Er:YAG激光桩道预处理的研究进展

本文回顾了Er:YAG激光活化根管冲洗技术的最新研究进展,包括光子诱导光声流(photon initiated photoacoustic streaming,PIPS)技术和冲击波增强发射光声流(shock wave enhanced emission photoacoustic streaming,SWEEPS)技术,探讨Er:YAG激光预处理桩道的原理、优点以及对纤维桩粘接强度的影响,以期为临床选择适宜的桩道处理方法提供新思路。     

补肾聪耳片对卡那霉素致聋豚鼠听毛细胞修复研究

目的 :探讨补肾聪耳片对卡那霉素致豚鼠感音性神经性耳聋的修复和保护作用。方法 :卡那霉素致聋制作动物实验模型 ,用中药制剂补肾聪耳片进行干预 ,通过听力和耳蜗病理实验观察其改善听力和对耳蜗毛细胞的修复作用。结果 :正常对照组和实验组相比各项观察指标 (耳廓听域反射、听性脑干诱发电位、外毛细胞听毛缺失率差别均有统计学意义 (P<0 01) ,超微结构检查发现中药制剂对耳蜗结构有明显的改善。结论 :补肾聪耳片能恢复神经反射的功能 ,改善耳听力 ,促进毛细胞修复。     

Er:YAG激光辅助龈下刮治和根面平整术治疗牙周炎的Meta分析

目的运用循证医学方法评价掺铒:钇铝石榴石(Er:YAG)激光辅助龈下刮治和根面平整术(SRP)治疗牙周炎较单纯SRP治疗牙周炎的临床疗效差异。方法通过检索Pubmed、Embase、Cochrane图书馆、知网、万方、维普等中英文数据库,查阅自建库以来至2020年11月30日的关于Er:YAG激光辅助SRP治疗牙周炎与SRP相比较的随机对照研究(RCT)。由2名研究员严格按照纳入及排除标准独立筛选文献、对文献进行质量评价、数据提取,用STATA14.0软件进行统计分析。结果共纳入9篇RCT,发现在治疗后3个月随访时,Er:YAG激光辅助SRP组的PD、PI值明显低于SRP组(PD:SMD=-0.434,95%CI:-0.844,-0.024,I~2:66.3%,P=0.038;PI:SMD=-0.516,95%CI:-0.978,-0.054,I~2:45.7%,P=0.029);在治疗后6个月随访时,Er:YAG辅助SRP组的PD、CAL值明显低于SRP(PD:SMD=-0.402,95%CI:-0.695,-0.108,I~2:16.2%,P=0.007;CAL:SMD=-0.316,95%CI:-0.608,-0.025,I~2:0.0%,P=0.034)。结论与SRP相比,Er:YAG激光辅助SRP治疗牙周炎在中短期能产生更好的效果,可以在牙周非手术治疗中常规使用。     

Er，Cr：YSGG激光对牙周炎患牙及健康牙根面的影响

目的：探讨应用RFPT5-14工作尖的Er, Cr: YSGG激光照射对牙周炎患牙及健康牙根面微观结构改变以及粗糙度的影响。方法：选取8颗因牙周炎拔除的患牙，用超声刮治器去除根面牙石，另选取8颗因正畸减数或阻生智齿拔除的健康牙，将每颗牙根面分为4个区域，对应为1~4组，分别进行如下4种处理：（1）不处理；（2）Gracey刮治器进行根面平整30 s；（3）低功率激光照射30 s；（4）高功率激光照射30 s。通过扫描电镜观察表面微观结构，通过三维光学轮廓仪测量表面粗糙度Ra值。结果：手工根面平整组的表面可见玷污层覆盖；激光照射组表面较清洁，可见消融样改变；高功率激光组可见局部有牙本质小管暴露。牙周炎患牙第1组的Ra值为（237.4±20.0） nm，第2~4组的Ra值分别为（135.7±11.9） nm（P=0.01）、（463.6±49.3） nm（P<0.001）和（486.0±59.0） nm（P<0.001）。健康牙第1组的Ra值为（191.4±44.5）nm，第2~4组的Ra值分别为（131.6±21.5） nm（P=0.482）、（463.7±34.6） nm（P<0.001）和（470.3±121.3） nm（P<0.001）。结论：应用RFPT5-14工作尖的Er, Cr: YSGG激光照射可造成牙周炎表面的病变牙骨质及健康牙表面的健康牙骨质微观结构的改变，可以有效减少根面玷污层，并可见有消融样改变。Er, Cr: YSGG激光照射可以增加根面粗糙度，还需进一步实验来评价激光照射后根面的生物相容性。     

