激光治疗牙本质敏感症的研究进展

牙本质敏感症作为一种口腔临床的常见病,其发病机制尚未完全清楚,目前较公认的是流体动力学说。脱敏治疗方法以封闭牙本质小管和降低牙髓神经敏感性为主,现阶段临床上仍无十分理想的脱敏手段。研究表明,激光治疗能弥补传统方法的不足,提高脱敏效果,特别是激光联合药物脱敏已成为近年牙本质敏感症治疗研究的焦点。文章对近年来国内外各种激光治疗牙本质敏感症的研究进展做一概述。     

奥敏清牙齿脱敏剂联合Er:YAG激光治疗青少年牙本质敏感症的临床观察及实验研究

目的:对奥敏清牙齿脱敏剂联合Er:YAG激光治疗青少年牙本质敏感症的疗效进行研究。方法:78例(共163颗患牙)青少年牙本质敏感症患者随机分为奥敏清组(n=54)、激光组(n=55)和联合组(n=54),奥敏清组患者给予单一奥敏清牙齿脱敏剂涂布治疗,激光组患者给予单一的Er:YAG激光照射治疗,联合组患者在Er:YAG激光照射后再涂布奥敏清牙齿脱敏剂治疗,比较治疗前、治疗即刻和治疗后1周、1月、3月、6月VAS值、总有效率。另将20颗新鲜离体牙随机分为4组,分别用生理盐水、奥敏清牙齿脱敏剂、Er:YAG激光及奥敏清联合Er:YAG激光处理,扫描电镜观察各模型样本形态。 结果:联合组在治疗即刻及治疗后各时间点的VAS值均显著低于奥敏清组和激光组(P<0.05);总有效率均显著高于奥敏清组和激光组(P<0.05);奥敏清组和激光组在治疗即刻、治疗后1周、1月、3月时的总有效率差异无统计学意义,但激光组在治疗后6月的总有效率却显著高于奥敏清组(P<0.05)。扫描电镜结果显示奥敏清、Er:YAG激光及奥敏清联合Er :YAG激光处理均可封闭牙本质小管,且奥敏清联合Er:YAG激光的封闭效果最佳。结论:奥敏清牙齿脱敏剂联合Er:YAG激光治疗青少年牙本质敏感症具有较好的临床效果。     

激光和脱敏剂治疗牙本质敏感症的临床疗效对比

目的对比Nd：YAG激光和Gluma脱敏剂治疗牙本质敏感症的临床疗效。方法 20例牙本质敏感症患者,两例对称的同名患牙分别随机分到激光组和Gluma组。激光组选用的参数为120 mJ,5 Hz,照射时间1 min,Gluma组药物涂擦时间为2 min。记录患者在治疗后即刻、术后1周、术后1个月对探针和气流刺激的视觉模拟评分（visual analogue scale,VAS）。结果术后即刻激光组、Gluma组VAS分别为4.05±0.95、4.75±1.33（P〉0.05）,术后1周激光组、Gluma组VAS分别为3.10±0.91、3.70±1.03（P〉0.05）,提示短期内激光和Gluma对牙本质敏感症的疗效无差异。术后1个月激光组、Gluma组的VAS分别为2.35±0.75、3.20±0.83（P〈0.01）,提示随着时间延长,激光照射可以显著缓解患者的牙本质敏感症状。结论 Nd：YAG激光（120 mJ,5 Hz）照射1 min与脱敏剂Gluma涂擦2 min相比,脱敏效果1周内两者无差异,术后1个月疗效以激光为优。     

Nd:YAG激光治疗牙本质敏感的研究进展

牙本质敏感是口腔常见病症,患病率高,影响患者口腔健康与生活质量。激光治疗牙本质敏感获得良好疗效,其中Nd:YAG激光成为激光治疗牙本质敏感的首选。本文就目前Nd:YAG激光治疗牙本质敏感的研究进展进行综述。     

2种方法联合治疗牙本质敏感症的临床研究

目的研究奥威尔脱敏糊剂和Nd:YAG激光以及它们联合作用在治疗牙本质敏感症中的作用。方法选择40例患者,共207颗患牙,分别进入空白组、奥威尔组、激光组、奥威尔+激光组联合组,每组10例患者。采用数字化疼痛评判法记录患者在治疗前、治疗后30 min、1周、6个月时的敏感程度。结果奥威尔组在治疗后30 min和1周时脱敏效果最明显,而激光组在治疗1周和6个月后效果明显。联合组在治疗后每个时间点效果均显著。空白对照组未发现明显改变。结论奥威尔和激光治疗均能对牙本质敏感症产生明显疗效。如果两者结合,效果会更好。     

