste in non-cavitated carious lesions.

Background: Dental caries is a progressive disease with varying phases of demineralization and remineralization. If diagnosed before surface cavitation, the scope of reversing the carious lesion is increased.

Aim: To evaluate caries preventive and caries inhibitory potential of Aluminum Gallium Arsenide (Al Ga As ) Laser irradiation in incipient noncavitated pit and fissure caries.

Methodology: One hundred four patients between the age of 18-25 years exhibiting site 1 size 0, bilateral noncavitated carious lesions on mandibular molars were selected. The contralateral tooth type served as control. The quantitative baseline assessment of carious lesions of both the groups was by a Laser fluorescence method (DIAGNOdent). Group A (Test) cases were irradiated with Al Ga As laser of 3.5 W for 30 s followed by application of CPP-ACP F remineralizing paste. On the contralateral tooth type only remineralizing paste was applied and these cases were included In Group B (Control). The follow up was done by laser fluorescence (LF) and IOPA radiographs every 3 months for 12 months. Decrease or fall in laser fluorescence values from baseline values indicated remineralization.

Result: Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD. Normality of data was tested by Kolmogorov-Smirnov test. Qualitative variables were compared using Chi-Square test /Fisher's exact test. Student's unpaired "t" test was applied to test the difference between mean values of two groups. Student's paired "t" test was applied to test the relative change between different time points. One-way ANOVA was applied to compare mean values between more than two groups followed by post hoc test "Tukeys HSD" for multiple comparisons. As per Lussi criteria, it was observed in Control group : 53 patients scored 4 and required operative intervention, 38 patients scored 3 which would necessitate repeating the remineralizing protocol, whereas Test group: 3 patients scored 4 and 5 patients scoring 3. Comparing the LF values, it was observed progression of caries denoted by increase in LF values in control was statistically significant with p value < 0.001 and SD of 7.04. Test group exhibited a fall in LF denoting caries reversal which was statistically significant with p value < 0.001 and SD of 5.80. The failure rate of Control was 51.5% and Test was 3%.

Conclusion: Based on the clinical results it was concluded that Al Ga As lasers can clinically bring about caries inhibition and can be a valuable tool in caries prevention.