Er∶YAG激光蚀刻牙釉质黏接效能的实验研究  

Effect of Er∶ YAG laser etching on enamel surface

作　　者：郑小婉 秦璐[1] 张冠民[1] 赵颖[1] 

机构地区：[1]首都医科大学宣武医院口腔科,北京100053

出　　处：《首都医科大学学报》2016年第3期286-293,共8页Journal of Capital Medical University

摘　　要：目的比较Er∶YAG激光蚀刻与传统磷酸酸蚀牙釉质表面后正畸托槽的黏接效果。方法选取因正畸需要而拔除4颗前磨牙的患者26例共104颗牙。每位患者的4颗离体前磨牙采用抽签法随机分入4组中,各组分别采用磷酸或不同工作参数的Er∶YAG激光处理牙釉质表面:A组35%(质量分数)磷酸酸蚀,B组Er∶YAG激光蚀刻(能量200 m J、频率30 Hz、水量6/8),C组Er∶YAG激光蚀刻(能量250 m J、频率30 Hz、水量6/8)和D组Er∶YAG激光蚀刻(能量300 m J、频率20 Hz、水量6/8)。应用扫描电镜下观察牙釉质表面微结构变化;应用原子力显微镜观测其表面粗糙度和表面峰峰值,然后黏接托槽并进行抗剪切强度和黏接剂残余指数的测定。结果扫描电镜下观察牙釉质表面,4组都表现为釉柱中心凹陷,呈Ⅰ型酸蚀模式。C组蜂窝状边界最清晰。4组间表面粗糙度差异有统计学意义(P<0.01),其中A组最低,B、C、D 3组随激光能量值提高而增加。牙釉质表面峰峰值D组最大,A组最小。抗剪切强度A组最高,C组与A组最接近,两组间差异无统计学意义(P>0.05)。4组间的黏接剂残余指数差异无统计学意义(P>0.05)。结论在合适工作参数下,Er∶YAG激光蚀刻后,牙釉质表面形貌和黏接效能与35%(质量分数)磷酸酸蚀后效果相近。Objective To compare the effect of Er∶ YAG laser etching on the surface of enamel with the phosphoric acid etching.Methods A total of 104 extracted premolars were collected from 26 orthodontic patients. The four premolars of each patient were randomly divided into 4 groups（ 26 teeth / group）,and the enamel etching were done respectively with different methods or at different parameters： group A 35% phosphoric acid etching and three Er∶ YAG laser groups（ group B 200 m J,30 Hz,6 /8 water; group C 250 m J,30 Hz,6 /8 water; group D 300 m J,20 Hz,6 /8 water）. Scanning electron microscope（ SEM） was used to observe the morphology of enamel surface,and atomic force microscope（ AFM） was used to measure the roughness of enamel. The shear bond strength（ SBS） and adhesive remnant index（ ARI） were surveyed after bracket bonding on the enamel surface. Results The enamel surface of four groups showed a pattern in which there was a distinct hollowing of prism centers,called typeⅠ etching pattern,with a generalized roughening enamel surface. The honeycomb border of group C was the clearest. The roughness value was raised with increasing laser parameters,and the significant statistical difference（ P 〈0. 01） existed among the four groups. The highest peak-peak values of enamel surface were in group D. Group A showed lowest peak-peak values. Group C has the most similar enamel-bonding interface morphology to that of group A. The highest SBS was measured in group A,group C has no statistically significant difference with group A（ P〈 0. 05）. No statistical difference of ARI scores were found in the four groups（ P 〉0. 05）. Conclusion YAG laser etching with appropriate parameter can achieve the similar enamel surface morphology and SBS to phosphoric acid etching.

关 键 词：Er∶YAG激光 蚀刻 抗剪切强度 扫描电镜 原子力显微镜 表面粗糙度 

分 类 号：R783.5[医药卫生—口腔医学]