半导体激光治疗牙本质过敏症的疗效观察

目的 探讨MDC-500型半导体激光对牙本质过敏症的疗效。方法 采用MDC-500型半导体激光及迪散CDISAN脱敏剂分别对34例患者进行脱敏疗效对比。结果 MDC-500型半导体激光治疗牙本质过敏症的成功率为91％,药物脱敏成功率为35％。结论 MDC-500型半导体激光比迪散CDISAN脱敏剂脱敏更有效。     

Nd:YAG激光治疗牙本质过敏症的临床疗效观察

目的 :探讨Nd :YAG激光治疗牙本质过敏症的疗效。方法 :15 3例患者的 2 70颗患牙 ,随机分为 2组 ,分别用Nd :YAG激光和Gluma脱敏剂进行治疗后观察疗效。结果 :实验组治愈率为 92 .5 9% ,有效率为94.0 7% ;对照组治愈率为 49.62 % ,有效率为 71.84%。结论 :2种治疗方法的疗效有显著性差异 (P <0 .0 1) ,激光治疗牙本质过敏的效果优于Gluma脱敏剂。     

半导体激光与化学药物治疗牙本质过敏的对比研究

牙本质过敏是一种较常见的牙体病 ,其治疗方法较多 ,但疗效均不理想。作者采用半导体激光对 40例牙本质过敏进行治疗 ,另 40例采用化学药物脱敏作为对照 ,观察疗效 ,以期找到一种比较理想的脱敏方法。材料和方法1 临床资料(1)纳入标准　牙合面重度磨耗或颈部牙本质暴露 ,尖锐的探针探查时出现不同程度的敏感 ,但牙髓活力正常 ,无龋齿、隐裂、充填物的牙齿。(2 )将 80例牙本质过敏患者分成两组 ,治疗组 40例 84颗牙采用半导体激光治疗 ,对照组 40例 73颗牙采用化学药物脱敏。2 设备和材料(1)半导体激光　采用上海曼迪森科贸有限公司ＭＤＣ- …     

Systemp脱敏剂治疗牙本质敏感症的疗效观察

目的 :观察Systemp脱敏剂治疗牙本质敏感症的临床疗效。 方法 :采用量化观察指标 ,对治疗前后不同时期的观察结果进行统计学分析。结果 :治疗后不同时期、不同牙位牙本质敏感程度均较治疗前明显降低。结论 :Systemp脱敏剂是一种较理想的治疗牙本质敏感症药物     

Nd:YAG激光治疗磨牙敏感症疗效观察

目的　观察评价脉冲Nd :YAG激光照射治疗磨牙敏感症的临床效果。方法　选择磨牙牙合面磨损致敏感的患者 42例 ,1 1 3例颗牙 ,随机分为实验组 (激光治疗组 )和对照组 (75%氟化钠甘油糊剂治疗组 )进行治疗并作疗效对比。结果　脉冲Nd :YAG激光照射治疗牙齿敏感症首次治疗、重复治疗的即刻有效率及 3个月的有效率均优于对照组。两组相差显著 (P <0 .0 0 5)。结论　脉冲Nd :YAG激光治疗磨牙牙合面牙本质敏感效果良好。     

Nd:YAG激光治疗牙齿感觉过敏症

牙齿感觉过敏症是口腔科的常见病和多发病。应用Nd:YAG激光技术治疗牙齿感觉过敏症已经取得了较好的疗效。有并且在这方面的研究成果正不断出现，成为一个热点，目前主要的研究集中在激光治疗的效果，牙髓的反应和对牙齿硬组织的影响方面，本文就激光治疗牙齿感觉过敏症的机制，疗效和失败的因素作一简要综述。     

Kr:F准分子激光对牙体硬组织的热效应研究

目的：评价Kr:F准分子激光照射牙齿后，对牙体硬组织的影响。方法；通过测量Kr:F准分子激光照射后牙齿硬组织的温度，并与Nd:YAG激光照射组进行比较。结果：10s,60s时，Kr:F准分子激光组牙齿硬组织的温度升高值明显低于Nd：YAG激光照射组（P＜0．01）。在照射10s-60s时间内，Kr:F准分子激光照射后牙齿硬组织的温度变化值也明显低于Nd:YAG激光照射组（P＜0．01）。结论：Kr:F准分子激光牙齿产热较少。     

