الفهرس 
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Abstract
Erosion is a widespread phenomenon with higher predilection in primary dentition. The aim of the present study is to assess the remineralizing effect of Er,Cr:YSGG laser application combined with CPP-ACPF after erosive demineralization by Coca-Cola in primary teeth and to weigh against the most effective timing Er,Cr:YSGG laser application i.e. before or after CPP-ACFP application. Fifty sound primary teeth (exfoliated/extracted for orthodontic reasons) with initial DIANOdent (DD) reading ≤ 5 were divided into 5 groups (n=10); group I: Artificial saliva, (Saliva natura, Medac, UK), group II: CPP-ACPF (MI paste Plus, GC Corp, USA), group III: Er,Cr:YSGG (Waterlase iPlus, USA), group IV: CPP-ACPF + Er,Cr:YSGG, group V: Er,Cr:YSGG + CPP-ACPF. Teeth were immersed in 20 ml of Coca-Cola for 10 min, 5 times/day with 3 hours interval (9 am, 12 pm, 3 pm, 6 pm and 9 pm) for 5 days. CPP-ACPF paste was applied to teeth in groups II, IV and V. a sufficient amount of paste was smeared evenly on all tooth surfaces using a brush and left undisturbed for 5 minutes. As recommended, the paste was applied twice per day; before the first erosive challenge and after the last one. Teeth in groups III, IV and V were irradiated with Er,Cr:YSGG under the supervision of the faculty staff at Misr International University (MIU). The device was adjusted at the following parameters: 0.75 W, 8.5 J/cm2, 12.5 mJ, 140 μs, 20 Hz without air/water cooling, using MGG6 Sapphire tip (diameter of 600 μm - 9 mm long). Laser was applied twice a day, before the first erosive challenge and after the last one. Each tooth surface was radiated horizontally and vertically. The handpiece was moved slowly for 10 sec in each direction to promote homogenous radiation. DIAGNOdent (DD) measurements were taken before and after the experiment. Data collected was tabulated and statistically compared using the SPSS software (ver. 21). At baseline, there was no significant difference in DD readings between all test groups (p=1.00), as sample size compromised only of teeth with readings ≤ 5. There was a significant difference in DD readings between baseline and after erosive-treatment cycles in all groups (p=0.004 and p=0.005) and collectively (p=0.00). The highest reading was in samples immersed in artificial saliva and the lowest was in those subjected to combined CPP-ACPF and Er,Cr:YSGG laser application There was no significant difference between samples immersed in artificial saliva, and after CPP-ACPF application. Similarly, there was no significant difference between samples treated by combined treatment of CPP-ACPF and Er,Cr:YSGG application, regardless the sequence used. The effect of Er,Cr:YSGG laser applications showed no significant difference when compared to all other groups. However there was a significant difference between samples immersed in artificial saliva or treated with CPP-ACPF application and those subjected to combined treatment CPP-ACPF along with Er,Cr:YSGG. Hence, it can be concluded that combining Er,Cr:YSGG laser and CPP-ACPF paste significantly increased enamel remineralization in primary teeth - regardless the sequence of application used- when compared to either CPP-ACPF or artificial saliva used alone.