Changes of the tooth enamel following the application of a new prevention method in children suffering from cerebral palsy and gastro-esophageal reflux disease

Abstract

Abstract. Aim: The purpose of the paper consisted in studying the structural and chemical composition changes of the tooth enamel occurred after simultaneous application of laser therapy and deep fluoridation of enamel at children suffering from cerebral palsy (CP) associated with the gastro-esophageal reflux disease (GERD). Material and methods: 36 children suffering from CP associated with GERD were taken into the study, with ages between 13 and 15. Depending on the prevention measures applied, the children were divided in 3 groups: L1 included 12 children who benefitted from deep fluoridation of the tooth enamel; in L2 we applied the physical-chemical method of preventing the caries and dental erosions (laser therapy and deep fluoridation of the enamel), the control group (L0 ) included 12 children whose teeth were brushed using fluoride toothpastes. For research on the structure and chemical composition of the tooth enamel, 24 teeth extracted for orthodontic purpose have been studied using the scanning electron microscopy - SEM and radio spectral microanalysis (REM) was performed using the method of energy dispersive X-ray spectroscopy. Results: Following the application of the exogenous methods for the prevention of caries and dental erosions, in groups L1 and L2 on the surface and in the deep layers of the enamel, we found deposits of CaF2 , MgF2 and CuF2 micro-globules, considerable reduction of carbon concentration, normalization of the relation between Ca/P and significant increase of fluorine content. The physical-chemical method for the prevention has contributed to the increase of the F concentration 1.63 times in the superficial layers and 2.08 times in the deep layers of the enamel, as compared to the method of deep fluoridation of the enamel. Conclusion: simultaneous application of laser therapy with nanofluorides at children suffering from CP ensures an effect of maximum protection