脉冲Nd:YAG激光促进氟保护漆治疗牙齿敏感症临床观察

目的　观察脉冲Nd :YAG激光促进氟保护漆治疗牙齿敏感症的临床疗效。方法　用计算机程序控制脉冲Nd :YAG激光照射经涂一层氟保护漆的牙齿敏感症患牙 ,并分别与单纯涂一层氟保护漆或单纯脉冲Nd :YAG激光照射的疗效相比较。结果　涂氟保护漆加脉冲Nd :YAG激光照射治疗牙齿敏感症优于单纯涂保护漆或单纯脉冲Nd :YAG激光照射 ,疗效有显著性差异 (P <0 .0 5 )。结论　涂氟保护漆和脉冲Nd :YAG激光照射的联合应用是一种治疗牙齿敏感症较为有效的手段     

Nd:YAG激光对猴牙牙髓的影响

目的：观察Nd：YAG激光对猴牙牙髓的影响，比较牙面涂布60g／L美蓝和经常规硝酸银脱敏后对激光照射效果的影响情况。方法：以1592、3185、4777mJ／mm^23种能量水平的Nd：YAG激光照射3只猴的30个牙面，用组织病理学方法观察牙髓变化情况。结果：1592mJ／mm^2照射组，不论牙面经何种处理，牙髓反应均与对照组相似，为0级；3185mJ／mm^2照射组，牙髓出现轻度改变；大能量、高频率的4777mJ／mm^2照射则出现广泛性成牙本质细胞变性、坏死。照射面色素的存在增加了激光对牙髓的刺激，氨硝酸银加丁香油酚还原成银沉淀，隔绝了外界刺激对牙本质和牙髓的影响，同样参数的Nd：YAG激光造成的牙髓损害在3组中最小。结论：大能量Nd：YAG激光可造成牙髓组织损伤性反应，照射面经不同的处理可影响Nd：YAG激光的照射效果。     

Er：YAG激光照射离体牙釉质后表面形态和髓腔温度的观察

目的观察不同能量和时间作用下Er：YAG激光照射人离体牙釉质后表面形态和髓腔温度的变化。方法临床收集24颗离体牙,制备成96个实验样本,按不同处理方法分为A、B两组,分别照射10、20 s,每组再分为6个亚组,选择超短脉冲20 Hz,分别采用1、2、3、4、5、6 W的能量对每个亚组样本的釉质进行照射,用数字式温度计记录髓腔温度的变化,扫描电子显微镜（SEM）下观察样本釉质形态的变化。结果随着照射时间的延长和能量的增加,髓腔温度有上升的趋势;SEM观察A、B两组的釉质形态均有改变,但两组均未发现熔融和碳化现象。结论在Er：YAG激光一定能量的照射下,釉质的形态和髓腔温度产生一定的变化,但是未出现熔融和碳化现象,为临床龋齿的治疗提供了依据。     

Er:YAG激光应用于牙齿漂白的研究进展

Er:YAG激光漂白作为一种新型牙齿漂白方法,与传统漂白技术相比,Er:YAG激光显著提高了漂白效率,具有安全性高、治疗时间短及漂白效果优异等优点,被广泛应用于临床操作.本文就Er:YAG激光漂白技术的作用原理、漂白特点及对牙体组织结构的影响作一综述.现有文献表明,Er:YAG激光对水和羟基磷灰石的高吸收特性使其可以作...     

脉冲Nd:YAG激光辅助极固宁脱敏剂治疗老年牙本质过敏症的临床研究

目的：研究脉冲Nd：YAG激光辅助极固宁脱敏剂治疗老年牙本质过敏症的临床效果。方法：实验组用脉冲Nd：YAG激光1W（30mJ／cm^2、15Hz）照射120sec后，涂擦极固宁脱敏剂3次;对照组强采用极固宁脱敏剂3次。结果：实验组即刻、3个月及6个月有效率分别为87．29％、81．36％和75．42％，对照组的有效率为79．09％、63．64％和52．73％。即刻两组差异无屁著性（P〉0．05），而3个月、6个月差异有显著性（P〈0．01）。结论：脉冲Nd：YAG激光辅助极固宁脱敏荆治疗老年牙本质过敏症是一种高效、作用持久、使用安全的方法。     

