Er∶YAG激光不同照射参数组合对牙本质小管封闭效果影响的研究  

The effects of different combination of Er∶YAG laser irradiation parameters on dentin tubule sealing

作　　者：杨久慧 陈永进 杨平 刘佳 陈星宇 杨欣宇 李强 YANG Jiuhui;CHEN Yongjin;YNAG Ping;LIU Jia;CHEN Xingyu;YANG Xinyu;LI Qiang(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi International Joint Research Center for Oral Diseases,710032,Xi'an;Department of General Dentistry&Emergency,Department of Orthodontics,The Third Affiliated Hospital of Air Force Medical University,China;Department of Stomatology,Yaozhou District People's Hospital,Tongchuan)

机构地区：[1]解放军联勤保障部队第966医院口腔科 [2]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病国际联合研究中心,空军军医大学第三附属医院急诊与综合临床科 [3]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病国际联合研究中心,空军军医大学第三附属医院口腔正畸科 [4]陕西省铜川市耀州区人民医院口腔科

出　　处：《实用口腔医学杂志》2025年第1期60-65,共6页Journal of Practical Stomatology

基　　金：国家口腔疾病临床医学研究中心专项课题(编号:LCB202204);空军军医大学第三附属医院新技术(编号:LX2022-304)

摘　　要：目的:探讨不同的Er∶YAG激光照射参数组合对牙本质小管封闭效果的影响。方法:160个2 mm厚牙本质片用0.5 mmol/L EDTA脱矿制备牙本质过敏症模型并等分成16个组(n=10),应用聚焦式(R02)和散焦式(R14)照射手具按照Er∶YAG激光的照射功率、照射距离和照射时间照射牙本质片。再将各组随机等分为照射即刻组和酸蚀磨损组(n=5),SEM观察牙本质小管横截面和纵剖面形态,ImageE-Pro Plus 6.0图像分析软件计算牙本质小管暴露面积和封闭率,测量牙本质小管封闭距离。结果:SEM观察可见,对照组牙本质小管口周界清晰、开放均匀,酸蚀磨损后牙本质小管口增大、开放明显;Er∶YAG激光处理后的照射即刻组牙本质小管口缩小或呈现出不同程度的熔融封闭,其中手具、照射功率、距离、时间分别为R02、0.5 W、3 cm、20 s/cm^(2),R14、0.5 W、3 cm、20 s/cm^(2),以及R14、0.6 W、3 cm、20 s/cm^(2)3组参数组合照射的牙本质小管口熔融物封闭均匀无缝,酸蚀磨损处理前后牙本质表面形态基本一致,纵剖面可见牙本质小管内封闭物更加均匀密实;形态学分析显示,上述三组参数组合的Er∶YAG激光照射后,无论是否酸蚀磨损处理,牙本质小管暴露面积均显著小于其它各组(P<0.05)、封闭率均显著高于其它各组(P<0.05)、牙本质小管封闭深度亦达到2.0μm以上。结论:R02和R14手具以0.5 W照射功率、3 cm照射距离、20 s/cm^(2)照射时间,以及R14手具以0.6 W照射功率、3 cm照射距离、20 s/cm^(2)照射时间的参数组合可以达到最佳的牙本质小管封闭效果。Objective:To explore the effects of different combination of Er∶YAG laser irradiation parameters on the dentinal tubule sealing.Methods:160 dentin discs with 2 mm thickness were etched with 0.5 mmol/L EDTA to establish the dentine hypersensitivity models.The discs were randomly divided into 16 groups(n=10).The R02 and R14 handpieces were used to deliver Er∶YAG laser to the dentin discs according to the different output power(W),irradiation distance(cm)and irradiation time(s/cm^(2)).Then,the samples of each group were divided into immediate irradiation subgroup and acid etching and wear subgroup(n=5).The dentinal tubules were observed with SEM,and the exposed area,the sealed rate and the occlusion depth of dentinal tubules were evaluated with ImageE-Pro Plus 6.0 software.Results:The dentinal tubules in the control group opened uniformly with clear perimeter,they were enlarged and opened after acid etching and tooth brushing.The dentinal tubules shrinked or sealed well with the melt layer after treatment by Er∶YAG laser irradiation with either parameter combination.Especially,uniform and seamless melt layer as well as similar dentin surface morphology before and post the acid etching and tooth brushing were obtained when the dentin discs were exposed to the following Er∶YAG laser irradiation parameter combinations,i.e.(R02,0.5 W,3 cm,20 s/cm^(2)),(R14,0.5 W,3 cm,20 s/cm^(2))and(R14,0.6 W,3 cm,20 s/cm^(2)).Significantly decreased exposed area and increased seal rate in the dentinal tubules treated in the above 3 laser irradiation parameter combination groups were observed than those in the other groups(P<0.05).Morphological analysis confirmed that whether the acid etching and tooth brushing were exerted.The occlusion depth of dentin tubule was more than 2.0μm in the dentinal tubules treated in the above 3 groups.Conclusion:Er∶YAG laser irradiation parameter combinations of R02,0.5 W,3 cm,20 s/cm^(2),R14,0.5 W,3 cm,20 s/cm^(2)and R14,0.6 W,3 cm,20 s/cm^(2)are suitable for the best dentin tubule sealing.

关 键 词：铒激光 牙本质过敏症 牙本质小管 参数 

分 类 号：R781.2[医药卫生—口腔医学]