Er:YAG激光和传统车针去龋后牙本质粘接强度的比较  

Comparison of dentin tensile bonding strength after caries removal with Er:YAG laser and traditional burs

作　　者：黄莉莉[1] 张佳钰[1] HUANG Li-li;ZHANG Jia-yu(Department of Endodontics of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine,College of Stomatology of Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院牙体牙髓科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《医疗卫生装备》2024年第4期56-60,共5页Chinese Medical Equipment Journal

摘　　要：目的:比较使用不同模式Er:YAG激光以及传统车针去龋后牙本质与复合树脂的粘接强度。方法:选用人类离体磨牙模拟龋坏,分别采用Er:YAG激光中短脉冲(medium short pulse,MSP)模式、Er:YAG激光超短脉冲(super short pulse,SSP)模式和传统车针去除模拟的龋坏后,采用自酸蚀粘接剂将牙体标本与复合树脂粘接制成试件。使用万能试验机对试件进行拉伸试验,测得断裂负荷和粘接强度,并采用单因素方差分析和Tukey多重比较进行统计学分析。采用扫描电子显微镜观察3种不同去龋方式处理后的牙本质表面形态,以及涂布自酸蚀粘接剂并固化后试件的横截面形态。结果:使用Er:YAG激光MSP模式处理后牙本质与复合树脂的粘接强度最高,SSP模式处理后次之,传统车针处理后最低,但差异无统计学意义(P>0.05)。扫描电子显微镜图像显示,Er:YAG激光MSP模式处理后的牙本质表面较平坦,牙本质小管内几乎没有残屑;Er:YAG激光SSP模式处理后的牙本质表面呈现鳞片状,牙本质小管内可见少量碎屑;而传统车针处理后牙本质小管大部分处于被表面牙本质部分甚至完全遮盖的状态,牙本质小管内充满残屑。结论:使用Er:YAG激光去龋相比传统车针去龋可以获得较好的牙本质粘接强度,且对牙本质小管的处理深度和洁净度明显优于传统车针去龋,其中MSP模式更佳。Objective To compare the tensile bond strength between the composite resin and the dentin surface treated with Er:YAG laser and traditional burs.Methods Er:YAG laser medium short pulse(MSP),Er:YAG laser super short pulse(SSP)and traditional burs were used to remove simulated caries on human in vitro molars,and then the molars were bonded with composite resin to form the specimens.Tensile tests were performed on the specimens using a universal testing machine,and fracture load and bond strength were measured and statistically analyzed using one-way ANOVA and Tukey's multiple comparison test.The surface morphology after treatment with the three different decay modes and the cross-sectional morphology of the dentins after applying and curing the self-etching adhesive were observed using a scanning electron microscope(SEM).Results The highest tensile bond strength was observed in the dentins treated with Er:YAG laser MSP mode,followed by the dentins with the SSP mode,and the dentins with the traditional burs showed the lowest tensile bond strength,however,the differences were not statistically significant(P>0.05).The SEM revealed that the dentins treated with the MSP mode had smooth surface and almost no debris found in the dentin tubules,the dentins with the SSP mode had scaly surface and a small amount of debris in the tubules,and the dentins with traditional burs had most of the tubules partially or even completely covered by the surface and full of debris.Conclusion Er:YAG laser behaves better than traditional burs in tensile bond strength for caries removal and depth and cleanness for tubules treatment,of which the MSP mode gains advantages over others.

关 键 词：ER:YAG激光 传统车针 去龋 牙本质 粘接强度 

分 类 号：R318.6[医药卫生—生物医学工程] TH787[医药卫生—基础医学]