Vapor emissions resulting from Nd:YAG laser interaction with tooth structure

The Neodymium:yttrium aluminum garnet (Nd:YAG) dental laser has been cleared by the United States Food and Drug Administration (FDA) for marketing in intraoral soft tissue treatment. The efficacy and safety of the Nd:YAG laser in the treatment of hard dental tissue as well as the effects of dental irradiation on the pulp and periodontium have been investigated. Odors resulting from laser irradiation have been reported, but the nature and toxicity of associated decomposition vapors is unknown and the health consequences of their inhalation have not yet been studied. OBJECTIVES: The purpose of this in vitro study was to identify vapors emitted during interaction of the Nd:YAG laser with carious human enamel and dentin and sound enamel and dentin coated with organic ink. METHODS: Vapor emissions were collected from prepared sections of extracted human teeth receiving laser irradiation of 100 mJ and 10 Hz for a duration of 1, 10, or 60 s. Emissions were collected by means of charcoal absorption tubes, and subsequently analyzed using a Gas Chromatograph equipped with Mass Selective (GC/MS) and Flame Ionization Detectors to identify the chemical constituents of the vapors. RESULTS: No compounds were identified in Nd:YAG laser-treated caries, enamel and dentin. No volatile vapors were identified from samples of tooth materials exposed to the laser for 1 or 10 s. Camphor was positively identified in the test sample which consisted of India ink-coated dentin and the reference sample of India ink-coated glass beads, both exposed to the laser for 60 s. 2,5-norbornadiene was tentatively identified in these samples. The Threshold Limit Value (TLV) of camphor is 2 ppm with a Lethal Dose Level (LDLo) of 50 mg/kg (human oral), while the TLV and LDLo of 2,5-norbornadiene is unknown. SIGNIFICANCE: Occupational and public health safety measures are discussed in this article. Further research is needed to quantify the compounds produced and to determine their toxicity to patients and to dental care providers.     

Why wavelength and delivery systems are the most important factors in using a dental hard-tissue laser: a literature review

Various lasers have been investigated in the dental clinic as an alternative to the dental drill for the treatment of dental hard tissues. Among the lasers, the erbium-based solid-state infrared lasers, operating at approximately 3 microm, have demonstrated they are effective in dental applications because of their high affinity for water in the hydroxyapatite of the tooth structure. Water is the dominant chromophore that absorbs the laser energy during hard-tissue treatment; this leads to well-established, mechanical, thermally driven, and explosive ablation, which is the basis for the erbium laser-tissue interaction. A review of the literature presents a number of studies in which the superior qualities of the Er:YAG laser, in particular, are demonstrated. Er:YAG irradiation results in the least amount of temperature increase at the laser-tooth interface. The Er:YAG laser generates photons with the strongest absorption by water in the enamel and dentin and, when combined with a water cooling spray, produces extremely minor zones of carbonization, debris, and necrosis after irradiation. Furthermore, the Er:YAG laser wavelength can be easily delivered with a hollow waveguide delivery system and contact sapphire tip, resulting in a more precise cavity preparation than other delivery systems. The Er:YAG laser system offers the optimal wavelength and the ability to be transmitted in the most efficient manner for successful dental hard-tissue ablation.     

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??Er??YAG??2940 nm??laser is in the near-infrared region of the electromagnetic spectrum where it is readily absorbed by water within and between the hydroxyapatite crystals in the tooth. With its many advantages such as painlessness??minimal invasiveness and comfort??Er??YAG laser has been widely used in dental practice since its introduction and is approved by the FDA in 1997 for dental hard tissues. It can effectively cut enamel and dentin without damaging the pulp and reduce the bacteria stayed in the dentin to prevent secondary caries. The surface morphology of cavities has been evaluated by SEM after laser preparation in the primary teeth??and the laser has been shown to be able to remove smear layer. The surfaces were scale-like and uneven with open dentinal tubules without plugging of the tubules. Self-etching system was recommended to be used after irradiation by Er??YAG laser on primary teeth to obtain superior bonding strength and less marginal micro-leakage. When used in caries therapy in children??most children considered Er??YAG laser was more comfortable and painlessness compared with drill treatment. At present??Er??YAG laser can undertake??cavity preparation in permanent or primary teeth??indirect pulp treatment??laser assisted pit and fissure sealants??preventive resin restoration??pulp amputation. Besides that Er??YAG laser can be used on soft tissue such as operculectomy??frenectomy??etc. Finally??laser has proven to offer new treatment opportunities that were not available in the dental field in the past.