Laser Used in the Treatment of Hypomineralized Occlusal Lesions in Teeth Enamel Affected by MIH
Condition: Dental Enamel Hypoplasia
MeSH terms: Dental Enamel Hypoplasia
Study type: Interventional

Summary: 
      Background: Nowadays an increase in the incidence of teeth affected by molar incisor
      hypomineralisation (MIH) has been observed. There are several treatment modalities that
      depend on the degree of severity of the defect, such as preventive procedures, restorative
      and even dental extractions. However, these changes may affect the retention and longevity of
      restorative materials. Therefore, the aim of this study is to evaluate the use of diode laser
      irradiation for the treatment of occlusal surfaces of moderate lesions in permanent first
      molars affected with MIH as a preventive method for dental caries and occlusal wear, besides
      verifying the discomfort of the treatment by patients. Methods: For this, a controlled and
      randomized study, with parallel groups, will be conducted comparing the treatment with diode
      laser and sealing with high viscosity glass ionomer cement in the teeth affected by the MIH.
      Participants will be assessed at baseline and after 1 week, 1, 6, 12, 18 and 24 months. As
      the main outcome, the presence of dentin caries lesion and /or occlusal surface wear included
      in the study with dentin involvement will be evaluated. A visual examination for caries
      detection will be done using the ICDAS, using the index based on classification in the United
      States Public Health Service - Modified (USPH) for evaluation of sealed teeth and impression
      of impacted teeth for quantitative analysis of the lesions. Other outcomes such as patient
      satisfaction with treatment, patient discomfort, impact on quality of life and participant
      perception, as well as the duration and cost of treatment, as well as their cost-efficacy,
      will also be evaluated. Multilevel statistical analyzes will be performed to verify the
      efficacy of Diode laser treatment compared to sealing, in addition to possible factors
      associated with this efficacy.
    


Intervention name(s): Diode laser group; Glass Ionomer Sealing Group
Intervention type(s): Procedure; Procedure
Intervention description(s): Prophylaxis of the selected region for the study with Robson brush and prophylactic paste, washing and drying, followed by application of diode laser (Sirolaser, Sirona Dental Systems GmbH, Bensheim, Germany) with wavelength of 970 nm +/- 10 nm, maximum power of 7 W CW, 1mW guide beam and 320μm optical fiber. Irradiation will be performed on the entire occlusal surface in contact mode, with power of 0.7 W (energy of 70 mJ) and frequency of 10 Hz for 30 seconds, having an energy density of 222.82 J / cm2. The FieldMaxII-TOP power meter (Coherent, Inc, USA) will be used prior to and after the applications. The laser will be applied in a sweeping motion throughout the affected surface, the fiber being maintained positioned perpendicular to the occlusal surface throughout the movement. The irradiation time will be standardized in 30 seconds.; Prophylaxis of the selected region for the study with Robson brush and prophylactic paste, washing and drying with cotton balls, followed by relative insulation with cotton rollers of the tooth in question, application of acid polyacrylic for 15 seconds throughout the surface, light drying with cotton ball, insertion of the high viscosity glass ionomer (Equia Forte in capsule - GC) through a specific applicator, after loss of the gloss of the digital pressure material with Vaseline for due drainage and surface protection of the material, removal of the excess, checking the occlusion with carbon paper, occlusal adjustments if necessary, superficial protection with petroleum jelly.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Diode laser group Prophylaxis of the selected region for the study and application of diode laser (Sirolaser, Sirona Dental Systems GmbH, Bensheim, Germany) with wavelength of 970 nm +/- 10 nm, maximum power of 7 W CW, 1mW guide beam and 320μm optical fiber. Irradiation will be performed on the entire occlusal surface in contact mode, with power of 0.7 W and frequency of 10 Hz for 30 seconds, having an energy density of 222.82 J / cm2.
Glass Ionomer Sealing Group Prophylaxis of the selected region for the study, followed by relative insulation with cotton rollers of the tooth in question, application of acid polyacrylic for 15 seconds throughout the surface, light drying with cotton ball, insertion of the high viscosity glass ionomer (Equia Forte in capsule - GC) through a specific applicator, after loss of the gloss of the digital pressure material with Vaseline for due drainage and surface protection of the material.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Lasers; Dental enamel hypoplasia; Preventive dentistry; Dental caries