Er：YAG激光对儿童窝沟封闭疗效影响的临床观察

目的：将Er：YAG激光应用于年轻恒牙窝沟封闭术,比较封闭剂的总保留率。方法：选择6～9岁、双侧下颌第一磨牙窝沟形态复杂的儿童60例为研究对象,随机分为A、B两组,采用自身半口对照方法：A组儿童对照侧实验牙应用金刚砂车针行釉质成形术,酸蚀,涂布窝沟封闭剂,实验侧实验牙应用Er：YAG激光行釉质成形术,涂布窝沟封闭剂;B组儿童对照侧实验牙处理同A组,实验牙应用Er：YAG激光行釉质成形术,酸蚀,涂布窝沟封闭剂。术后让受试儿童对治疗评分,定期随访,观察封闭剂保留情况。结果：63．3％的受试儿童愿意主动选择激光治疗。3、6个月复诊时,两组封闭剂的总保留率没有统计学差异（P＞0．05）;12、18个月复诊时,封闭剂材料总保留率：激光＋酸蚀剂组＞传统车针组＞激光组,差异有统计学意义（P＜0．05）。结论：激光是更容易被儿童接受的治疗方式,Er：YAG激光应用于恒牙釉质窝沟封闭时需要配合使用酸蚀剂,增强封闭剂固位。     

脉冲Er:YAG激光去龋、备洞临床技术要点

脉冲Er:YAG激光是一种应用于口腔硬组织的新型激光,在国外临床上已广泛使用,有关这方面的研究也较多,国内临床使用还不多见,脉冲Er:YAG激光的特点在于治疗过程中无痛、不刺激牙髓组织、不改变牙体组织结构特征等.DEKA Smart 2940D型Er:YAG激光机操作简单,能够去龋、制备各类窝洞,本文就脉冲Er:YAG激光在临床应用的技术特点作一总结.     

脉冲Er:YAG激光去龋、制洞的临床和扫描电镜观察

目的:临床观察脉冲Er:YAG激光去除龋损组织和术中患者的疼痛反应。扫描电镜脉冲Er:YAG激光去龋后洞壁表面的结构特征。方法:使用脉冲Er:YAG激光去除龋损组织、制洞,扫描电镜观察。结果:脉冲Er:YAG激光能够完全去除龋损组织,制洞,术中患者基本无疼痛反应。脉冲Er:YAG激光制洞后的牙体组织表面无玷污层、无微裂,牙本质小管口呈开放状态,洞壁表面粗糙。结论:脉冲Er:YAG激光可以去除龋损组织、制洞,洞壁结构利于黏接,患者术中无疼痛反应或轻度的酸痛感,无需局部注射麻醉。     

Er：YAG激光和Nd：YAG激光联合应用治疗口腔均质型白斑

目的：探讨Er：YAG激光和Nd：YAG激光联合应用治疗口腔均质型白斑的临床疗效。方法：应用Er：YAG激光和Nd：YAG激光联合治疗均质型白斑31例,根据病损面积、患者的疼痛状况调整激光参数。治疗间隔时间1个月。结果：本组31例白斑治愈14例,显效14例,有效3例,治愈率45．1％,有效率90．3％。结论：Er：YAG激光和Nd：YAG激光联合应用治疗口腔均质型白斑临床疗效好,不良反应小,是治疗口腔均质型白斑的有效方法之一。     

Er：YAG激光在龋病防治中的研究进展

龋病是影响人类口腔和全身健康的常见疾病,目前龋病的预防和治疗方法主要是应用氟化物及窝沟封闭和涡轮机机械去腐。铒钇铝石榴石(Er：YAG)激光是一种新型牙体硬组织激光,可以高效切割牙体硬组织,因其安全、无痛、微创而越来越受人们重视。本文就其在龋病预防和去腐备洞对牙髓的影响、微渗漏、粘接性等方面性能的研究进展作一综述。     

