Er:YAG激光对乳牙釉质蚀刻作用的研究  

The effects of Er: YAG laser on the etching of deciduous teeth enamel

作　　者：解萌[1] 石宏[1] 李廷 张晓晓 贾丽颖 XIE Meng;SHI Hong;LI Ting;ZHANG Xiao - xiao;JIA Li - ying(School of Stomatology, Hebei Medical University, Shijiazhuang 050017, China)

机构地区：[1]河北医科大学口腔医院,河北石家庄050017 [2]河北省儿童医院,河北石家庄050017

出　　处：《牙体牙髓牙周病学杂志》2018年第9期515-520,共6页Chinese Journal of Conservative Dentistry

摘　　要：目的:观察不同功率Er:YAG激光蚀刻乳磨牙窝沟釉质后的形态改变及其对乳牙窝沟封闭的临床效果。方法:将12个离体乳磨牙分为6组(n=2):空白对照组(未做任何处理)、磷酸酸蚀组(350 g/L磷酸酸蚀60 s)、激光Ⅰ组(100 mJ,10 Hz)、激光Ⅱ组(200 mJ,10 Hz)、激光Ⅲ组(300 mJ,10 Hz)、激光Ⅳ组(400 mJ,10 Hz);扫描电镜下观察釉质的表面形态特点,并选取适宜的激光参数用于乳牙窝沟封闭术中。另随机选择3~6岁的患儿37例共198牙,采用自身对照法,分别用350 g/L磷酸(n=101)和Er:YAG激光(n=97)(300 mJ,10 Hz,100%水量,20 s)蚀刻乳磨牙后行窝沟封闭术,术后3、6、12个月复查,比较两组窝沟封闭剂完全保留率。采用Wong-Baker面部表情疼痛量表评价患儿的满意度。结果:离体牙实验中,激光Ⅰ组釉质表面为不规则的凹坑状结构,大小不均;激光Ⅱ组釉质表面凹坑状结构较激光Ⅰ组明显,但大小仍不均;激光Ⅲ组的釉质表面为大小均匀的凹坑状结构,直径较激光Ⅱ组大,与釉质表面呈蜂窝状结构的磷酸酸蚀组相似;激光Ⅳ组出现釉质熔融现象。在乳牙窝沟封闭术中,激光蚀刻组患儿与酸蚀刻组3、6、12个月窝沟封闭剂的完全保留率比较均无统计学差异(P> 0. 05),激光蚀刻组患儿满意度高于磷酸酸蚀组(P <0. 05)。结论:Er:YAG激光蚀刻乳磨牙釉质表面形态改变与酸蚀刻最相似的参数是300 mJ,10 Hz,100%水量,20 s;采用此参数进行Er:YAG激光蚀刻并行窝沟封闭术后,窝沟封闭剂的完全保留率与磷酸酸蚀相似,患儿感受更为舒适。AIM： To observe the morphological characteristics in pit and fissure of deciduous molars enamel etched by Er：YAG laser with different parameters and the effects of the laser in clinical application. METHODS： 12 extracted deciduous teeth were randomly divied into 6 groups（ n =2） and prepared as follows： the blank control group （without any treatment）, phosphoric acid etching group （treated with 350 g/L phosphoric acid 60 s）, laser Ⅰ group （100 mJ/10 Hz）, laser Ⅱ group （200 mJ/10 Hz）, laser Ⅲ group （300 mJ/10 Hz）, laser Ⅳ group （ 400 mJ/10 Hz ）. After preparation, the samples were observed under SEM for the selection of appropriate laser parameter applied to clinical treatment. 198 deciduous teeth in 37 children of 3-6 years old were included in a self-control study in which one side deciduous molars were etched by Er：YAG laser with the power of 300 mJ/10 Hz/100%water/20 s and the other sides were prepared by 350 g/L phosphoric acid etching. The patients were followed up at 3,6 and 12 months after operation, the intact sealant retention rate was investigated. The patients’ satisfaction was evaluated by Wong-Baker facial pain scale. RESULTS： The non-uniform pits on the enamel surface were shown in laser Ⅰ group and the sizes were significantly different. Pits on the enamel surface of laser Ⅱ group were non-uniform and larger than that of laser Ⅰ group. Compared with laser Ⅱ group, pits on the enamel surface of laser Ⅲ group were larger uniform honeycomb structures with rough bottom which was the most similar to that of phosphoric acid group in wich the enamel surface was uniform honeycomb structure. The enamel melting occurred in laser Ⅳ group. There was no statistically significant difference of intact sealants retention rate at 3,6 and 12 months follow-up between the 2 groups （ P 〉0.05 ）. The satisfaction rate of laser etching group was higher than that of phosphoric acid etching group （ P 〈0.05 ）. CONCLUSION： Er：YAG laser etching with t

关 键 词：ER:YAG激光 蚀刻 乳磨牙 扫描电镜 窝沟封闭 满意度 

分 类 号：R781.05[医药卫生—口腔医学]