不同激光封闭牙本质小管效果的体外研究  

Comparative study on the effects of Er:YAG laser and semiconductor laser in sealing dentinal tubule

作　　者：何颖 陈世照 武明轩[1] HE Ying;CHEN Shizhao;WU Mingxuan(Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology of Hebei Medical University,Hebei,Shijiazhuang 050017,China)

机构地区：[1]河北医科大学口腔医学院·口腔医院牙周二科河北省口腔医学重点实验室河北省口腔疾病临床医学研究中心,石家庄市050017

出　　处：《河北医药》2021年第16期2463-2466,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20201194)。

摘　　要：目的研究比较Er:YAG激光和半导体激光对牙本质小管的封闭率和抗老化效果,探讨哪种激光封闭牙本质小管效果更佳,从而为临床选择何种激光进行牙本质脱敏治疗提供理论参考。方法将25个厚2 mm的牙本质片用0.5%mmol/L的EDTA去除玷污层以制作成牙本质敏感模型,将其中5个样本作为空白对照组,另20个样本随机分成2组,每组10个,应用不同激光进行牙本质脱敏处理:A组:Er:YAG激光处理;B组:810 nm半导体激光处理。随机抽取2组各一半样本,用扫描电镜观察牙本质小管暴露率,剩余样本进行老化试验后再进行电镜扫描,观察牙本质小管的暴露率。结果老化试验前,电镜扫描可见,对照组的牙本质小管形态完整、均匀开放,Er:YAG激光和半导体激光照射后牙本质小管口表层均有均匀致密的牙本质熔融层形成。图像分析结果可见,A、B组牙本质小管暴露面积明显小于对照组(P<0.01),且B组牙本质小管的暴露面积明显小于激光组,2组之间的差异有统计学意义(P<0.01)。老化试验后电镜扫描可见:A组牙本质小管大部分被侵袭开放,B组牙本质小管暴露明显小于A组,差异有统计学意义(P<0.01)。结论半导体激光较Er:YAG激光封闭牙本质小管效果更佳,且抗老化效果更好,值得临床广泛推广应用于治疗牙本质过敏症。Objective To compare the effects of Er:YAG laser and semiconductor laser in sealing dentinal tubule,so as to provide theoretical reference for clinical selection of laser for dentin desensitization treatment.Methods A total of 25 dentin discs with 2mm thickness were prepared and etched with 0.5 mmol/L EDTA to establish the dentine hypersensitivity models,in which 5 specimens taken as control group,and the other 20 specimens were divided into two groups,with 10 specimens in each group.The specimens in group A were treated by Er:YAG laser,and those in group B were treated by semiconductor laser(810nm).The half of the samples in group A and group B were randomly selected for scanning electron microscopy(SEM)to observe the exposure rate of dentine tubules,and the remaining specimens were examined by electron microscope scanning after aging test.Results Before aging test,the electron microscope scanning showed that the dentinal tubules in control group were intact and opened uniformly.The dentinal tubules were sealed well and the melt layer formed over the dentin when dentin discs were exposed to the laser irradiation ether Er:YAG laser or semiconductor laser.In addition,the exposed area in group A and group B was significantly less than that in control group(P<0.01),moreover,which in group B was significantly less than that in group A(P<0.01).After aging test,the electron microscope scanning showed that the dentinal tubules in group A were invaded and opened again,and the exposed area in group B was significantly less than that in group A(P<0.01).Conclusion The semiconductor laser is superior to Er:YAG laser in sealing dentin tubules,the former has better anti-aging effect,therefor,which is worthy of clinical application and promotion.

关 键 词：ErYAG激光 半导体激光 牙本质过敏 牙本质小管 扫描电镜 

分 类 号：R783[医药卫生—口腔医学]