Er∶YAG激光联合次氯酸钠对管间峡区的清理作用

目的:评价Er∶YAG激光与NaClO联合应用对根管及管间峡区内有机碎屑的清理效果,为探索新型根管及管间峡区清理技术提供实验依据.方法:挑选经过统一根管预备后含有管间峡区的前磨牙50颗,随机分为5组,分别采用以下方法进行处理:A组仅使用1.0％NaClO冲洗1 min,B、C、D组分别用0.5、1.0、2.0 W Er∶YAG激光照射1 min,同时联合使用1.0％NaClO冲洗,E组不做任何处理.标本脱钙包埋后切片,行H-E染色后采集图像进行观察,测量根管及管间峡区内剩余有机碎屑的含量,分别计算根管及管间峡区的清洁度.采用SPSS 13.0软件包对数据进行统计学分析.结果:A、B、C、D4组根管清洁度分别为95.24％、96.53％ 、97.63％和98.22％,管间峡区清洁度分别为16.50％、51.48％ 、52.56％和53.83％,B、C、D3组根管及管间峡区清洁度均优于A组,差异显著(P＜0.05).B、C、D3组间比较根管及管间峡区清洁度无显著差异(P＞0.05).结论:Er∶YAG激光和NaClO冲洗液联合应用可获得较理想的根管及管间峡区清理效果,有望成为一种新型、有效的根管及管间峡区清理技术.     

Er: YAG激光与Nd: YAG激光在种植体周围炎中的研究进展

种植体周围炎是导致种植修复失败的主要原因之一,其治疗方式多样,但各有其局限性。其中,激光治疗具有高效杀菌、止血止痛、微创等优势,是种植体周围炎的一种有效辅助治疗方法。不同波长激光作用原理不同,Er:YAG激光和Nd:YAG激光联合治疗种植体周围炎的临床效果显著,两者作用范围及作用深度互补,具有较好的应用前景。本文就Er:YAG激光和Nd:YAG激光在种植体周围炎中的研究进展及联合应用进行综述。     

Nd:YAG激光和Er:YAG激光对根管内粪肠球菌杀灭效果的研究

［摘要］ 目的 观察Nd:YAG激光、Er:YAG激光及两者联用对根管内粪肠球菌的杀灭效果。方法 选取离体牙建立粪肠球菌感染模型,随机分为五组：A组：生理盐水组;B组：1%次氯酸钠溶液组;C组：Nd:YAG激光组;D组：Er:YAG激光组;E组：Nd:YAG激光+Er:YAG激光组。通过细菌培养和扫描电镜观察对比各组的杀菌效果。结果 细菌培养和扫描电镜结果显示：A组杀菌率最低,B组杀菌率最高,E组次高。除C组和D组间杀菌率相近外（P>0.05）,各组间均有统计学差异（P<0.05）。结论 Nd:YAG激光和Er:YAG激光均有一定的根管杀菌效果,两者联用效果更佳,可作为传统消毒方法的补充。     

Er:YAG激光去除全瓷冠1例报告

<正>全瓷材料因其优异的美学性能、良好的生物相容性及机械性能成为口腔领域常用的修复材料。但在临床中,不完善的牙体治疗,修复体的破损、折裂,以及患者对修复体颜色、美观不满意等原因,常导致需要拆除全瓷修复体^[1-2]。传统钻磨去粘接法耗时耗力,在拆除过程中,往往会造成医源性的牙体组织再损伤,一方面破坏了牙体组织的结构,降低了牙体组织的抗力,减少了再粘接面积;另一方面造成全瓷修复体完全的破损,失去了再利用的可能性,最终可能会影响再治疗的效果^[2-4]。因此,全瓷修复体去粘接的问题亟待解决。     

Er: YAG激光在口腔医学中的应用

Er：YAG激光属于中红外线激光,是新一代水动力生物激光系统,拥有适合切除口腔软硬组织的特点,与传统治疗方法相比具有许多优点,可减轻治疗过程中的不适感和疼痛,患者更易接受。因铒激光在牙科治疗中的研究和应用的不断深入,本文对其工作原理及其在口腔治疗中的优势和应用进行综述。     