Er：YAG激光制备窝洞对树脂充填微渗漏的影响

目的应用离体牙比较复合树脂与Er：YAG激光及传统牙钻制备窝洞洞壁间微渗漏的差异。方法将30颗前磨牙随机分为3组,每组10颗牙,制备Ⅴ类洞：Ⅰ组牙钻预备加酸蚀处理;Ⅱ组单纯激光预备组、Ⅲ组激光预备加酸蚀处理组,经冷热循环染色后,在体视显微镜下记录微渗漏程度并应用非参数统计方法分析数据。结果各组内颈壁的染料渗透情况均比壁明显（P〈0.05）;在壁,单纯激光预备组产生的微渗漏最严重（P〈0.05）,激光预备加酸蚀处理组与牙钻预备加酸蚀处理组微渗漏无统计学差异;在颈壁,三组充填体边缘微渗漏情况无统计学差异。结论Er：YAG激光可代替牙钻备洞,结合酸蚀处理与充填体有良好的密合度。     

不同参数的Er：YAG激光离体牙窝洞预备的形态学观察

目的：观察Er：YAG激光对离体人牙进行窝洞预备后的形态学改变,比较不同的能量设置及不同的水气比作用下的预备效果。方法：将10个无龋的离体磨牙随机分为5组（n＝2）,分别用不同Er：YAG激光参数进行窝洞预备。扫描电镜下观察牙釉质和牙本质的形态学改变。结果：经Er：YAG激光照射后,牙釉质呈现出一个粗糙不平的表面,牙本质层清洁,小管开放。在总功率相近的情况下,当水冷却降到50％或切割牙釉质时脉冲能量增加到700 mJ、切割牙本质时脉冲能量增加到400 mJ时,牙釉质及牙本质表面可发生部分熔融改变。结论：Er：YAG激光使用合适的参数进行牙体硬组织的切割安全有效,但在功率相近的情况下,水冷却不足或能量过大（牙釉质＞700 mJ,牙本质＞400 mJ）可损伤牙体组织。     

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。     

Er：YAG激光在儿童口腔科中的应用

随着生产力的发展，科学技术不断进步，无痛和微创治疗技术已经成为现今医学领域追求的目标，几乎是兼备了以上两大要素的激光技术可谓是应运而生。自从二十世纪六十年代第一台激光机问世以来，激光的在医学领域的研究和应用就迅速发展起来。     

Cavity size difference after caries removal by a fluorescence-controlled Er:YAG laser and by conventional bur treatment

To determine the extensions of cavities prepared conventionally by bur or by a fluorescence-controlled Er:YAG laser. Sixty-five human teeth with dentine caries were bisected through the caries lesion and were treated by a fluorescence-controlled Er:YAG laser in a non-contact or a contact mode or by a rotary bur. The specimens were subjected to histological staining and a quantitative evaluation of cavity area (mm²) by computer-assisted alignment. Data were tested for statistical significant differences by the Wilcoxon test (p < 0.05). Twenty-three out of 29 cavities were smaller after caries removal with the non-contact laser compared to the bur. For a threshold level of seven, a cavity size difference of 1.63 (1.86) mm² was calculated compared to a cavity size difference of 5.35 (5.05) mm² after bur excavation. The differences were statistically significant (p = 0.029). No significant differences were observed between the cavity size differences after excavation with the non-contact or the contact laser handpiece. Residual bacteria within the cavity floor were found only in low numbers after all treatments. The present in vitro study indicates that caries removal by a fluorescence-controlled Er:YAG laser using a threshold level of seven resulted in less dentine loss than preparations by a bur.     

Fluorescence-controlled Er:YAG laser for caries removal in permanent teeth: a randomized clinical trial

The aim of this randomized clinical study was to compare the efficacy of a fluorescence-controlled erbium-loaded yttrium aluminum garnet (Er:YAG) laser with conventional bur treatment for caries therapy in adults. Twenty-six patients with 102 carious lesions were treated using either the Er:YAG laser, at threshold levels of 7, 8, 9, and 10 [U], or rotary burs. Both techniques were applied to each lesion at separate locations. After treatment, dentine samples were obtained using a carbide bur. The viable counts of Streptococcus mutans (SM) and lactobacilli (LB) [expressed as colony-forming units (log10 CFUs)], treatment time, pain, vibration, and sound intensity were determined. The median numbers of CFUs for SM and LB were not statistically different between laser and bur treatment at threshold levels 7 and 8 [U]. At threshold levels 9 and 10 [U], the median number of CFUs for LB [1.11 (range: 0.00–2.04)] were significantly higher following laser treatment than following bur treatment [0.30 (range: 0.00–0.60)]. The results indicate that treatment with a fluorescence-controlled Er:YAG laser at threshold levels of 7 and 8 removed caries to a level similar to that achieved using conventional bur treatment, with clinically irrelevant amounts of remaining bacteria. Although more time consuming, laser treatment provided higher patient comfort than bur treatment.     

