Er:YAG激光在牙体硬组织疾病应用中对髓腔温度的影响  

Effect of Er:YAG laser on pulp cavity temperature in hard tissue diseases

作　　者：李璐 申静[1,2,3] 高静 王丽霞[1,2,3] 索来 曲佳菲[1,2,3] LI Lu;SHEN Jing;GAO Jing;WANG Lixia;SUO Lai;QU Jiafei(Dept.of International Medical Center,Tianjin Stomatologial Hospital,Tianjin 300041,China;School of Medicine,Nankai University,Tianjin 300071,China;Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction,Tianjin 300041,China)

机构地区：[1]天津市口腔医院国际诊疗中心,天津300041 [2]南开大学医学院,天津300071 [3]天津市口腔功能重建重点实验室,天津300041

出　　处：《武汉大学学报（医学版）》2023年第7期873-878,共6页Medical Journal of Wuhan University

基　　金：天津市医学重点学科(专科)建设项目资助(编号:TJYXZDXK-078D)。

摘　　要：目的:通过比较Er:YAG激光辅以不同脉冲能量与照射时间作用于牙体硬组织时所引起的牙髓腔温度变化来探索Er:YAG激光应用于牙体硬组织疾病治疗的安全工作参数范围。方法:收集新鲜离体50颗牙,制备牙本质小管暴露模型,根据实验中照射Er:YAG激光脉冲能量与时间的不同将样本随机分为10组(80 mJ/P,10 s;120 mJ/P,10 s;160 mJ/P,10 s;200 mJ/P,10 s;250 mJ/P,10 s;80 mJ/P,20 s;120 mJ/P,20 s;160 mJ/P,20 s;200mJ/P,20 s;250 mJ/P,20 s)。利用数字测温仪对髓腔温度进行实时监测并记录,得出不同组别照射完毕时的即刻温度T、全程最高温度T_(max)、温度变化值△T、达到最高温度所需要的时间t_(max)。结果:T、T_(max)、△T、t_(max)随着照射时间的延长,均呈现升高趋势,且10 s组与20 s组之间差异显著(P<0.05);当照射时间相同时,T、T_(max)、△T均随脉冲能量的增加而升高,而tmax之间的差异未见明显规律。结论:(1)Er:YAG激光对髓腔温度的影响与其脉冲能量、作用时间呈正相关;照射距离为1 cm,单次照射时间10 s,脉冲能量低于200 mJ/P时认为对牙髓组织相对安全;若照射时间延长至20 s时,应尽可能保持脉冲能量小于120 mJ/P。(2)Er:YAG激光作用于牙体硬组织时,其热量呈持续释放状态,因此操作过程中可延长使用间隔时间以免引起过多的热量聚集而损伤牙髓。Objectives:To obtain the best working parameters of Er:YAG laser applied in dental treatment by comparing the temperature of the pulp cavity induced by Er:YAG laser with different pulse energy and irradiation time.Methods:The collected 50 fresh teeth were divided into 10 groups,then pre‑pared for the dentin tubule exposure models.Different groups were irradiated with five kinds of pulse energy parameters and two kinds of exposure time(80 mJ/P,10 s;120 mJ/P,10 s;160 mJ/P,10 s;200 mJ/P,10 s;250 mJ/P,10 s;80 mJ/P,20 s;120 mJ/P,20 s;160 mJ/P,20 s;200 mJ/P,20 s;250 mJ/P,20 s).The digital temperature measuring instrument was used for monitoring the pulp cavi‑ty temperature in a real‑time manner,to record and culculate the indices such as the immediate temper‑ature(T),the maximum temperature(T_(max))in the whole process,the temperature change value(△T),and the time required to reach the maximum temperature of the medullary cavity(tmax)of differ‑ent groups.Results:With the extension of irradiation time,T,T_(max),△T,and t_(max)all showed an in‑creasing trend.And there was a significant difference between the 10 s group and the 20 s group(P<0.05).When the irradiation time was the same,T,T_(max)and△T all increased with the increase of pulse energy,but there was no obvious difference in tmax.Conclusion:①The effect of Er:YAG laser on the temperature of the medullary cavity was positively correlated with its pulse energy and action time;when the exposure distance is 1 cm,single‑time exposure time is 10 s and pulse energy is less than 200 mJ/P,and the pulp tissue is relatively safe;if the exposure time is prolonged to 20 s,the pulse energy shall be less than 120 mJ/P.②When Er:YAG laser acts on the hard tissue of the tooth,its heat is released continuously,so the interval time can be extended during the operation to avoid ex‑cessive heat accumulation and damage to the pulp.

关 键 词：ER:YAG激光 牙体硬组织 髓腔温度 

分 类 号：R781[医药卫生—口腔医学]