Er:YAG激光对树脂粘结牙釉质强度的影响

目的探讨Er:YAG激光处理釉质表面对树脂粘结牙釉质剪切强度的影响。方法选取40颗完整的人离体双尖牙,在颊面用金刚砂片切出略大于4mm×4mm的平面,分为4组,每组10颗牙。分别对牙釉质表面进行处理,A组:酸蚀(35%磷酸),B组:Er:YAG激光,C组:Er:YAG激光加酸蚀,D组:酸蚀加Er:YAG激光;每组8颗牙分别在处理后的牙釉质表面粘结光固化复合树脂,进行剪切强度测试,2颗牙扫描电镜观察。结果 C组的剪切强度值最高(16.0±4.2Mp),与其它组有显著性差异(P<0.05);D组的剪切强度值最低(7.1±2.9Mpa),与其它组有显著性差异(P<0.05);A组与B组的剪切强度值为11.3±5.7Mpa和10.3±4.6Mpa,二者相比差异无显著性(P>0.05)。扫描电镜观察A组:表面较平整,空洞、裂隙小而均匀;B组:表面凹凸不平,结构紊乱,有大小不一的坑洞及少量碎屑,未见熔融现象;C组:表面不平整,整体结构均匀,无明显碎屑及裂隙,秞柱排列整齐;D组:孔隙不均匀,部分区域较为平整,可见较长的裂隙及碎屑。结论 Er:YAG激光蚀刻可达到类似酸蚀的效果。Er:YAG激光照射后再酸蚀可明显提高剪切强度。     

Nd:YAP激光与Er:YAG激光在口腔医学的应用现状

自20世纪60年代激光首次用于口腔学科的几十年来,激光在临床得到越来越广泛的应用。目前,应用于口腔疾病的激光器有很多种,每种激光器各有其优缺点。本文比较了Nd：YAP激光与Er：YAG激光在口腔临床中的应用现状。     

Er:YAG激光在龋病诊治应用方面的研究进展

Er：YAG激光是一种新型的牙体硬组织切割激光,在龋病诊治中的应用正不断深入。本文就Er：YAG激光切割牙体硬组织的机制、牙髓反应,以及在龋病诊断、预防、治疗方面的应用作一综述。     

Er:YAG激光牙周治疗对根表面形态的影响

目的 了解Er:YAG激光牙周治疗对牙根面形态可能产生的影响.方法 用于牙周袋消毒(80mJ,10Hz)的Er:YAG激光照射离体牙根面,扫描电镜下观察对根面的影响并与激光脱敏(60 mJ,2 Hz)后的根面进行比较.结果 激光牙周袋消毒后根表面产生熔融,呈鳞片状覆盖根面;激光脱敏后根面表层被完全去除,露出整齐粗糙的牙本质.结论 激光牙周袋消毒后对根面有影响,但小于激光脱敏对根面的影响.     

Visualization of irrigant flow and cavitation induced by Er:YAG laser within a root canal model

Introduction

Laser-activated irrigation (LAI) has recently been introduced as an innovative method for root canal irrigation. However, there is limited information about the cleaning mechanism of an Er:YAG laser. In this study, we visualized the action of laser-induced bubbles and fluid flow in vitro to better understand the physical mechanisms underlying LAI.

Methods

An Er:YAG laser was equipped with a novel cone-shaped tip with a lateral emission rate of approximately 80%. Laser light was emitted at a pulse energy of 30, 50, or 70 mJ (output energy: 11, 18, or 26 mJ) and a repetition rate of 1 or 20 pulses per second, without air or water spray. Fluid flow dynamics in a root canal model were observed by using glass-bead tracers under a high-speed camera. Moreover, laser-induced bubble patterns were visualized in both free water and the root canal model.

Results

Tracers revealed high-speed motion of the fluid. A full cycle of expansion and implosion of vapor and secondary cavitation bubbles were clearly observed. In free water, the vapor bubble expanded for 220 microseconds, and its shape resembled that of an apple. In the root canal model, the vapor bubble expanded in a vertical direction along the canal wall, and bubble expansion continued for ≥700 microseconds. Furthermore, cavitation bubbles were created much more frequently in the canal model than in free water.

Conclusions

These results suggest that the cleaning mechanism of an Er:YAG laser within the root canal might depend on rapid fluid motion caused by expansion and implosion of laser-induced bubbles.     

Effect of Er:YAG laser treatment on the root canal walls of human teeth: an SEM study

Abstract— The purposes of the study were to observe the morphological changes on root canal walls after instrumentation and irrigation, and assess the efficacy of conventional cleansing procedures and the effectiveness of Er:YAG laser in removing debris and smear layer from the root canal walls. Thirty-six endodontically treated human mandibular incisor teeth with single root canals were bisected longitudinally and divided into three groups of 12 teeth. Group 1 (Gl) was left unlased as a control. The teeth of group 2 (G2) and group 3 (G3) were irradiated by Er:YAG laser (laser parameters were set at 1 W, 100 mJ/pulse and 10 Hz) for 3 s and 5 s. The teeth were prepared for scanning electron microscope study. Control specimens showed debris and heavy smear layer obscuring the dentinal tubules at all levels in the canals. The root canal walls irradiated by Er:YAG laser were free of debris, with an evaporated smear layer and open dentinal tubules. These results suggested that Er:YAG laser irradiation had an efficient cleaning effect on the prepared root canal walls.     