Er：YAG激光在龋病治疗时消除疼痛疗效观察

目的：探讨Er:YAG激光在龋病治疗中的止痛效果。方法：使用Er:YAG激光治疗9例龋齿、观察临床效果及疼痛情况。结果：治疗过程中实验组患者疼痛得分平均为0．22且均未麻醉,而牙钻组疼痛得分平均为1．6,且2例进行麻醉。结论Er:YAG激光可以较好地解决龋齿治疗中的疼痛问题。     

Evaluation of selective caries removal in deciduous teeth by a fluorescence feedback-controlled Er:YAG laser in vivo

This study investigated the ability and efficacy of an Er:YAG laser with a fluorescence feedback system for caries removal in deciduous teeth. Seventy-nine carious lesions were excavated using a fluorescence-controlled Er:YAG laser. Endpoint of treatment was defined by emission of fluorescence from the dentine surface below the pre-selected threshold level of 7 units and the subsequent termination of Er:YAG laser radiation. Dentine samples were obtained from the cavity floor, and viable counts of both Streptococcus mutans and Lactobacilli, expressed as colony forming units (log CFU), were evaluated. Preparation time was recorded to assess efficacy of the treatment procedure. S. mutans and/or Lactobacilli were found in 25 out of 79 lesions. Regarding the counts for S. mutans and Lactobacilli, the median log CFU was 0 (min, 0; max, 5.5) and 0 (min, 0; max, 6), respectively, with 2.4% of all samples yielding more than 100 CFU S. mutans and 4.8% yielding more than 100 CFU Lactobacilli. In 8 out of 79 cases, laser excavated cavities were not judged being caries-free using the conventional tactile criterion for assessing caries tissue. Focussing on these teeth, the median log CFU was 0 (min, 0; max, 0.5) for S. mutans and 0 (min, 0; max, 1.6) for Lactobacilli. The mean time for treatment was 2.3 +/- 1.2 min. Of the children, 93.8% rated the laser treatment to be comfortable. The study indicates that the fluorescence feedback-controlled Er:YAG laser might be an appropriate device for caries removal in children using the suggested threshold level of 7 units.     

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激光与传统机械去腐制备洞形的体外可行性比较

目的　为Er：YAG激光去除龋损和粘接修复的可行性提供更多的证据。方法　选取南京医科大学附属口腔医院口腔颌面外科门诊拔除的36颗龋坏深及牙本质的磨牙。每个离体牙的龋损都被切成大小相等的两份,分别纳入对照组(机械预备组)和实验组(Er：YAG激光组)。通过测量微拉伸粘接强度(mTBS)、微渗漏深度、观察组织学形貌、微观形态和测量操作时间比较了Er：YAG激光与传统机械法在这些方面的特性。结果　实验组的微拉伸粘接强度高于对照组(n=13,P<0.05),而平均微渗漏深度低于对照组,但差异无统计学意义(n=13,P>0.05)。实验组残留感染牙本质小管少于对照组(n=6,P<0.01)。扫描电镜观察显示,实验组牙本质小管开放、清晰、裸露,而经机械预备的牙本质表面有玷污层(n=4)。实验组的去龋时间明显长于对照组(n=36,P<0.05)。结论　虽然去龋时间较长,但Er：YAG激光用于窝洞预备较传统机械法有更高的微拉伸粘接强度和更少的感染牙本质小管残留。因此,Er：YAG激光是一种合适的临床去龋方法。     

Er:YAG激光去除Zenostar T全瓷冠的能量评估方法研究

目的 评估Er:YAG激光作用于不同厚度Zenostar T全瓷修复样品后的温度变化情况,探讨激光能量、材料厚度和温度变化之间的相关性,为临床使用Er:YAG激光去除Zenostar T全瓷冠提供初步的依据与指导.方法 选择Zenostar T全瓷修复材料,制成长和宽均为10 mm,厚度分别为1.0 mm、1.5 mm...     

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。