Efficacy of different remineralizing agents on primary teeth exposed to therapeutic gamma radiation: An in vitro randomized control study

Therapeutic radiation-induced caries is a major side effect. Dental and oral heath are adversely affected by the direct effects of radiotherapy. Preventive procedures are preferred to reinforce dental tissue resistance against radiation damage. Research aim is to test the impact of different remineralizing protocols on the mineral content of deciduous enamel exposed to a therapeutic dose of gamma radiation. Thirty deciduous enamel specimens were divided randomly into three experimental categories based on the type of remineralizing agent used. Group I (gamma irradiated teeth, then painted with fluoride varnish), Group II (gamma irradiated teeth, then treated with bioactive glass) and Group III (gamma irradiated teeth, and then treated with a diode laser 980 nm). Prepared specimens were assessed for mineral content by environmental Energy Dispersive X-ray Analysis. SEM photomicrographs were performed simultaneously. Results were investigated concerning pre- and post-irradiation values difference. The paired-samples t-test was performed to compare the atomic and weight percentages of the selected elements obtained from the samples in the control groups before and after therapeutic radiation. One-way analysis of variance and post hoc Tukey tests were used to compare between the categories regarding weight and atomic percentages. Calcium/Phosphorus (Ca/P) ratio and Fluoride content decreased significantly after radiotherapy. Fluoride content significantly increased after remineralizing agents' application with the greatest increase in Bioactive glass group followed by fluoride varnish (F.varnish) group and the least increase was in diode laser group. Significant increase in Ca/P ratio in bioactive glass group followed by insignificant increase in F.varnish group (I) with the least increase noticed in the Diode laser group. Therapeutic radiation caused marked decrease in enamel mineral content. However, the reminralizing agents applied have an improving effect on the caused damage.