根管预备尺寸对Er:YAG激光消毒效果的影响

目的 比较Er:YAG激光在不同根管预备尺寸情况下的消毒效果。方法 368颗离体上颌单直根管前牙,随机分为8组,机用K3镍钛锉预备至以下尺寸: A1组和B1组（#25/0.06）、A2组和B2组（#30/0.06）、A3组和B3组（#35/0.06）、A4组和B4组（#40/0.06）。高压灭菌后,A组接种粪肠球菌,B组接种白念菌。每组冲洗方法均为Er:YAG激光+3% NaOCl,Er:YAG激光+17% EDTA,Er:YAG激光+生理盐水,然后收集各组处理后根管壁表面微生物样本,进行微生物培养和计数,采用GraphPad Prism 5.02软件包分析各组绝对残留菌落数及菌落相对残留率。结果 Er:YAG激光对粪肠球菌与白念菌的消毒效果在预备尺寸为#40/0.06最佳,#35/0.06次之。#40/0.06、#35/0.06的消毒效果与#30/0.06、#25/0.06相比,差异显著（P＜0.05）。结论 在#25/0.06～#40/0.06根管尺寸范围内,Er:YAG激光联合3% NaOCl、17% EDTA和生理盐水冲洗上颌前牙单直根管时,根管预备尺寸不应小于#30/0.06。     

Nd: YAG laser irradiation in root canal disinfection

Abstract The purpose of this study was to assess the efficacy of Nd:YAG laser irradiation in disinfecting the root canal system. Seventy-five teeth were uniformly instrumented and sterilized, and their root canals were infected for 60 min with an overnight culture of Enterococcus faecalis in Tryptic Soy Broth. The teeth were divided into 6 groups: 1 - non-infected controls; 2 - infected controls; 3 - infected, laser treated; 4 - infected, laser dummy (dye only); 5 - infected, laser dummy (dye and air-water spray); 6 - infected, NaOCl-treated (reference group). After treatment, the root canals were dried and dentinal shavings removed for a post-treatment culture. Quantitative analysis of bacteria surviving the various treatments were performed, and the bacterial counts for each group were compared. SEM analysis of teeth split longitudinally was used to illustrate the effect of treatment on the smear layer and on surface bacteria. Nd:YAG laser irradiation (group 3) significantly reduced the number of bacteria while NaOCl irrigation (group 6) effectively disinfected the canals.     

Effect of Er:YAG laser and EDTAC on the adhesiveness to dentine of different sealers containing calcium hydroxide

AIM: To evaluate the effect of 15% EDTAC solution and Er:YAG laser irradiation on the adhesiveness to dentine of root canal sealers containing calcium hydroxide. METHODOLOGY: The crowns of 60 maxillary human molars were ground until dentine was exposed. The teeth were divided into three groups of 20 teeth: group I, the dentine surface received no treatment; group II, 15% EDTAC solution was applied to the dentine; group III, the dentine received Er:YAG laser application (11 mm focal distance with perpendicular incidence to dentine surface; 4 Hz frequency; 200 mJ energy; 2.25 W potency; 62 J total energy; 1 min application time). Aluminium cylinders filled with the sealers, Sealer 26, Apexit, Sealapex and CRCS, were then applied to the treated surfaces. Adhesiveness was measured with a universal testing machine, with traction results given in MegaPascals (MPa). These results were submitted to anova tests. RESULTS: Statistical analysis showed significant differences (P < 0.01) amongst adhesiveness values of the sealers and treatments tested. Thus, sealers could be ranked in decreasing adhesiveness values: Sealer 26, CRCS, Apexit, Sealapex. Er:YAG laser irradiation and EDTAC solution application increased adhesiveness values only for Sealer 26 and Apexit. Laser irradiation was superior to EDTAC application only for Sealer 26 adhesiveness values. CONCLUSIONS: Er:YAG laser is as efficient as EDTAC solution in increasing adhesiveness of root canal sealers containing calcium hydroxide to human dentine.     