Effect of silica coating and laser treatment on the flexural strength,surface characteristics,and bond strength of a dental zirconia

This study investigated the effect of irradiation with an erbium‐doped yttrium aluminium garnet (Er:YAG) laser and coating with silica on the surface characteristics, bond strength, and flexural strength of dental zirconia. Three hundred and forty‐three standard zirconia specimens were created, and 49 were assigned to each of seven surface treatment groups: (i) no treatment; Er:YAG laser (80 mJ/2 Hz) with pulse widths of 50 μs (ii), 100 μs (iii), 300 μs (iv), or 600 μs (v); or tribochemical silica coating at the partially sintered stage (vi) or after sintering was complete (vii). All specimens were sintered after the surface treatments, except for the group in which specimens were sintered before treatment. The study outcomes were roughness, surface loss, microshear bond strength (μSBS), and biaxial flexural strength (BFS). Mean roughness and surface loss values were significantly higher in specimens from irradiated groups than in those from silica‐coated groups. Regarding μSBS, after aging, specimens from all experimental groups presented very low and similar μSBS values, irrespective of the surface treatment. Silica coating after sintering yielded the highest BFS (1149.5 ± 167.6 MPa), while coating partially sintered specimens with silica resulted a BFS (826.9 ± 60.9 MPa) similar to that of the untreated control group (794.9 ± 101.7 MPa). Laser treatments, irrespective of pulse width used, significantly decreased the BFS. In the group treated with laser at 300 μs pulse width, specimens exhibited the lowest BFS value (514.1 ± 71.5 MPa). Adhesion to zirconia was not stable after aging, regardless of the surface treatment implemented.     

Noninvasive delivery of siRNA and plasmid DNA into skin by fractional ablation: Erbium:YAG laser versus CO2 laser

The present study was conducted to evaluate the impacts of fractional erbium (Er):YAG and CO₂ lasers on skin permeation of small interfering (si)RNA and plasmid (p)DNA vectors. In vitro skin delivery was determined with a Franz diffusion cell. In vivo absorption was investigated by observing fluorescence and confocal microscopic imaging. Fractional laser-mediated ablation of the skin resulted in significant enhancement of dextran and siRNA penetration. Respective fluxes of dextran (10 kDa) and siRNA, which had similar molecular size, with Er:YAG laser irradiation at 5 J/cm² were 56- and 11-fold superior to that of intact skin. The respective permeation extents of dextran and siRNA by the CO₂ laser at 4 mJ/400 spots were 42- and 12-fold greater than that of untreated skin. Fluorescence and confocal images showed increased fluorescence intensities and penetration depths of siRNA and pDNA delivery. According to an examination of the follicular permeant amount and fluorescence microscopy, hair follicles were important deposition areas for fractional laser-assisted delivery, with the Er:YAG modality revealing higher follicular siRNA selectivity than the CO₂ modality. This is the first report of siRNA and pDNA penetrating the skin with a sufficient amount and depth with the assistance of fractional lasers.     

Novel method for facial rejuvenation using Er:YAG laser equipped with a spatially modulated ablation module: An open prospective uncontrolled cohort study

Facial aging is a complex biological process that affects the skin and superficial musculoaponeurotic system (SMAS). A new technology (RecoSMA) for skin rejuvenation based on acoustic-interference method using Er:YAG laser (2936 nm) equipped with a special module SMA that targets both the dermis and SMAS was evaluated in an open-label prospective cohort study of 100 female patients treated for facial rejuvenation. Measure of clinical improvement included investigator-rated clinical photography using the Modified Fitzpatrick Wrinkle Scale, and ultrasound measurements in the dermis a week, 30 days and six months post treatment. All patients completed the study and no complications were noted. Improvements in skin tone and texture were noted in all participants and significant decrease in wrinkle depth was demonstrated at the six-month follow-up that was confirmed by ultrasound skin measurements. Data presented herein confirm the safety and efficacy of RecoSMA treatment for facial rejuvenation.     

