Er: YAG激光与传统机械去龋效果的体外可行性比较  

An in vitro feasibility study comparing Er:YAG laser and conventional mechanical devices for cavity preparation

作　　者：邵钰 尚琼 郭蓉 葛米雪 周红艳[1] 杨颜菁[1,3] SHAO Yu;SHANG Qiong;GUO Rong;GE Mixue;ZHOU Hongyan;YANG Yanjing(Department of Pediatric and Preventive Dentistry,Affliated Stomatology Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院儿童口腔科,江苏南京210029 [2]常州市口腔医院儿童口腔科,江苏常州213000 [3]上海市口腔病防治院儿童口腔科,上海200000

出　　处：《口腔医学》2021年第6期493-498,共6页Stomatology

基　　金：江苏省自然科学基金(BK20181363);上海市市立医院新兴与前沿技术项目(SHDC12019126)。

摘　　要：目的为Er:YAG激光去除龋损和粘接修复的可行性提供更多的证据。方法选取南京医科大学附属口腔医院口腔颌面外科门诊拔除的36颗龋坏深及牙本质的磨牙。每个离体牙的龋损都被切成大小相等的两份,分别纳入对照组(机械预备组)和实验组(Er:YAG激光组)。通过测量微拉伸粘接强度(mTBS)、微渗漏深度、观察组织学形貌、微观形态和测量操作时间比较了Er:YAG激光与传统机械法在这些方面的特性。结果实验组的微拉伸粘接强度高于对照组(n=13,P<0.05),而平均微渗漏深度低于对照组,但差异无统计学意义(n=13,P>0.05)。实验组残留感染牙本质小管少于对照组(n=6,P<0.01)。扫描电镜观察显示,实验组牙本质小管开放、清晰、裸露,而经机械预备的牙本质表面有玷污层(n=4)。实验组的去龋时间明显长于对照组(n=36,P<0.05)。结论虽然去龋时间较长,但Er:YAG激光用于窝洞预备较传统机械法有更高的微拉伸粘接强度和更少的感染牙本质小管残留。因此,Er:YAG激光是一种合适的临床去龋方法。Objective To provide more evidence for the feasibility of an erbium-doped yttrium-aluminum-garnet(Er: YAG) laser in caries removal and adhesive restoration. Methods Thirty-six freshly extracted human molars with dentin caries were used. Each carious lesion of the isolated tooth was cut into equal-sized halves. One half was assigned to the study group(Er: YAG laser irradiation group) and the other half to the control group(mechanical excavation group). Five experiments were conducted to compare the characteristics of the Er: YAG laser of conventional mechanical devices in terms of microtensile bond strength(mTBS), microleakage, histology, micromorphology and excavation time. Results The study group showed higher mTBS than the control group(n=13, P<0.05). The mean microleakage depth of the study group was lower than that of the control group without significant difference(n=13, P>0.05). The study group had less remaining infected dentin tubules than the control group(n=6, P<0.001). Scanning electron microscope evaluation of samples in the study group showed open, clear and exposed dentinal tubules, while smear layers were observed on dentin surface treated by a bur(n=4). However, the study group showed longer time for caries removal than the control group(n=36, P<0.05). Conclusion Although the time for caries removal is longer, the Er: YAG laser used in cavity preparation is superior to conventional mechanical devices in terms of higher mTBS and less remaining infected dentin tubules. Therefore, the Er: YAG laser is a suitable alternative clinical treatment for caries removal.

关 键 词：ER:YAG激光 窝洞预备 传统机械法 龋病 

分 类 号：R781.05[医药卫生—口腔医学]