不同参数Er∶YAG激光堵塞牙本质小管效果的研究  

Study on Occluding Effect of Er∶YAG Laser Irradiation with Different Parame⁃ters on Human Dentinal Tubules

作　　者：李鑫 陈新梅[4] 李雯[1,2,3] 苗雷英 LI Xin;CHEN Xinmei;LI Wen;MIAO Leiying(Affiliated Hospital of Medical School,Nanjing 210008,China;Department of Endodontics,Nanjing Stomatological Hospital;Research Institute of Stomatology,Nanjing University;Department of Dentistry and Endodontics,West China Stomatology Hospital,Sichuan University)

机构地区：[1]南京大学医学院附属口腔医院,南京市210008 [2]南京市口腔医院牙体牙髓病科 [3]南京大学口腔医学研究所 [4]四川大学华西口腔医院牙体牙髓病科

出　　处：《中国激光医学杂志》2024年第3期135-140,178,179,180,共9页Chinese Journal of Laser Medicine & Surgery

基　　金：南京市卫生科技发展项目一般项目(YKK23183)。

摘　　要：目的评价不同参数Er∶YAG激光照射后堵塞牙本质小管的效果。方法选择完整、无龋的人离体前磨牙20颗,制备牙颈部牙本质样本80个,根据不同照射光参数分为激光照射能量40 mJ组(A组)、能量60 mJ组(B组)、能量80 mJ组(C组)和能量100 mJ组(D组),根据激光照射次数再细分为激光照射1次组(A1组、B1组、C1组、D1组),激光照射2次组(A2组、B2组、C2组、D2组),激光照射4次组(A4组、B4组、C4组、D4组),共12个小组,每组5个样本。同时设置空白对照组,取20个样本,即牙本质样本标本不进行任何处理。各激光照射组处理后即刻采用扫描电镜观察各组牙本质表面形貌,并应用图像分析软件分析牙本质小管口的封闭情况,计算牙本质小管堵塞率。结果不同参数Er∶YAG激光均能不同程度堵塞牙本质小管口;其中能量60~80 mJ照射2、4次,能封闭大部分牙本质小管,且表面光滑。图像分析软件结果显示,与空白对照组及A1组比较,其余各激光照射组牙本质小管口开放面积均明显下降(P<0.05);激光照射能量为40、60、80、100 mJ时,照射1次各组牙本质小管堵塞率均显著低于对应同组的照射2次和4次各组(P<0.05)。结论能量60~80 mJ的Er∶YAG激光照射2~4次能有效堵塞牙本质小管,是相对合适的Er∶YAG激光脱敏剂量参数。Objective To evaluate the occluding effect of Er∶YAG laser irradiation on human dentinal tubules.Methods Complete and caries-free human premolars were selected to prepare 80 neck dentin samples,which were randomly assigned to 5 groups:blank control group,40 mJ laser irradiation group(group A),60 mJ laser irradiation group(group B),80 mJ laser irradiation group(group C)and 100 mJ laser irradiation group(group D).The laser irradiation groups were further divided by frequency of laser irradiation:1 exposure groups(group A1,B1,C1 and D1),2 exposures groups(group A2,B2,C2 and D2)and 4 exposures groups(group A4,B4,C4 and D4),12 groups in total.There were 5 sample surfaces in each group.The dentin samples of the blank control group were not treated.The dentin surface morphology of each group was observed with scanning electron microscopy(SEM).The occlusal condition of dentin tubule was analyzed with image analysis software,and the occlusal rate of dentin tubule was worked out.Results The Er∶YAG laser of different parameters blocked the dentin tubule to different degrees.2 or 4 times 60-80 mJ irradiation was used to seal most of the dentin tubules,and the surface was smooth.The results of image analysis software showed that,compared with that of the blank control group and A1 group,the open area of dentin tubule in other laser irradiation groups decreased more remarkably(P<0.05).When the laser energy was 40 mJ,the occlusion rate of dentin tubule of group A1,A2 and A4 appeared a tendency of decrease(P<0.05).Under the laser energy of 60,80 and 100 mJ,the occluding rates of dentin tubule in groups B1,C1 and D1 were significantly lower than those in group B2,C2,D2,B4,C4 and D4(P<0.05).Conclusions The YAG laser irradiation of 60-80 mJ for 2-4 times will effectively block dentin tubules,which is a relatively appropriate dose parameter for Er∶YAG laser desensitization.

关 键 词：牙本质敏感 Er∶YAG激光 牙本质小管 

分 类 号：R616.4[医药卫生—外科学] R781[医药卫生—临床医学]