Er:YAG激光光子激活光声流技术对根管壁牙本质失水状况及牙根抗压强度的影响

目的探讨PIPS-Er:YAG激光技术(光子激活光声流)治疗后根管壁牙本质失水状况及对牙根抗压强度的影响。方法选取2018年7—9月南京市口腔医院口腔颌面外科门诊拔除的120颗健康正畸减数牙(单根牙)进行离体牙实验,按随机数字表法将其均分为A组(PIPS-Er:YAG激光冲洗组)、B组(注射器冲洗组)、C组(超声荡洗组)和D组(空白对照组,未治疗),比较治疗后各组根管壁牙本质失水状况和治疗前后牙根抗压强度的差异。结果 1) A~D组内各标本根管上、中、下段根管壁牙本质含水量依次递增,但差异无统计学意义(P>0.05);根管壁上段:A、C组低于B、D组(P<0.05),A组略低于C组(P>0.05),B组低于D组(P<0.05);根管壁中段:A组低于B~D组(P<0.05),A组略低于C组(P>0.05),B组低于D组(P<0.05);根管壁下段:A组低于B~D组(P<0.05)、A组略低于C组(P>0.05),B组低于D组(P<0.05)。2) A、B、C组与D组间的抗压强度差异无统计学意义(P>0.05)。结论使用Er:YAG激光PIPS技术能降低根管壁牙本质的含水量,且不会降低牙根的抗压强度,有良好的临床应用前景。     

Morphology, chemical structure and diffusion processes of root surface after Er:YAG and Nd:YAG laser irradiation

OBJECTIVES: The aim of this in vitro study was to evaluate the effects of Er:YAG and Nd:YAG lasers on morphology, chemical structure and diffusion processes of the root surface. MATERIAL AND METHODS: 60 root samples were irradiated for 1 min each either with 60 mJ/p, 80 mJ/p and 100 mJ/p using Er:YAG laser or with 0.5W, 1.0W and 1.5W using Nd:YAG laser. Scanning electron microscopy (SEM) was used to determine the morphology, infrared (IR) spectroscopy to assess the alterations in chemical structure and one dimensional electron paramagnetic resonance imaging (1-D EPRI) was used to estimate the diffusion coefficients in dental root samples. RESULTS: Er:YAG laser treatment resulted in deep crater formation with exposed dentin. Morphological alterations of root surface after Nd:YAG laser irradiation included cracks, crater formation, meltdown of the root mineral and resolidified porous globules formation. Er:YAG laser failed to alter the intensity of Amide peaks I, II or III. In contrast, treatment with Nd:YAG laser, using the highest power setting of 1.5W, reduced the intensity of Amide peak II and III in comparison to the control. The diffusion coefficients were increased significantly in all Er:YAG and Nd:YAG treated root samples. CONCLUSION: This study demonstrated that Er:YAG laser influences only on morphology and diffusion processes of root surfaces, while Nd:YAG laser also alters the chemical structure of root proteins.     

脉冲Nd:YAG激光在一次性根管充填术中的应用

研究脉冲Nd :YAG激光在一次性根管充填术中的临床应用。方法:选取临床上确诊为牙髓炎、牙髓坏死、慢性根尖周炎10 0例10 0颗患牙,用脉冲Nd :YAG激光辅助进行一次性根管充填治疗(实验组5 0个患牙)及常规治疗(对照组5 0个患牙) ,比较两种方法1周后的术后反应及1年后的远期疗效。结果:脉冲Nd :YAG激光辅助进行一次性根管充填治疗,术后1周反应较常规治疗方法轻,二者1年后的远期疗效差别不大。结论:脉冲Nd :YAG激光辅助进行根管一次性充填治疗,疗程短,复诊次数少,操作简单,效果好。     

Er：YAG激光切除牙根断面的扫描电镜观察

目的对Er：YAG激光切除的牙根断面进行扫描电镜研究,并通过对比超声金刚砂尖以及高速涡轮金刚砂车针切除牙根断面的不同表面状态,为Er：YAG激光应用于临床根尖切除术提供依据。方法将30颗上颌中切牙随机分为3组（Er：YAG激光切除组、超声金刚砂尖切除组、高速涡轮金刚砂车针切除组）,分别使用Er：YAG激光、超声金刚砂尖以及高速涡轮金刚砂车针在距离根尖3 mm处进行牙根切除。使用扫描电镜观察3组牙根断面残屑及玷污层、牙本质小管开放、裂隙以及器械切割痕迹情况。结果Er：YAG激光切除组和超声金刚砂尖切除组牙根断面有少量残屑、玷污层,并有牙本质小管开放;高速涡轮金刚砂车针切除组牙根断面有大量残屑及玷污层,没有牙本质小管开放。高速涡轮金刚砂车针切除组中能看到大量裂隙出现,超声金刚砂尖切除组中可见裂隙出现,而Er:YAG激光切除组中几乎没有裂隙出现。高速涡轮金刚砂车针切除组和超声金刚砂尖切除组牙根断面的表面粗糙并有明显切割痕迹,而Er：YAG激光切除组牙根表面没有切割痕迹,较为平滑。结论Er：YAG激光应用于根尖切除具有一定的优势,其牙根断面组织形态学方面的表现明显优于超声金刚砂尖和高速涡轮金刚砂车针。