两种参数设置的激光联合氟化物治疗牙本质敏感症的临床评价  

The clinical evaluation of treatment of dentin hypersensitivity by two different parameters of laser combined with fluoride

作　　者：殷凌云[1] 于鸿滨[1] 杨向红[1] 李克增 欧阳骞[1] Yin lingyun;Yu hongbin;Yang xianghong;Li kezeng;Ou yangqian(The Affiliated Yan’an Hospital,Kunming Medical University,Kunmimg 650051)

机构地区：[1]昆明医科大学附属延安医院,昆明650051

出　　处：《口腔材料器械杂志》2022年第1期34-39,共6页Chinese Journal of Dental Materials and Devices

摘　　要：目的比较两种不同参数设置的激光联合氟化物治疗牙本质敏感症的临床效果。方法60例患者,270颗面磨耗导致牙本质敏感症的患牙,随机分为:Nd:YAG激光治疗(A组)、Er:YAG激光治疗(B组)和多乐氟组(C组),根据激光输出功率不同分为低功率组(A1、A2、B1、B2组),高功率组(A3、A4、B3、B4组),其中A2,A4、B2,B4组为激光与多乐氟联用。采用数字化疼痛评判法(visual analogue scale,VAS)记录其在治疗前、治疗后5 min、1周、1个月、3个月和6个月的牙齿敏感程度,并进行统计学分析。结果各实验组治疗前VAS评分差异无统计学意义;A4组疼痛降低86.9%,明显优于其他实验组(P<0.01);A2、A4组(疼痛分别降低76.9%、86.9%)疗效优于A1、A3组(疼痛分别降低66.6%、73.7%),A3疗效优于A1组(P<0.01);Er:YAG激光治疗组是否联合氟化物治疗或增加输出功率对疗效无明显影响(P>0.05);A1、B1组疼痛降低(66.6%、62%)差异无统计学意义(P>0.05),A3、B3组仅在即刻(70.2%、63.7%)和6个月时(66.7%、57.8%)差异有统计学意义(P<0.01)。结论在半年内激光治疗牙本质敏感症疗效稳定;Nd:YAG激光配伍氟化物联合治疗效果更明显,在安全范围下,适当增加输出功率有助于增强脱敏效果。Objective The aim of this clinical study was to compare the clinical effect of two different parameters of treatment of dentin hypersensitivity by laser combined with fluoride.Methods Sixty patients(270 teeth)with dentin hypersensitivity caused by attrition of occlusal surface were randomly divided into three groups:Nd:YAG laser treatment(group A),Er:YAG laser treatment(group B)and Duraphat group(Group C).According to the laser energy settings,the patients were divided into lower-power group(Group A1,2,B1,2)and higherpower group(Group A3,4,B3,4),Group A2,4 and B2,4 were combined with Duraphat.The level of sensitivity to pain of each volunteer was analyzed by visual analog scale(VAS)using cold air stimuli and exploratory probe before treatment,and at 5 min,1 week,1 month,3 months,and 6 months after treatment.Results There was no significant difference in VAS score among the experimental groups before treatment.After treatment,the reduction VAS scores of Group A4 was 86.9%,which was significantly better than that of other experimental groups(P<0.01);the reduction VAS scores of A2,A4 groups(76.9%,86.9%)was better than that of A1,A3 groups(66.6%,73.7%),and that of A3 group was better than that of A1 group(P<0.01);whether the Er:YAG laser treatment group combined with fluoride or increased output power had no significant effect on the efficacy(P>0.01).There was no significant difference between Groups A1 and B1(66.6%,62%)(P>0.01),and there was significant difference between Groups A3 and B3 at 5 min(70.2%,63.7%)and 6 months(66.7%,57.8%)(P<0.01).Conclusion The effect of laser treatment on dentin hypersensitivity was stable within half a year,and Nd:YAG laser combined with fluoride was more effective.On the premise of not causing irreversible damage to the tooth body and pulp,increasing the output power properly is helpful to enhance the desensitization effect.

关 键 词：牙本质敏感症 ND:YAG激光 ER:YAG激光 氟化物脱敏剂 激光参数 

分 类 号：R781.2[医药卫生—口腔医学]