Effect of Er: Cr: YSGG Laser on the Remineralizing Potential of Self- Assembly Peptides in Incipient Carious Lesions (In Vitro Study)

Background: Remineralization of incipient carious enamel lesions is an accepted biological model in restorative dentistry. Recently self-assembly peptides are gaining wide acceptance as being a biomimetic organic analogue simulating the natural amelogenesis procedure. In parallel, Er: Cr: YSGG lasers are thought to alter tooth substrate to be more recipient for subsequently applied remineralizing agent; however, a conjunction between lasers and self-assembly peptides was not tackled in literature. Aim: This study investigates the effect of Er:Cr:YSGG laser surface pre-treatment on the remineralizing potential of biomimetic self-assembling peptide (P11-4) on incipient carious lesion in terms of surface micro-hardness assessment. Methodology: Artificial enamel lesions were created on the buccal surface of 32 specimens, and were randomly allocated to four groups; G1: control- artificial saliva, G2: self-assembly peptide (Curodont Repair), G3: Er:Cr:YSGG laser surface treatment and G4: combination of Er:Cr:YSGG laser surface treatment followed by self-assembly peptide remineralizing agent application according to manufacturer’s instruction. Surface microhardness (SMH) test was assessed at baseline, after demineralization and after treatment followed with pH cycling. Values were analyzed using ANOVA and Bonferroni’s post-hoc test. Results: The highest statistically significant values of SMH were found in G4 followed by G2 and G3 while the lowest values were found in group G1 . Conclusion: A synergistic effect was observed between laser as a surface pre-treatment and self-assembling peptide, showing superior enamel remineralization results with the highest surface micro-hardness measurements compared to the use of laser and self-assembling peptide alone.