Pretreatment and posttreatment effect of LASER on the color and surface characteristics of silver diamine fluoride-treated carious primary molars: An in vitro study

Background: Silver diamine fluoride (SDF) has gained significant attention in the past decades owing to its proven efficacy in arresting active carious lesion. LASERs in combination with topical fluorides have been shown to have a synergistic effect. This study aims to evaluate and compare the pretreatment and posttreatment effect of LASER on the color stability and surface characteristics of SDF treated carious primary molars. Materials and Methods: Thirty extracted carious primary molars were allocated into three Groups: Group 1: SDF; Group 2: Pretreatment LASER followed by SDF; and Group 3: SDF followed by posttreatment LASER. Spectrophotometric analysis, Scanning Electron Microscope (SEM), and Energy Dispersive X-ray Spectrophotometer for elemental analysis were done . One-way ANOVA was used for intergroup comparisons, Paired t -test and repeated-measures ANOVA were used for intra-group comparisons. The level of significance was set at 5%. Results: On intergroup comparison, color change (∆E) was the highest in Group 3 (32.16 + 13.40) followed by Group 1 (29.19 + 13.42) and Group 2 (25.78 + 15.48) ( P value = 0.60). Color change was the highest during intra-group comparisons of baseline and posttreatment LASER in Group 3. SEM images of Group 2 revealed smooth regular compact globular structures, whereas Group 1 and 3 revealed irregular granular structures. Conclusion: Application of diode LASER following SDF treatment significantly improved the remineralization properties of carious primary molars, as evidenced by increased mineral uptake. In contrast, LASER pretreatment resulted in the lowest color change, indicating reduced discoloration risk. These findings highlight the importance of LASER timing to optimize both therapeutic efficacy and esthetic outcomes in pediatric dental care.