In vivo PIXE–PIGE study of enhanced retention of fluorine in tooth enamel after laser irradiation

The presence of fluoride in tooth enamel reduces the solubility of hydroxylapatite by acid attack. Fluoride presence (even at low concentration) in the oral cavity is efficient against caries process. We propose a new approach of the explanation of the increase of fluoride retention in the tooth enamel when low power laser irradiation is applied after the treatment with fluoride gel (fluoridation). External beam PIGE measurements of fluorine on extracted teeth have been made in order to determine the best sequence of the operations. The laser irradiation after fluoride application is more efficient than the reverse procedure. This observation is in agreement with previous observations that the fluorine penetration in the enamel takes place first in the soft organic material present between the polycrystalline (prismatic) structure before being integrated in the crystalline composition of hydroxylapatite in order to produce fluoro-apatite. As those in vitro measurements do not reflect the whole process in the saliva, in vivo PIGE measurements have been also performed. We have demonstrated, by repeating the PIGE measurements (at least five times at various time intervals) that a significant increase of the fluoride retention took place even 18 months after the unique laser treatment. The complete experimental procedure is described: fluoride application, laser irradiation, PIGE measurements with 2.7 MeV protons (repeated measurements at the same place on the same tooth in order to follow the evolution) and safety tests before in vivo analyses.