果酸联合点阵式Er:YAG激光治疗面部毛孔粗大的临床疗效观察

目的评价果酸联合点阵式Er:YAG激光治疗面部毛孔粗大的有效性。方法收集面部毛孔粗大患者60例,随机分成果酸治疗组、点阵式Er:YAG激光治疗组及联合治疗组3组,每组20例,分别比较3组患者治疗前、治疗后4周毛孔标准照片评分差异有无统计学意义,两两比较3组患者治疗后4周毛孔标准照片评分差异有无统计学意义。结果 3组患者治疗前、治疗后4周毛孔标准照片评分比较差异均有统计学意义(P0.01)。联合治疗组与单一果酸治疗组、单一Er:YAG治疗组比较差异均有统计学意义(P0.01)。结论果酸联合点阵式Er:YAG激光治疗面部毛孔粗大比单一使用果酸或点阵式Er:YAG激光治疗面部毛孔粗大临床疗效更好。     

Er:YAG 激光和酸蚀预处理对自粘结树脂水门汀粘结强度的影响

目的:探讨Er:YAG 激光和酸蚀预处理对自粘结树脂水门汀粘结强度的影响?方法:44颗前磨牙根据对牙本质表面预处理方式的不同随机分为4组:对照组?Er:YAG 激光组?酸蚀组(35%磷酸)?Er:YAG 激光+酸蚀组?每组11颗牙中随机选出1颗切取3 mm厚牙本质片,按相应分组要求预处理后进行扫描电镜观察;每组剩余10颗牙制备一致标准牙本质表面后按相应分组要求预处理,用自粘结树脂水门汀RelyXTM Unicem将其与Everest ZS 氧化锆瓷片粘结,24 h后测试各组剪切粘结强度并进行统计分析?结果:扫描电镜观察显示采用不同方式预处理后,牙本质表面形态改变明显;统计分析结果显示剪切粘结强度由高到低为Er:YAG 激光组(7.18 ± 2.54)MPa?Er:YAG 激光+酸蚀组(5.50 ± 2.09)MPa?对照组(4.05 ± 1.04)MPa?酸蚀组(3.61 ± 0.70)MPa;Er:YAG 激光组?Er:YAG 激光+酸蚀组与对照组有显著性差异(P < 0.05),酸蚀组与对照组无显著性差异(P > 0.05)?结论:酸蚀对自粘结树脂粘结强度的改变无明显影响,Er:YAG 激光预处理能有效提高自粘结树脂与牙本质和氧化锆瓷的粘结强度?     

Comparison of the effect and safety of Er:YAG laser combined with fluoride and methylene blue-photodynamic therapy on caries prevention

目的 比较Er:YAG激光-氟化钠联合法与亚甲基蓝-光动力疗法（MB-PDT）的防龋效果及安全性。方法 建立28只大鼠龋齿模型,随机分成7组：不同功率密度的光动力疗法（PDT）组、激光+氟化钠联合组、激光组、氟化钠组和0.9%生理盐水组。分光光度法检测变异链球菌生长抑制情况;激光荧光诊断仪（LF）检测龋损脱矿程度;组织病理观察牙髓及颊黏膜损伤状况。结果 PDT组与激光+氟化钠联合组光密度值明显低于其他处理组（P<0.05）;不同处理方法均可使LF值上升,出现不同程度的脱矿;组织病理学观察,70 mw·cm^-2的联合组和Er:YAG激光组存在牙髓及颊黏膜损伤。结论 相同参数下,联合组与PDT均有良好的杀菌效果,但PDT不良反应少、损伤小,是一种高效且安全的防龋手段。