Antibacterial and Odontogenesis Efficacy of Mineral Trioxide Aggregate Combined with CO2 Laser Treatment

Introduction: Mineral trioxide aggregate (MTA) has been successfully used in clinical applications in endodontics. Studies show that the antibacterial effects of CO2 laser irradiation are highly efficient when bacteria are embedded in biofilm because of a photothermal mechanism. The aim of this study was to confirm the effects of CO2 laser irradiation on MTA with regard to both material characterization and cell viability. Methods: MTA was irradiated with a dental CO2 laser using directly mounted fiber optics in the wound healing mode with a spot area of 0.25 cm(2) and then stored in an incubator at 100% relative humidity and 37 degrees C for 1 day to set. The human dental pulp cells cultured on MTA were analyzed along with their proliferation and odontogenic differentiation behaviors. Results: The results indicate that the setting time of MTA after irradiation by the CO2 laser was significantly reduced to 118 minutes rather than the usual 143 minutes. The maximum diametral tensile strength and x-ray diffraction patterns were similar to those obtained without CO2 laser irradiation. However, the CO2 laser irradiation increased the amount of Ca and Si ions released from the MTA and regulated cell behavior. CO2 laser irradiated MTA promoted odontogenic differentiation of hDPCs, with the increased formation of mineralized nodules on the substrate's surface. It also up-regulated the protein expression of multiple markers of odontogenic and the expression of dentin sialophosphoprotein protein. Conclusions: The current study provides new and important data about the effects of CO2 laser irradiation on MTA with regard to the decreased setting time and increased ion release. Taking cell functions into account, the Si concentration released from MTA with laser irradiation may be lower than a critical value, and this information could lead to the development of new regenerative therapies for dentin and periodontal tissue.